Rest and Sleep PDF

Ch. 55 Rest and Sleep ❖ Rest is a relaxed state where a person is aware however the heart rate and activity are decreased. Sleep is rest with altered consciousness and relative activity. ❖ A person will start showing confusion and lack of good judgment after 72 hours without sleep. ❖ Circadian...

Ch. 55 Rest and Sleep ❖ Rest is a relaxed state where a person is aware however the heart rate and activity are decreased. Sleep is rest with altered consciousness and relative activity. ❖ A person will start showing confusion and lack of good judgment after 72 hours without sleep. ❖ Circadian rhythm is a natural clock our bodies adjust to on a 24-hour rotation. People who are blind have issues with their circadian rhythm as they cannot see light and dark. ❖ Sleep occurs in stages o Nrem – more and more relaxed, makes up 75-80% of sleep ▪ Stage 1-between rest and sleep, easily awakened ▪ Stage 2- asleep but easily aroused ▪ Stage 3 – being aroused is more difficult ▪ Stage 4 – deeper sleep, muscles relax, metabolism slowed o REM – eyes dart, dreams and nightmares occur, which causes adrenaline to increase and vitals then increase. Makes up 20-25% of sleep. o Stage 1 Stage 2 Stage 3 Stage 4 Stage 3 Stage 2 REM Stage 2 Stage 3 Stage 4 Stage 3 Stage 2 REM… ❖ After not sleeping well for a few nights, the body will make you catch up on sleep which is termed REM rebound. After the sleep/wake cycle will normalize. ❖ Factors that affect sleep include diet, stress, smoking and drinking, medications, development factors, age, exercise, or circadian rhythm being off. ❖ Different ages should get different amounts of sleep o Newborns/infants should sleep 18-19 hours per night and sleep on back with nothing in the crib and no co-sleeping. At 8-16 weeks, they should start sleeping through the night, need to get a routine and sick with it. o Toddlers need to sleep 11-14 hours per day and include 1-2 naps. Age 5 and older should not need naps. o School age children need 9-12 hours of sleep, tis is when stress starts to affect sleep. o Teens need 8-10 hours per night o Adults need 7-9 hours per night and there are tons of effectors ❖ Sleep Disorders  o Insomnia occurs when someone has difficulty falling asleep, staying asleep, maintaining sleep and it can be intermittent insomnia. o OSA or obstructive sleep apnea is when the throat relaxes an the the airway is blocked. Males, obesisty, and those with thick neck circum. are at a higher risk. Apnea means no breathing, which means oxygen decreases and carbon dioxide increases. When the CO2 builds up, the body tells the brain, it wakes the body up so it can breathe. This is the snoring, gasping for air and startling awake state. The body goes into a flight or fight response and BP increases, usually causing a headache in the morning. It is a sleep study that is done to diagnose where electrodes and O2 sensors monitor the body. ▪ Cpap or bipap – cpap is an older version and not normally prescribed anymore Pap-positive air pressure C- continuous Bi- Bi-level o Pediatric OSA- same as adults, however the cause is normally due to tonsils and adenoids and the reoccurring symptoms are more behavioral issues from the child. o Narcolepsy is daytime sleepiness regardless of how much sleep was gotten the night before and regardless of the actions being done, they can be driving, walking, working, etc. Modafinil (Provigil) are the medication given to keep people with narcolepsy awake. This is one disorder that cannot be cured, only symptoms can be treated. o Restless leg syndrome or RLS is when legs do not relax, are jerky, or cant get comfortable. Some medications can cause it, Ropinirole is a normal treatment o Parasomnia - o Somnambulism- sleep walking – will do natural things to them like dressing, eating, etc, with no memory of it and are oblivious to others when it occurs. They should not be woken up. o Sleep Terrors – intense feeling of fear and trauma, screaming, terrified, however still asleep and no idea it is happening. Do not wake, just hold to comfort them and let it pass. o Sleep enuresis- bed wetting. Happens more with boys than girls and can happen more after traumatic experiences. ❖ Sleep hygiene include all the things that a person can do to help sleep happen such as a night routine, eye mask, no phones or tv, moderate or minimal exercise, lights off, white noise, decreased room temperature, protein or low carb snack, and staying away from smoking or caffeine.