Chapter 18 Comfort, Rest, and Sleep

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Chapter 18

Comfort, Rest, and Sleep

• Comfort facilitates rest and sleep

• Safe, clean, and attractive environment contributes to comfort

Question

•Is the following statement true or false?

Client rooms resemble bedrooms that are bare, white, and have sterile environments.

Answer

False.

Client rooms are now bright, colorful, and tastefully decorated.

The Client Environment • Environment: nursing care room, furnishings• Client rooms

– Wall: relaxing color schemes, wallpapers– Floor: carpeted or linoleum surface– Lighting: adequate lighting, adjustable intensity– Climate control: temperature, humidity, ventilation

The Client Environment (cont’d)

• Room furnishings– Bed

o Mattresso Pillowso Linen

– Privacy curtain

The Client Environment (cont’d)

• Room furnishings (cont’d)– Overbed table– Bedside stand– Chairs

Sleep and Rest

• Functions of sleep

– Promotes emotional well-being

– Enhances various physiologic processes

– Reduces fatigue

Sleep and Rest (cont’d)

• Functions of sleep (cont’d)

– Stabilizes mood

– Improves blood flow to brain

– Improves immune system

– Improves capacity for learning and memory storage

• Sleep phases– Nonrapid eye movement (NREM)

o Quiet sleep– Rapid eye movement (REM)

o Active or deepest stage of sleep

Characteristic Electroencephalogram Wave Form

• Sleep cycles

– Alternate through NREM and REM phases

• Sleep requirements

– Vary among different age groups

• Factors affecting sleep

– Old age

– Light

– Activity

– Environment

– Motivation

REM and NREM Sleep in Younger Adults and Older Adults

• Factors affecting sleep (cont’d)– Emotions and moods– Food and beverages– Illness– Drugs

o Sedatives and tranquilizerso Hypnotics and stimulants

Question

Alcohol is a depressive drug that promotes healthy sleep.

Answer

False.

Alcohol is a depressive drug that promotes sleep, but it tends to reduce normal REM and deep sleep stages of NREM sleep.

Sleep Assessment

• Sleep questionnaires

• Sleep diary

• Nocturnal polysomnography

• Multiple sleep latency test

Sleep Disorders

• Insomnia• Hypersomnia

– Narcolepsyo Sleep paralysis and cataplexyo Hypnogogic hallucinations

– Sleep apnea/hypopnea syndrome

Question

Apneic episodes can be reduced by sleeping in other than the supine position, losing weight, and avoiding substances that depress respirations such as alcohol or sleeping medications.

Answer

Apneic episodes can be reduced by sleeping in other than the supine position, losing weight, and avoiding substances that depress respirations such as alcohol or sleeping medications.

Sleep Disorders (cont’d)

• Sleep-wake cycle disturbances

– Shift work

– Jet travel

– Seasonal affective disorder

• Parasomnias

Nursing Implications

• Identify nursing diagnoses – Develop plan of care

• Sleep-promoting nursing measures– Maintaining sleep rituals– Reducing intake of stimulating chemicals– Promoting daytime exercise

Nursing Implications (cont’d)

• Sleep-promoting nursing measures (cont’d)– Adhering to regular schedule for retiring and

waking– Progressive relaxation– Back massage

o Various techniques and purposes

General Gerontologic Considerations

• More comfortable with own bed furnishings

• Prefer warmer room temperatures

• Insomnia and hypersomnia are frequent manifestations of depression

• Sundown and sunrise syndrome

• Relaxation techniques before bedtime

General Gerontologic Considerations (cont’d)

• Hypnotic medications not recommended for use longer than 2 weeks

• Difficulty falling asleep • Institutional schedules may interfere with established

pattern of sleep; modifications may be necessary• Important to identify potential sources of sleep

disorders

General Gerontologic Considerations (cont’d)

• Cognitive impairments may result in sundown or sunrise syndromes

• Chronic conditions may interfere with sleep:– Pain– Difficulty breathing– Frequent urination

• Short naps or rest periods can restore energy without interfering with nighttime sleep

Chapter 18 Comfort, Rest, and Sleep

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