Professional Documents
Culture Documents
REST
By:
Mr. M. Shivanandha Reddy
Definition
• Rest is a condition in which the body is in a
decreased state of activity without physical
emotional stress and freedom from anxiety.
DISORDERS DUE
TO OTHER
DYSOMNIAS PARASOMNIAS
MEDICAL
CONDITIONS
DYSOMNIAS
• The sleep itself is pretty normal.
• But the client sleeps too little, too much, or at
the wrong time.
• So, the problem is with the amount (quantity),
or with its timing, and sometimes with the
quality of sleep.
DYSOMNIAS
• Common Dysomnias are:
• Insomnia
• Hypersomnia
• Narcolepsy
• Sleep Apnea
• Insufficient Sleep/ Sleep Deprivation
Insomnia
• Insomnia is described as the inability to fall
asleep or remain asleep.
• Persons with insomnia awaken not feeling
rested.
• Insomnia is the most common sleep
complaint.
• Acute insomnia lasts one to several nights and
is often caused by personal stressors or worry.
• If the insomnia persists for longer than a
month, it is considered Chronic insomnia
……..Insomnia
• Insomnia can result from physicl discomfort
and more often from mental tension or
anxiety.
• People who are habituated to drugs or who
takes large amounts of alcohol are at high risk
for insomnia.
Insomnia
Clinical manifestations:
■ Difficulty falling asleep
■ Waking up frequently during the night
■ Difficulty returning to sleep
■ Waking up too early in the morning
■ Unrefreshing sleep
■ Daytime sleepiness
■ Difficulty concentrating
■ Irritability
Insomnia
• Treatment is development of new behavioral
patterns that induces sleep
• Create a sleeping environment that induces
sleep
• Create positive sleep thoughts
Hypersomnia
• Hypersomnia refers to conditions where the
affected individual obtains sufficient sleep at
night but still cannot stay awake during the
day.
• Hypersomnia can be caused by medical
conditions, for example, CNS damage and
certain kidney, liver, or metabolic disorders,
such as diabetic acidosis and hypothyroidism.
Hypersomnia
• Treatment of hypersomnias include treating
the underlying disease conditions
Narcolepsy
• Narcolepsy is a disorder of excessive daytime
sleepiness caused by the lack of the chemical
hypocretin in the area of the CNS that
regulates sleep.
• Clients with narcolepsy have sleep attacks or
excessive daytime sleepiness, and their sleep
at night usually begins with a sleep-onset REM
period (dreaming sleep occurs within the first
15 minutes of falling asleep).
Narcolepsy
• People sleeps several times a day even when
they are conversing with people or while
driving.
• CNS stimulants and Antidepressants are the
drugs used to treat narcolepsy.
Sleep Apnea
• Sleep Apnea is characterized by frequent short
breathing pauses during sleep.
• Although all individuals have occasional
periods of apnea during sleep, more than five
apneic episodes longer than 10 seconds in an
hour is considered abnormal and should be
evaluated by a sleep medicine specialist.
…….Sleep Apnea
• Sleep Apnea is most frequently diagnosed in
men and postmenopausal women, it may
occur during childhood.
• Three types of apnoea based on the cause
• 1. Obstructive Apnoea
• 2. Central Apnea
• 3. Mixed Apnea
…….Sleep Apnea
• 1. OBSTRUCTIVE APNOEA:
• Obstructive apnea occurs when the structures of
the pharynx or oral cavity block the flow of air.
• Enlarged tonsils and adenoids, a deviated nasal
septum, nasal polyps, and obesity predispose the
client to obstructive apnea
• Treatment includes surgical removal of tonsills,
correcting nasal septum, weight loss may be
helpful.
…….Sleep Apnea
• 2. CENTRAL APNEA:
• Due to defect in the respiratory centre of the
brain.
• Clients who have brainstem injuries and often
have central sleep apnea.
• 3.MIXED APNOEA
• Mixed apnoea is combination of obstructive
and central apnea
Insufficient Sleep/ Sleep Deprivation
• A prolonged disturbance in quality and
quantity of sleep can lead to a syndrome
called as sleep deprivation.
• It is not a sleep disorder but result of
prolonged sleep disturbance.
• It produces various physiological and
behavioural symptoms based on the severity
of deprivation.
Insufficient Sleep/ Sleep Deprivation
Individuals may develop:
• Attention and concentration deficits
• Reduced vigilance
• Distractibility
• Reduced motivation
• Fatigue
• Diplopia and dry mouth.
PARASOMNIAS
• Something abnormal occurs during sleep itself, or
during the times when the client is falling asleep
or waking up
• The quality, quantity, and timing of the sleep are
essentially normal.
Most common DISORDERS are:
• Bruxism
• Enuresis
• Periodic limb movement disorder
• Sleep talking
• Sleep walking
…….PARASOMNIAS
■ Bruxism. Usually occurring during stage II
NREM sleep, characterized by clenching and
grinding of the teeth.
• This clenching and grinding of the teeth can
eventually erode dental crowns, cause teeth
to come loose, and lead to deterioration of
the temporomandibular (TMJ) joint, called
TMJ syndrome
…….PARASOMNIAS
■ Enuresis. Bed-wetting during sleep occuring
in children over 3 years old.
• More males than females are affected.
• It often occurs 1 to 2 hours after falling asleep.
…….PARASOMNIAS
• Periodic limb movement disorder (PLMD).
In this condition, the legs jerk twice or three
times per minute during sleep.
• It is most common among older adults.
• Respond well to medications such as
levodopa, pramipexole , ropinirole, and
gabapentin
…….PARASOMNIAS
• Sleeptalking. Talking during sleep occurs
during NREM sleep before REM sleep.
• It rarely presents a problem to the person
unless it becomes troublesome to others
…….PARASOMNIAS
• Sleepwalking. Sleepwalking (somnambulism)
occurs during stages III and IV of NREM sleep.
It is episodic and usually occurs 1 to 2 hours
after falling asleep.
• Sleepwalkers tend not to notice dangers (e.g.,
stairs) and often need to be protected from
injury
Disorders due to other medical
conditions
• These disorders are associated with Medical
or Psychiatric or other illness
• Usually the disorders that cause sleep
disturbance includes:
• Depression
• Alcolism
• Thyroid dysfunction
• Peptic ulcer
• COPD- chronic obstructive pulmonary disease
Nursing Interventions To Promote
Sleep
• 1. Sleep-Wake Pattern
• Maintain a regular bedtime and wake-up
schedule
• Eliminate day time naps. If naps are taken,
limit to 20 minutes or less twice a day
• Instruct the client to go to bed when sleepy.
• Use warm bath and relaxation techniques
• If unable to sleep in 15 to 30 minutes, get out
of bed and persue some relaxation activity.
…..Nursing Interventions To Promote
Sleep
• Establish a regular, relaxing bedtime routine
before sleep such as reading, listening to soft
music, taking a warm bath, or doing some
other quiet activity.
• Avoid dealing with office work or family
problems before bedtime
• Get adequate exercise during the day to
reduce stress, but avoid excessive physical
exertion at least 3 hours before bedtime.
…….Nursing Interventions To Promote
Sleep
• 2. Environment:
• Create a sleep-conducive environment that is
dark, quiet, comfortable, and cool.
• Keep noise to a minimum; block out
extraneous noise as necessary with white
noise from a fan, air conditioner.
• Sleep on a comfortable mattress and pillows.
• Listen to relaxing music
• Increase exposure to bright light during the
day
……..Nursing Interventions To Promote
Sleep
• 3. Diet:
• Limit alcohol, caffeine, and nicotine in late
afternoon and evening
• Consume carbohydrates or milk as a light snack
before bedtime.
• Avoid heavy and spicy foods. Heavy or spicy foods
can cause gastrointestinal upsets that disturb
sleep
• Decrease fluids 2 to 4 hours before sleep
……Nursing Interventions To Promote
Sleep
• 4.Medications:
• Use sleeping medications only as a last resort
• Minimize the usage of medicines as much as
possible because many contain antihistamines
that cause daytime drowsiness.
• Take analgesics 30 mins before bedtime to
relieve aches and pains.
• Consult the health care provider about
adjusting other medications that may cause
insomnia.