Purposes of Sleep

1. Cellular growth

2. Repair of damaged tissues

3. Review and process days event

Kinds of Sleep

(REM sleep)

rapid eye movement

* Mental/emotional equilbrium

* active sleep

*vital signs elevated/irregular (gastric secretions increase)

*vivid dreams

*process day events

*profound muscle relxation, twitching

*Consume more o2 & apnea during this stage

Kinds of Sleep

(NRem sleep)

non rapid eye movement

* Restores body physically

*lowers B/P

*lowers pulse

*lowers respiration

*lower metabolism

NREM Stages

I. Drifitng off to sleep, very light sleep, easily awakened

(involuntary muscle jerks)

II. Light sleep, body processes begin to slow (lowers V.S)

III. P and R continue slow, more difficult to arouse

IV. Deep sleep-P and R drop 20-30% below waking rates.  Very relaxed, rarely moves. Diffficult to arouse. Thought to physically restore body. Delta sleep/slow rate sleep

Sleep Cycle

I, II, II, IV, III, II, REM,II,III,IV,etc

Typical last 90-100 minutes

4-6 cycles ppl go through.

example: NREM I-->NREM II-->NREM III-->NREM IV-->2nd NREM III-->2nd NREM II-->REM-->3rd NREM II-->wakefullness

Influences on Sleep Pattern

(sleep habits)

Circadian Rhythmn-->Internal biologic clock; sleep is optimum when synchron with yoru clock.  Some ppl can reset their biological clock.

Desynchronized sleep-->poor sleep pattern is frequently changed.  Awakenings more likely.  Desynchronize sleep

Environment

In the hospital, there is more desynchronize sleep.  Because of the different noise

problems in hospital: frequent urination, loneliness

Age

Newborn-->sleep alot (16 hours) infant-->(10hrs)

Preschool-->(9-16hrs)

School age-->8-10 hours

adolescent-->7-9 hours

older adult-->6-7 hours

Illness

Medications

Given as therapy.  If have to take steroids.  Timing of medications.  B/P is more variable.

For sleep, sedation decrease REM sleep

Anxiety

Interfer with sleep. psychological needs also

Alcohol

Smal amount induce sleep. Large amount interferes with Delta & REM sleep

Exercise

Nutrition

Caffeine

Naps

Too much daytime napping, interfer with sleep at night

Morning nap is more restorative

Smoking

Sleep Deprivation

(short term)

* fatigue

irritability

apathy

dark circles around eye

inattention/inability to concentrate

headache

Sleep Deprivation

(long term)

* Behaviour & personality change

*distorted perception

*Hallucinations

*disorientation of time, place

Decrease coordination

slurred speech

Influence of hospitalization and illness on sleep pattern

Desynchronized sleep

Poor quality, may exhibit some signs of short term deprivation

Sleep Deprivation

Sleep Fragmentation

Continually interrupt sleep cycle

Physiological effects of sleep fragmentation and rebound REM

- increased myocardial irritabilty

-Ventricular fibrillation

-depressed pulmonary function

-increased intracranial pressure

-increased sleep apnea