| Unit 9 Rest, Sleep and Activity Chapter 1 Rest Meaning of Rest The ill and injured need rest. Rest, however, is not merely inactivity, and distraught patients may find rest difficult. Rest implies calmness, relaxation without emotional stress, and freedom from anxiety. Chapter 2 Sleep Sleep, a basic physiologic need, is defined as a state of unconsciousness from which a person can be aroused by appropriate sensory or other stimuli. Biorhythms Biorhythmology, the study of the biologic rhythms of the body, is receiving increasing attention from biologists and health professionals. Rhythmic biologic clocks (biorhythms) exist in plants, animals, and humans. Kinds of Sleep Electroencephalograms (EEGs) provide a good picture of what occurs during sleep. Electrodes are placed on various parts of the sleeper’s scalp. There are two kinds of sleep: REM (rapid eye movement) sleep and NREM (non-REM) sleep. REM sleep REM sleep is not a passive, but a relatively active state; so REM sleep is also referred to as paradoxical sleep (PS) or fast wave sleep (FWS). Its characteristics include: ● Vivid (colorful and busy) dreaming ● Variable blood pressure ● Irregular muscle movements, e.g., muscle twitches ● Frequent bursts of rapid eye movement ● Release of steroids in small bursts NREM sleep is also referred to as deep, restful sleep or slow wave sleep (SWS) because the brain waves of a sleeper during NREM sleep are slower than the alpha and beta waves of a person who is awake or alert. Characteristics of NREM sleep include: ● Dreamlessness ● Decreased blood pressure ● Decreased respiratory rate ● Slow and rolling eye movements NREM sleep has four distinct stages, each of which is characterized by distinct bwww.med126.com/jianyan/rain wave patterns. Stage I Stage I is a transition stage, lasting about 5 minutes, during which the person drifts off from wakefulness to sleep. The person feels drowsy and relaxed. The eyes roll slightly from side to side, and the heart and respiratory rates drop slightly. Stage II During stage II, there is light sleep, and body processes continue to slow down. The eyes are generally still, heart and respiratory rates decrease slightly, and body temperature and metabolic rate fall. Stage III During stage III, the heart and respiratory rates as well as other body processes slow further, due to domination of the parasympathetic nervous system. Stage IV Stage IV signals deep sleep, during which delta waves predominate and become even slower. Sleepers’ heart and respiratory rates drop 20% to 30% below those they exhibit during waking hours. The sleeper is very relaxed, rarely moves, and is difficult to arouse. Sleep Cycle Sleep is cyclic. The usual sleeper experiences four to six cycles of sleep during 7 to 8 hours. Each cycle lasts about 90 minutes. The ratio of NREM to REM sleep varies with age (see the section on developmental changes below) and with other factors. Psychological stress creates a need for more REM sleep. As a result, the person awakens with the feeling that sleep was not restful and that he or she dreamt more than usual. Chapter 3 The Nursing for Rest and Sleep Assessing the Needs for Rest and Sleep The nurse assesses (a) sleep habits, (b) clinical signs and symptoms of the need for sleep, (c) developmental changes, and (d) factors influencing rest and sleep. Sleep habits When assessing an individual’s sleeping habits, the nurse must consider: ● Patient’s usual amount of sleep ● Patient’s usual practices prior to sleeping, such as reading ● Patient’s usual hours for sleeping ● Time it takes the patient to fall asleep ● Number of times the patient awakens during sleep and the reasons Developmental changes The amount of sleep individuals requires decreases not only with age but also with the decr卫生资格考试网easing growth rate. Sleep Disorders The two most common sleep disorders are insomnia in adults and parasomnias in children. Less usual sleep disorders are hypersomnia, narcolepsy, sleep apnea, and sudden infant death syndrome. Insomnia Insomnia is the inability to obtain sufficient quality or quantity of sleep. It is not the total lack of sleep, in fact, people with insomnia often obtain more sleep than they realize. Hypersomnia The opposite of insomnia, hypersomnia, is excessive sleep of more than 9 hours at night. The afflicted person often sleeps until noon and takes many naps during the day. Interventions to Promote Rest and Sleep ● Help the patient relax before sleep. The nurse helps the patient relax, for instance, by providing diversions, pain relief, a clean, comfortable bed, and an odor-free room. ● Help the patient maintain usual sleep routines. ● Eliminate unnecessary noise, such as loud laughter, while patients are asleep. ● Provide an environment in which patients feel safe and are assured that help is nearby even when they sleep. | 
