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Nursing- sleep

NREM(non-rapid-eye-movement) about 75-80# of sleep at night Four stages
Loss of NREM sleep causes immunosuppression, slow tissue repair, low pain tolerance,profound fatigue, and increases susceptibility to infection
REM sleep occurs about every 90 min last from 5- 30 min
Arterial changes during NREM sleep arterial BP falls, pulse decreases, peripheral blood vessels dilate, cardiac output decreases, metabolic rate decreases, growth hormone peak levels, intracranial pressure decreases
Loss of REM sleep causes physiological disturbances such as apathy, depression, irritability, confusion, disorientation, hallucination, impaired memory, insomnia
amount of sleep for newborns 16-18 hrs on irregular schedule with pds of 1-3 hrs awake. REM sleep immediately
amount of sleep for infants 14-15 hrs per day. 5 hours a night with two naps per day
amount of sleep for toddlers between 12-14 hours in ages 1-3
amount of sleep for preschooler (3-5 yrs old) 11-13 hrs
amount of sleep for school age (5-12 yrs old) 10-11 hrs a night
Nurses should educate parents on what for infants and newborns? self soothing techniques. Put them to bed when drowsy not asleep
Educate parents of toddlers If they have enough attention from them during the day maintain a good sleep schedule will be healthy for everyone. Soothing objects
Educate parents of preschoolers Maintain regular sleep schedule/ routine. Limit or eliminate TV at night to reduce nightmares.
Educate parents and school age children Promote healthy sleep habits
amount of sleep for adolescents (12-18 yrs old) 9-10 hrs
educate parents of teens Dangers and symptoms of sleep deprivation.
Nocturnal emissions wet dreams in boys. educate them that this is normal
risk if not getting enough sleep hypertension, depression, heart attack, stroke, car crashes
what stage does alcohol disrupt in sleep REM
L- tryptophan turkey, warm milk
Insomnia unrefreshed, daytime sleepiness, difficulty concentrating
risk with hypnotic sleep aids may lead to dependency, do not address problem
Antihistamines dizziness, sedation, hypotension Not to be used w/ asthma or glaucoma
sleep apnea more than 5 pds/hour or five pauses lasting longer than 10 sec/h
obstructive sleep apnea structural defect
central sleep apnea brain injury
mixed sleep apnea combination of structure and neuro
hypersomnia sleep all night but cant stay awake during day CNS damage, kidney, liver, metabolic, thyroid
narcolepsy onset age 15-30 adorall/amphetamines
bruxism stage ii non rem, teeth grinding
periodic limb movement (PLMD) legs jerk twice or three times/min during sleep
somnabulism sleep walking occurs during 3 and 4 of non rem
valerian mild insomnia/ RLS
chamomile mild sedative, some herbs harmful to liver
sedative-hypnotic med CNS depression Ambien- less rebound
antianxiety meds decrease arousal - not in pregnant woman
Noctec (chloral hydrate) 7-10 hrs
Lunesta (eszopiclone) 6 hrs
Dalmane (flurazopam) 47-100 hrs
lorazapam (Ativan) 10-20 hrs
melatonin 1 hr
temezepam (restoril) 9-15 hrs
triazolam (halcion) 1.5-5.5 hrs
zaleplon(sonata) 1 hour
zolpidem (ambien) 2.6 hrs rapid onset tolerance, withdrawl. dependence not demonstrated - give just prior to bed - contraindicated with alcohol - do not combine with other dugs that depress CNS
mondafinil(Provigil) narcolepsy and excessive daytime sleepiness half life 15hrs - does not interfere with sleep at night
Created by: bns5192