Chapter 34 - Sleep Part 2
How many hours of sleep per day on average is standard for teenagers?
- 8 to 10 hours per day
How many hours of sleep per day on average is standard for school aged children, aged 6 to 13?
- 9 to 11 hours per day
What are some characteristics of a school-aged child's sleep pattern?
- Younger school-aged children may require 10 to 12 hours nightly, whereas older children in this stage may average 9 to 11 hours. - Sleep needs usually increase when physical growth peaks.
What can compromise patient safety?
- fatigue and sleepiness of nurses, doctors, etc. - increases the risk of medical errors
What is chronic fatigue often a symptom of?
- illness
What are the objectives relative to sleep health identified in Healthy People 2020?
- increasing the proportion of adults who get sufficient sleep - increasing the proportion of students in grades 9 through 12 who get sufficient sleep - expanding the proportion of people with obstructive sleep apnea (OSA) who seek medical evaluation - reducing the rate of vehicular crashes related to drowsy driving
What role does ghrelin perform?
- it promotes the continuation of eating
What role does leptin perform?
- it signals the brain to stop eating
What are the nursing implications relative to teenagers and sleep?
- Advise parents that their adolescents' complaints of fatigue or inability to do well in school may be related to not enough sleep. Excessive daytime sleepiness (EDS) may also make the teenager more vulnerable to accidents and behavioral problems.
What hormones contribute to the sleep-weight link?
- leptin and ghrelin - research suggests that sleep deprivation lowers leptin levels and elevates ghrelin levels, thus increasing one's appetite
What are some characteristics of an older adults sleep pattern?
- An average of 7 to 8 hours of sleep is usually adequate for this age group. - Sleep is less sound, and stage IV sleep is absent or considerably decreased. Periods of REM sleep shorten. - Older adults frequently have great difficulty falling asleep and have more complaints of problems sleeping. - Decline in physical health, psychological factors, effects of drug therapy (e.g., nocturia), or environmental factors may be implicated as causes of inability to sleep.
How many hours of sleep per day on average is standard for preschoolers?
- 11 to 13 hours per day
How many hours of sleep per day on average is standard for toddlers?
- 11 to 14 hours per day
How many hours of sleep per day on average is standard for infants?
- 12 to 15 hours per day
How many of sleep per night is considered standard for older adults?
- 7 to 8 hours per night
How many hours of sleep per night is considered standard for adults?
- 8 hours despite obvious variations seen in the general population - standard range is 7 to 9 hours per day
What are some nursing implications relative to older adults and sleep?
- A comprehensive nursing assessment and individualized interventions may be effective in the long-term care of this age group. - Emphasize concern for a safe environment because it is not uncommon for older adults to be temporarily confused and disoriented when they first awake. - Use sedatives with extreme caution because of declining physiologic function and concerns about polypharmacy. - Encourage older adults to discuss sleep concerns with their health care provider.
What does the Joint Commission encourage health care facilities to do regarding the reduction of fatigue-related risks?
- Assess work schedules and staffing to address extended work shifts and hours. - Review hand-off processes and procedures to ensure safe transfer of information. - Request staff input in designing work schedules to minimize staff fatigue. - Develop and implement a fatigue management plan. - Educate staff about sleep hygiene and the effects of fatigue on patient safety. - Address staff concerns about fatigue. - Encourage teamwork to support staff who work extended shifts. - Keep the effects of fatigue in mind when reviewing adverse events.
What are some characteristics of a preschoolers sleep pattern?
- Children in this stage generally sleep 11 to 13 hours at night. - The REM sleep pattern is similar to that of an adult. - Daytime napping decreases during this period, and by the age of 5 years, most children no longer nap. - This age group may continue to resist going to bed at night.
What are the nursing implications relative to school-aged children and sleep?
- Discuss the fact that the stress of beginning school may interrupt normal sleep patterns. - Advise that a relaxed bedtime routine is most helpful at this stage. - Inform parents about the child's awareness of the concept of death possibly occurring at this stage. Encourage parental presence and support to help alleviate some of the child's concerns.
What are some nursing implications relative to middle-aged adults and sleep?
- Encourage adults to investigate consistent sleep difficulties to exclude pathology or anxiety and depression as causes. - Encourage adults to avoid use of sleep-inducing medication on a regular basis.
What are the nursing implications relative to preschoolers and sleep?
- Encourage parents to continue bedtime routines. - Advise parents that waking from nightmares or night terrors (awakening screaming about 20 minutes after falling asleep) are common during this stage. Waking the child and comforting the child generally helps. Sometimes use of a night light is soothing.
What are the nursing implications relative to toddlers and sleep?
- Establish a regular bedtime routine (e.g., reading a story, singing a lullaby, saying prayers). - Advise parents of the value of a routine sleeping pattern with minimal variation. - Encourage attention to safety once child moves from crib to bed. If child attempts to wander out of room, a folding gate may be necessary across the door of the room.
What are some characteristics of a toddlers sleep pattern?
- Need for sleep declines as this stage progresses. May require two naps during the day and end this stage sleeping 11 to 14 hours a night and napping once during the day. - They may begin to resist naps and going to bed at night. - They may move from crib to youth bed or regular bed at around 2 years.
What are the nursing implications relative to young adults and sleep?
- Reinforce that developing good sleep habits has a positive effect on health, particularly as a person ages. - If loss of sleep is a problem, explore lifestyle demands and stress as possible causes. - Suggest use of relaxation techniques and stress-reduction exercises rather than resorting to medication to induce sleep. Sleep medications decrease REM sleep, may be habit forming, and frequently lose their effectiveness over time.
What are some characteristics of a teenagers sleep pattern?
- Sleep needs of teenagers vary widely, but the average requirement is 8 to 10 hours. The growth spurt that normally occurs at this stage may necessitate the need for more sleep; however, the stresses of school, activities, and part-time employment may cause adolescents to have a restless sleep. Adolescents tend to go to bed later than younger children and adults, but early morning start times for high school frequently require an early awakening time. This can result in an average of only 7 to 7.5 hours of sleep a night. - Many adolescents do not get enough sleep.
What are the nursing implications relative to newborns and sleep?
- Teach parents to position infant on the back. This is the only safe sleeping position for infants less than 1 year old. Sleeping in the prone position increases the risk for sudden infant death syndrome (SIDS). - Advise parents that eye movements, groaning, grimacing, and moving are normal activities at this age. - Encourage parents to have infant sleep in a separate area rather than their bed. - Caution parents about placing pillows, crib bumpers, quilts, stuffed animals, and so on in the crib because this may pose a suffocation risk.
What are some characteristics of a young adults sleep pattern?
- The amount of sleep required is 7 to 9 hours. - Sleep is affected by many factors: physical health, type of occupation, exercise. Lifestyle demands may interfere with sleep patterns. - REM sleep averages about 20% of sleep.
What happens when a decrease in leptin and an increase in ghrelin occurs due to insufficient sleep?
- To compound the problem, the brain may interpret a drop in leptin as a sign of starvation. Unfortunately, the brain then signals the body to eat more while it simultaneously lowers the body's metabolic rate. When this happens, people are more likely to gain weight, even if food intake is decreased.
What are some characteristics of a middle-aged adults sleep pattern?
- Total sleep time decreases during these years, with a decrease in stage IV sleep. - The percentage of time spent awake in bed begins to increase. - People become more aware of sleep disturbances during this period.
What are some of the effects a person can experience with insufficient sleep?
- anxiety, personal conflicts, loneliness, depression, gastrointestinal symptoms, increase in type 2 diabetes, hypertension, and higher rates of cardiovascular disease including strokes, and substance abuse - a person who has experienced shortened sleep by just a few hours a night can have a reaction time similar to someone intoxicated with alcohol
What are some factors that affect rest and sleep?
- developmental considerations, motivation, culture, lifestyle, habits, environmental factors, psychological stress, illness, and medications
What did the NSF report that 55% of Americans did while drowsy?
- driving
What are some characteristics of a newborns sleep pattern?
- sleeps an average of 16 hr/24 hr; averages about 4 hours at a time - on average, they sleep 12 to 15 hours at night, with several naps during the day - usually by 8 to 16 weeks of age, they sleep through the night - REM sleep constitutes much of their sleep cycle
Who identified a link between insufficient sleep and obesity in adults and children?
- the NSF
What does the term "short sleeper" refer to?
- to someone who sleeps less than 6 hours a night