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Sleep / Rest for Older Adults

Sleep / Rest for Older Adults. Objectives. Describe the normal changes in sleep patters associated with age. Identify the causes of sleep disturbance among older adults. Assess sleep in older adults. Provide nursing interventions to restore sleep quality among older adults.

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Sleep / Rest for Older Adults

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  1. Sleep / Rest for Older Adults

  2. Objectives • Describe the normal changes in sleep patters associated with age. • Identify the causes of sleep disturbance among older adults. • Assess sleep in older adults. • Provide nursing interventions to restore sleep quality among older adults.

  3. Review of sleep cycle • Non Rapid Eye Movement (NREM) – • Stage 1 - period of drifting • Stage 2 - relaxation and light sleep • Stages 3 and 4 - restorative • Rapid Eye Movement (REM), sometimes called paradoxical sleep There are 4 stages in a REM cycle: 1, 2, 3, and 4. • Each cycle is about 90 minutes

  4. Changes in sleep patterns • 50% of older adults have reported sleep disturbances, but 1 in 8 are diagnosed by a physician • 12% - 25% of HEALTHY older adults • 22% - 61% of HOSPITALIZED older adults • Common complaints: daytime fatigue; difficulty falling asleep

  5. Changes in sleep patterns • Increased REM Stage 1 wakefulness • Decreased NREM (Stage 3 and 4) slow wave deep sleep • Increase in nighttime awakenings: nocturia, restless legs syndrome, periodic limb movements in sleep (PLMS), sleep apnea

  6. Circadian rhythm • Regular variation in physiologic parameters that occur over the course of a 24-hour day • Irregular Sleep/Wake Pattern • Irregular sleep/wake timing • Daytime napping • Advanced Sleep Phase Syndrome • Intractable early evening sleepiness • Awakening between 2 and 4 a.m.

  7. Sleep Disturbances • Dyssomnias • Parasomnias • Disorders associated with medical or psychiatric disorders • Proposed sleep disorders

  8. Causes of sleep disturbances • Periodic limb movements in sleep (PLMS) • Acute and Chronic Illness • Commonly Occurring Problems • Nocturia • Dementia • Alcoholism • Depression

  9. Assess Sleep • Sleep history • Medical history • Diet and drug history • Psychosocial history • The Pittsburgh Sleep Quality Index (PSQI).pdf PSQI Try This Assessment Series available on Hartford Institute website at www.hartfordign.org

  10. Nursing Interventions • Refer for sleep-related disorders with PLMS or other medical psychological and other symptoms • Nonpharmacologic Option • Remove contributing factors • Educate the patient; implement Sleep Hygiene Measures; expose to light upon awakening • CPAP • Cognitive behavior therapy

  11. Nursing Interventions • Pharmacologic Option • Temazepam • Triazolam • Benzodiazepines, behavioral approaches – short term • Close monitoring and reassessment

  12. Summary • Normal changes in sleep patterns • Causes of sleep disturbances • Assessment of sleep • Nursing interventions: pharmacologic and no pharmacologic; sleep hygiene measures

  13. QUESTIONS?

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