Sleep
Introduction
`A regular recurrent easily
reversible state of the organism characterised by relative quiescence and by a
great increase in the threshold of response to external stimuli`, (Hartmann
1973)
List ways in which sleep
differs from unconsciousness
List factors which may
inhibit sleep
Environment
Noise
Cold or heat
Discomfort
Pain
Physiology
Co-ordination between the
CNS, PNS, CVS, endocrine, respiratory and muscular systems
Sleep is produced by reduced
RAS (reticular activating system) activity in the brain stem and wakefulness
promoted by increased RAS activity
Wakefulness seems to be
promoted by release of Noradrenaline and sleep promoted by release of
serotonin. Other proteins and hormones are also involved.
EEG
Electroencephalography
Two phases REM and NREM
Stage I
Lightest level of sleep
Just dropped "off",
relaxed, floating thoughts
Lasts for few minutes
Gradual reduction in vital
signs and metabolism
Stage 2
Greater relaxation, vague
dream experiences, look asleep, but easily waken up.
Lasts for 10-30 minutes
Body functions continue to
slow
Stage 3
Initial stages of deep sleep
Complete relaxation, pulse
rate down, metabolism down and not easily waken up.
Lasts for about 30
minutes
Stage 4
Deepest stage
Very relaxed, difficult to
awaken
Sleep walking and enuresis
may occur during this stage
REM sleep
Occurs 50 - 90 minutes after
falling asleep
About 20% of sleeping time
Variations in vital signs
Loss of skeletal muscle tone
Period of light sleep in
which dreaming occurs
REM backwards and forward,
babies have more REMs but are decreased with age.
If awaken suddenly people may
report vivid dreams.
REM period is said to promote
mental restoration, psychological integration, update memory and integrate
emotionally meaningful experience.
List factors which may give
rise to variation in the amount of sleep required
Age
Individual variation
Quality of sleep enjoyed
Alcohol or drug consumption
Mood
Anxiety
Boredom
Sex - women sleep more than men
Body weight - weight gain leads to more sleep, weight
loss to less
Exercise - promotes sleep if not taken immediately
before sleep
Functions of sleep
Unborn children sleep
Children need more sleep than
adults: growth takes place during sleep
Growth hormone reaches peak
production in stages 3 and 4
Children have more REM sleep
than adults
Adults spend up to 1/3 of
their time sleeping.
Increased levels of protein
synthesis - repair of tissues
Provides greater degree of
rest
Reduced metabolic
requirements
Increases levels of ATP
Effects of sleep deprivation
Fall in body temperature and
less effective Thermoregulation
Difficulty in focusing
Reduced orientation
Reduced concentration
Impaired judgement
Irritability and restlessness
Impaired healing
Hallucinations
Ultimately death
Circadian rhythms
The 24 hour cycle
Rhythms of temperature, heart
rate, blood pressure, urine production, hormonal secretions
Jet lag and shift work may
disrupt these rhythms
List ways in which nurses can
promote normal sleep patterns in their patients
Sleep
Introduction
`A regular recurrent easily
reversible state of the organism characterised by relative quiescence and by a
great increase in the threshold of response to external stimuli`
List ways in which sleep
differs from unconsciousness
List factors which may
inhibit sleep
Physiology
Co-ordination between the
CNS, PNS, CVS, endocrine, respiratory and muscular systems
Sleep is produced by reduced
RAS (reticular activating system) activity in the brain stem and wakefulness
promoted by increased RAS activity
Wakefulness seems to be
promoted by release of Noradrenaline and sleep promoted by release of
serotonin. Other proteins and hormones are also involved.
EEG
Electroencephalography
Two phases REM and NREM
Stage I
Lightest level of sleep Just dropped
"off", relaxed, floating thoughts
Lasts for few minutes Gradual
reduction in vital signs and metabolism
Stage 2
Greater relaxation, vague
dream experiences, look asleep, but easily waken up.
Lasts for 10-30 minutes Body functions
continue to slow
Stage 3
Initial stages of deep sleep Lasts for about 30 minutes
Complete relaxation, pulse
rate down, metabolism down and not easily waken up.
Stage 4
Deepest stage Very
relaxed, difficult to awaken
Sleep walking and enuresis
may occur during this stage
REM sleep
Occurs 50 - 90 minutes after
falling asleep
About 20% of sleeping time Variations in vital
signs
Loss of skeletal muscle tone Period of light sleep in
which dreaming occurs
REM backwards and forward,
babies have more REMs but are decreased with age.
If awaken suddenly people may
report vivid dreams.
REM period is said to promote
mental restoration, psychological integration, update memory and integrate
emotionally meaningful experience.
List factors which may give
rise to variation in the amount of sleep required
Functions of sleep
Unborn children sleep
Children need more sleep than
adults: growth takes place during sleep
Growth hormone reaches peak
production in stages 3 and 4
Children have more REM sleep
than adults
Adults spend up to 1/3 of
their time sleeping.
Increased levels of protein
synthesis - repair of tissues
Provides greater degree of
rest Reduced metabolic
requirements
Increases levels of ATP
Effects of sleep deprivation
Fall in body temperature and
less effective thermoregulation
Difficulty in focusing Reduced
orientation
Reduced concentration Impaired
judgement
Irritability and restlessness Impaired healing
Hallucinations Ultimately
death
Circadian rhythms
The 24 hour cycle
Rhythms of temperature, heart
rate, blood pressure, urine production, hormonal secretions
Jet lag and shift work may
disrupt these rhythms
List ways in which nurses can
promote normal sleep patterns in their patients