Nursing 105

Essentials of Nursing Study Guide

©2018 Achieve Page 124 of 160 Stage 4 sleep is markedly decreased and in some cases absent.; first REM period is longer; as a result of the change in stage 4 sleep, older people have less restorative sleep Individual Preferences and Patterns Shift work and shift changes require the re-arrangement of activities so as to be ready to sleep at the right time. Moderate exercise is conducive to sleep, excessive exercise can delay sleep. Alcohol and stimulants disrupt REM sleep. Caffeinated beverages act as stimulants of the CNS, thus interfering with sleep. Smoking has a stimulating effect on the body. Smokers are usually easily aroused and often describe themselves as light sleepers. How are circadian rhythm disorders treated? Circadian rhythm disorders are treated based on the kind of disorder diagnosed. The goal of treatment is to fit a person's sleep pattern into a schedule that allows him or her to meet the demands of the desired lifestyle. Therapy usually combines proper sleep hygiene techniques and external stimulus therapy, such as bright light therapy or chronotherapy. Chronotherapy is a behavioral technique in which the bedtime is gradually and systematically adjusted until a desired bedtime is achieved. Bright light therapy is designed to reset a person’s circadian rhythm to a desired pattern. When combined, these therapies may produce significant results in people with circadian rhythm disorders. • Infants: sleep as long as 22 hours a day, others 12-14 hours a day; periods of wakefulness gradually increase during the first months; by 4 months most infants sleep through the night and establish a pattern of daytime naps; many infants begin waking up again in the middle of the night between 5 and 9 months of age • Toddlers: a normal sleep-wake cycle is usually established by age 2 or 3; sleep requirements decrease to 10-12 hours per day; toddlers have 20-30% REM sleep • Preschoolers: require 11-12 hours of sleep; still require bedtime rituals; REM is 20-30% (higher than adults) and Stage 1 sleep is less • School age children: need 8-12 hours of sleep a night without daytime naps; REM reduces to about 20% • Adolescents: require 8-10 hours of sleep each night to prevent undue fatigue and susceptibility to infections; boys begin to experience nocturnal emissions • Young adults: require 7-8 hours of sleep; many use sleep medications in order to fall asleep • Middle aged adults : usually sleep 6-8 hours per night; REM is about 20% • Older adults: 6.3 Factors Influencing the Patient’s Rest and Sleep Age and Developmental Level • Newborns: sleep 16-18 hours a day, usually divided into about seven sleep periods