How Nurse Practitioners Can Promote Healthy Sleep

a woman counting sheep asleep - featured image

The present speed of life hardly allows enough time for breaks and relaxation. It can make consistently having an enjoyable night’s sleep seem like a fantasy. However, quality sleep is just as crucial to general well-being as balanced food and regular exercise. 

Emotions, wellness, and cognitive function all improve with adequate sleep. Frequent sleep deprivation increases the likelihood of several illnesses and disorders. These include memory loss, weight gain, and cardiovascular disease, as well as stroke.

How does sleep deficiency affect human health?

Overall health and sleep are closely related, and maintaining excellent sleep hygiene is just as important to one’s general health as following a balanced diet and engaging in regular exercise. To replenish strength for both mental and physical tasks, sleep is vital. An inability to fall asleep might indicate sleep deprivation.

Insomnia is a complex ailment that can be either chronic or acute in nature. Traveling across time zones, irregular timetables at work, and nighttime professional occupations (such as a job at a call center, air traffic controller, and healthcare professional) can all lead to brief or detailed episodes of sleeplessness. 

Prolonged sleeplessness is also associated with substance misuse, including dependency on drugs or alcohol, as well as other problems such as weight gain, chronic pain, and stress.

What is the role of nurses in helping patients have healthy sleep patterns?

Sleep-related disorders are a very complex issue and can be caused by a variety of factors, including the environmental, professional, and behavioral choices of an individual. 

In such a situation, educated healthcare professionals, such as nurses, need to step up and educate the masses about the importance of a healthy sleep cycle and the benefits of having a sound night’s sleep.

A person’s atmosphere and surroundings can have a significant impact on sleeping habits, particularly in healthcare facilities where lights, noise, and disturbances are constant. Nursing care is essential since sleep deprivation can have rapid adverse effects. 

Nurses need to understand insomnia in order to support patients in achieving peaceful sleep. Individuals with sleep disorders should be educated regarding how to treat their disease properly along with methods to prevent it. 

Clinical placement for nurse practitioner students can help prepare nurses to identify, manage, and treat patients who are suffering from a poor night’s sleep. Texas Woman’s University offers clinical placements for nurse practitioner students and also has a specially designed master’s course for prospective family nurse practitioners. 

This course offers a unique opportunity for aspiring FNPs because it is taught completely online, and includes fully online 13-week fully didactic courses as well as clinical placement opportunities. 

It is an ideal program for nurses who are already working but wish to continue their advanced studies to enhance their knowledge and improve their chances of securing new jobs in the future.

The approach of nurses in promoting healthy sleep in patients

Described below is the strategy that nurses use to identify, treat, and manage patients suffering from sleeplessness or insomnia.

How do nurses conduct sleep assessments in patients?

To screen patients for sleeping disorders, nurses begin by interviewing the patient and getting a thorough clinical history. Inquiries concerning the patient’s sleeping patterns, daily schedule, problems linked to their sleep, and potential sleep-influencing causes are made. 

The first question nurses might ask patients in their assessment is about the sleep duration (i.e., the number of hours they sleep), especially during the night, as well as their sleep schedule (what time they go to sleep and wake up). 

Furthermore, nurses also ask patients about the quality of their sleep, identifying things such as how many times a patient wakes up during the night. 

When dealing with patients suffering from unhealthy sleeping patterns, nurses also inquire about where they sleep and how comfortable the environment is, identifying factors such as beds, light, comfort, room temperature, etc. 

Additionally, nurses ask patients about the symptoms associated with sleep and unusual sleep-related behaviors, such as nightmares, sleepwalking, snoring, restless legs, and sleeptalking. Nurses also question individuals who are suffering from sleep-related problems about their daytime functioning and alertness.

How do nurses screen patients for sleep disorders?

Nurses start a targeted evaluation of an individual’s sleep habits with general interview questions. 

Subsequently, nurses evaluate and assess fundamental aspects of restful sleep, which include bedtime and awake time, quality of sleep, sleeping span during the night, daytime alertness, and working schedule. 

Moreover, nurses also ask patients about their age because each age group requires a certain level of sleep hours to stay healthy and fit. 

For example:

  • 0- to 12-month-old babies require 12 to 16 hours of sleep daily
  • 1- to 2-year-old children need 11 to 14 hours of sleep daily
  • 3- to 5-year-old children require 10 to 13 hours of sleep daily
  • 6- to 12-year-old children need 9 to 12 hours of sleep daily
  • 13- to 18-year-old teenagers require 8 to 10 hours of sleep daily
  • adults aged 18 and above need 7 to 8 hours of sleep daily.

Nurses ask a number of questions during the diagnosis phase of an individual who is suffering from sleeplessness or insomnia, which include:

  • What is the usual number of hours you sleep every night?
  • Do you always fall asleep and rise at the same time, even during the weekends?
  • How would you rate your sleep quality in the past one to two months?
  • How easy is it for you to stay awake and alert throughout the day without feeling sleepy or tired?
  • How well are you able to perform all the daytime tasks without feeling lethargic due to a poor night’s sleep?
  • How frequently do you suffer from a compromised night’s sleep?
  • How frequently do you struggle to fall asleep or remain asleep throughout the night?
  • Do you have family or a partner who snores?

Which lifestyle changes do nurses advise for a good sleep?

Lifestyle modifications can frequently lead to an improvement in sleep deprivation. Individuals suffering from insomnia must be informed and educated by nurses about restful sleeping practices.

Nurses guide individuals on the importance of making their bedrooms a comfortable place for restful sleep. They educate patients to stay away from uncomfortable or bright light sources such as TVs and electronics to prevent disturbance during sleep hours. 

Moreover, nurses also educate individuals on avoiding anything that might interfere with their sleep cycles, such as late-night work and erratic timetables. Nurses also advise patients, prior to going to bed, to stay away from substances such as nicotine, alcohol, and caffeine. 

Although alcohol might facilitate sleep, it causes sleep that is often restless compared to usual. 

As a result, individuals who have consumed alcohol are more prone to wake up in the middle of the night. The effects of caffeine may persist for eight hours or more, so individuals should ideally avoid caffeine at any time in the afternoon.

Furthermore, nurses also suggest patients engage themselves in some sort of physical activity during the daytime, or early morning physical exercise, or take part in some sports activity because a sedentary lifestyle is one of the major causes of bad sleep or sleepless nights. 

They also suggest individuals who are suffering from sleep-related issues steer clear of midday naps, particularly in the latter part of the day, as this might help patients to be able to sleep throughout the night. 

To keep a normal process of sleep time and wake time, nurses should also advise individuals to consume meals on a regular timetable and stay away from nighttime meals, as well as reduce the number of liquids consumed right before sleeping, as this might enable them to sleep better and longer without needing to use the bathroom.

Additionally, nurses guide patients to involve themselves in stress-relieving activities such as gardening or meditation. 

Also, patients should involve themselves in discovering fresh approaches that assist them to de-stress and unwind before going to bed, such as listening to relaxing music, reading interesting books, or taking a hot bath. 

Nurses should also suggest patients get involved in massage treatment or yoga to help them relax. To treat sleep-related issues in elderly patients, nurses may also advise acupuncture. Nurses also check whether an individual is taking any prescription or OTC medicines that might affect their sleep.

How do nurses treat and manage sleep-related disorders in their patients?

Sleep has been acknowledged as being important for nursing care because of its healing properties and being good for well-being since Florence Nightingale’s time. Hospitalization is frequently associated with sleep problems and altered sleeping habits, particularly in those recovering from surgery. 

Patients in intensive care and healthcare facilities frequently complain about difficulty falling asleep, having spells of waking throughout the night, and being sleepier throughout daytime hours. 

In addition to sickness and pain, additional factors that contribute to poor sleep at healthcare facilities include uncomfortable beds, temperature extremes, noise caused by IV pumps and other medical equipment, and disturbances from other patients and staff. 

Problems with sleep may also result from the use of drainage tubes, urine catheters, and intravenous catheters. Lack of restful sleep at nighttime can result in elevated daytime tiredness, which can hinder movement and delay the healing process following the operation. 

Studies show that sleep difficulties following surgery might last for several months. As a result, it is critical to offer nursing techniques that effectively encourage sleep.

Medication therapies

For persistent sleep disorders, cognitive behavioral therapy is typically the initial kind of counseling that is advised. For the treatment of sleep deprivation, some prescription drugs may be recommended. Although some are designed for usage for a long time, and others are intended for use for only a few days or weeks. 

Authorized nurse practitioners can recommend drugs for individuals that can enhance their quality of sleep. Below are some medications that nurses might suggest to improve a patient’s sleep.

Benzodiazepines such as lorazepam (Ativan): 

Nurses who are in authority, such as family nurse practitioners, may prescribe benzodiazepines such as lorazepam (Ativan) to patients suffering from sleep-related issues. 

The drug helps reduce anxiety and panic attacks and helps to reduce the stress that surrounds insomnia, although it is recommended that such medications are only prescribed in the short term, as they can be addictive.

Benzodiazepine-receptor agonists, such as zolpidem (Ambien): 

This medicine helps to reduce the number of times a patient wakes up during the night. It works to promote longer sleep which, in turn, promotes better mental and social health, logical thinking, and overall well-being.

Melatonin-receptor agonists, such as ramelteon (Rozerem): 

Melatonin-receptor agonists work to decrease neuronal firing of the suprachiasmatic nucleus (SCN). What this means is that the brain’s “alert” signals are turned down, essentially meaning a patient can sleep for longer without being disturbed. 

Orexin-receptor antagonists, such as suvorexant (Belsomra): 

Narcoleptics are not advised to use this medication as this medicine promotes the onset of sleep. In simple terms, this drug makes patients feel sleepy very quickly.

Some patients may use over-the-counter medications to aid their sleep. 

While these medicines can be helpful in the short term, individuals are not recommended to use them for an extended period due to potential side effects. Rather, patients should seek medical attention from a qualified professional who can offer long-term, more permanent solutions. 

Many of these over-the-counter medications have antihistamines in them, which can induce drowsiness. Again, while this can help patients get to sleep in the short term, antihistamines are not recommended for sleep disorder therapy, and they can be dangerous for certain individuals. 

The sleep component melatonin is produced in laboratories and is available as a medicine. To get better sleep, melatonin pills are taken by numerous individuals. This substance, however, has not been shown to be a successful therapy for sleep disorders in studies. 

Melatonin side effects could consist of headaches and migraines, digestive problems, lowered mood, and daytime tiredness. Moreover, it may interfere with the body’s ability to regulate blood pressure, leading to either elevated blood pressure or low blood pressure.

Evidence-based behavioral nursing interventions to promote healthy sleep in patients

Lowering patients’ exposure to bright light at nighttime by utilizing red lamps and Actiwatches to track activity, sleep, and light color sensitivity is one behavioral method nursing professionals advocate and employ. 

Less bright white light has been shown to improve sleep for both elderly and pediatric individuals. Using red light instead has been found to improve sleep in patients and satisfy nurses’ visual demands when they are undertaking nighttime care.

Furthermore, nursing professionals strive to lessen noise pollution. Upon assessment, patients are asked about various aspects that interfere with and disturb their sleep, and the answers often include alarms, bed sounds, squeaky devices, and interruptions from fellow patients. 

Thus, the work of the nursing professionals resulted in several positive adjustments, such as fixing noisy wheels on chairs, fixing bed motor problems, replacing the automated tissue paper equipment in the hallways with manually operated ones, and modifying the frequency of floor buffing.

Prohibiting prolonged visitor stays in patients’ rooms or hospitals is another method used by nurses. Sometimes, nurses can request that guests staying longer in private rooms maintain silence by not utilizing excessive lighting, televisions, or mobile devices after dark. 

Nurses stress the significance of multidisciplinary teams combining care along with managing the environment to minimize sleep disturbances. “Quiet Time”, a multidisciplinary endeavor, takes place from twelve to five in the morning as well as from two to four in the afternoon. 

Decreasing lights, shutting patient room doors, and speaking quietly are all part of quiet time.

Another sleep-promoting approach used by nurse practitioners is to find out from their patients what sleep aids they utilize in their homes, such as additional blankets, cushions, or music players, and utilize these in a hospital setting. 

Patient education and counseling

Nurses play a significant role in educating and counseling patients who are suffering from insomnia, sleep deprivation, or any other sleep disorder. Nurses also provide crucial diagnosis and treatment information to patients’ families, as well as direction to therapies, and medicine that may be able to refresh their sleeping patterns. 

Without nurses, healthy sleep promotion would decrease, and suffering patients would not have access to resources to aid them in recovery. Thankfully, nurses provide evidence-based practice, ensuring that the patients they care for receive the best possible treatment either in the hospital or when they return home.