How Nurse Practitioners Can Promote Healthy Sleep
Contents
- How does sleep deficiency affect human health?
- What is the role of nurses in helping patients have healthy sleep patterns?
- The approach of nurses in promoting healthy sleep in patients
- How do nurses conduct sleep assessments in patients?
- How do nurses screen patients for sleep disorders?
- Which lifestyle changes do nurses advise for a good sleep?
- How do nurses treat and manage sleep-related disorders in their patients?
- Medication therapies
- Benzodiazepines such as temazepam and lorazepam (Ativan):
- Benzodiazepine-receptor agonists, such as zolpidem (Ambien):
- Melatonin-receptor agonists, such as ramelteon (Rozerem):
- Orexin-receptor antagonists, such as suvorexant (Belsomra):
- Evidence-based behavioral nursing interventions to promote healthy sleep in patients
- Patient education and counseling
- Sources
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, the CDC lists these daily sleep needs by age:
- newborns (0 to 3 months) need 14 to 17 hours
- babies aged 4 to 12 months need 12 to 16 hours, including naps
- 1- to 2-year-old children need 11 to 14 hours, including naps
- 3- to 5-year-old children need 10 to 13 hours, including naps
- 6- to 12-year-old children need 9 to 12 hours
- 13- to 17-year-old teenagers need 8 to 10 hours
- adults aged 18 to 60 need 7 or more hours, adults aged 61 to 64 need 7 to 9 hours, and adults 65 and older need 7 to 8 hours.
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. Caffeine’s effects can last for several hours, so many people sleep better if they avoid it in the afternoon and evening.
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 regular daytime activity is linked to better sleep.
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. Some patients ask about acupuncture, but NCCIH notes the evidence for acupuncture in insomnia is limited. 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.
Sleep problems after surgery do not always end at discharge. As a result, it is critical to offer nursing techniques that effectively encourage sleep.
Medication therapies
For chronic insomnia, cognitive behavioral therapy for insomnia (CBT-I) is the recommended first treatment. 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.
Nurse practitioners can prescribe medications within the limits of their state license, and prescribing controlled substances also requires DEA registration. Below are some prescription options a prescriber might consider. None should be started without an individual evaluation.
Benzodiazepines such as temazepam and lorazepam (Ativan):
Some benzodiazepines, such as temazepam, are approved for short-term treatment of insomnia. Others, such as lorazepam (Ativan), are approved for anxiety and are sometimes used when anxiety drives sleeplessness.
The FDA requires a boxed warning on all benzodiazepines about abuse, addiction, physical dependence and withdrawal reactions. They are meant for short-term use and should be tapered under supervision, never stopped suddenly.
Benzodiazepine-receptor agonists, such as zolpidem (Ambien):
Zolpidem treats insomnia, meaning trouble falling or staying asleep, and is normally used for short periods. MedlinePlus warns that zolpidem may cause complex sleep behaviors, such as sleep-driving, that people do not remember afterward.
Melatonin-receptor agonists, such as ramelteon (Rozerem):
Ramelteon acts on melatonin receptors in the suprachiasmatic nucleus (SCN), the brain’s master clock. It is used for trouble falling asleep rather than for staying asleep.
Orexin-receptor antagonists, such as suvorexant (Belsomra):
Suvorexant blocks orexin, a brain chemical that helps keep you awake, and treats trouble falling or staying asleep. People with narcolepsy are usually told not to take suvorexant.
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.
Melatonin, a hormone the body makes, is sold in the U.S. as a dietary supplement, and the FDA does not approve supplements for safety or effectiveness before they are sold. NCCIH reports there is not enough strong evidence to recommend melatonin for chronic insomnia, although it may help with jet lag and some body clock problems.
Reported side effects include headache, dizziness, nausea and sleepiness. Labels are not always accurate, and people who take blood thinners, have epilepsy or take other medicines should talk with a clinician before using it.
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.
Dimmer light at night can help patients sleep. Some hospitals use red or low night lighting so patients can rest while nurses can still see to give 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.
In some hospitals, nurse-led projects have led to practical fixes, 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. Some hospitals schedule multidisciplinary “Quiet Time” periods overnight and 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.
Anyone with ongoing sleep problems should see a clinician for a diagnosis and a treatment plan that fits their health needs.
