Activity of Living: Sleep and Rest

Activities of living are to do with things, as humans, we do every day to survive. In Roper, Logan and Tierney there are twelve model activities that are essential to living and these are maintaining a safe environment, communicating, breathing, eating and drinking, eliminating, personal cleansing and dressing, controlling body temperature, mobilising, working and playing, expressing sexuality, sleeping and the last one dying (Holland et al, 2012 p. 2). This essay is going to be concentrating sleep and rest and what these two words mean. Also going to be focusing on identifying what skills nurses need to obtain this information from patients at the initial stage if assessment and also when the information is gathered, what actions the nurse needs to take in order to assist the person in helping with any underlying factors that may contribute to a patient not getting enough of both sleep and rest. This essay is also going to discuss what conditions that affect sleep and rest and how these things can be resolved for better autonomy.
Sleep and rest are similar but different at the same time. Sleep is defined as being in an unconscious state in which the body continuously maintains its own bodily functions like breathing (McFerran, 2008). Sleep is also when the body recuperates and mends itself for the next day. It is also when the body is to heal itself as well. Rest can be defined as the body just stopping of any movement in order to relax and recover strength (Oxford Dictionary, 2013). The body needs sleep in order to be healthy but not enough sleep can lead to poor concentration, lack of judgement and become irritable (Crisp et al, 2013 p 1038). Fatigue is a major cause of accidents and if you are deprived of sleep for around 17 hours it can equate to a blood alcohol concentration of around 0.05 (Levitt-Jones & Bourgeois, 2012). Therefore the average individual in a 24 hour period should have around 6-8 hours of quality sleep every night (Levitt-Jones & Bourgeois, 2012). In saying this, in different stages of life, the amount of sleep needed can differ. Babies need around 18 hours a day, but this is split into intervals lasting up to 2-4 hours at a time. By the time they are 3 years of age the amount of sleep per night can change to around 13 hours with a little nap during the day, by the time the child is around 10 ehy only need around 8-10 hours per night (Holland et al, 2012 p 417). In adolescence years, their sleeping pattern changes. Adolescent children need up to 10 hours of sleep per night, but by the time they are 17 this can go down to around 7-8 hours a night (Holland et al, 2012 p 417). By the time individuals go into adulthood, the average sleep that is needed per night is anywhere from 7-8 hours per night, but as they go into their 30’s, the sleeping pattern changes and it can become lighter and they wake more easily (Holland et al, 2012 p417). Woman are affected more due to the fact that in this stage of life, pregnancy is a major disturbance to sleeping patterns, even though woman do sleep longer than men, their sleep is not sufficient sleep due to the disturbances in sleep like frequent urination plus the movement of the baby (Holland et al 2012 p. 417), so frequent rest is necessary. Also, woman start to go through menopause, can affect sleep from the hot flushes and also the night sweats. Women also tend to sleep deeper than man, which is a factor to why woman live longer than men (Holland et al, 2012 p.417). When individuals get into their older stages of life, their length of sleeping during the night is shortened to around 5 hours per night, but during the night they tend to wake up on a more frequent basis, to catch up on the lack of sufficient sleep, the elderly tend to have more day time naps or a rest. Also some other factors affect the sleeping patterns for the elderly like the loss of their spouse and the fact that they have to live alone. Another factor could be their mental state due to depression or dementia and also environmental and economic factors like how to keep warm, their personal safety and also keeping healthy. There are also the underlying medical conditions that could contribute to sleep and rest.
Some medical conditions that can contribute to sleep deprivation and these can be either intrinsic or extrinsic factors. Some intrinsic medical conditions could include insomnia, narcolepsy and sleep apnoea (Crisp et al, 2013 p. 1041). Insomnia is regarded as unsatisfactory sleep during the night in which daytime function is affected and the individual feels tired during the day (Crisp et al, 2013 p. 1041). Insomnia is more likely to be seen in woman, and is treated in different forms through changes in sleeping patterns or through short term use of medication. Narcolepsy is associated with the brain functioning which regulates the cycle of being asleep or awake (Crisp et al, 2013 p. 1043). A person with narcolepsy during the day, could a sudden urge of being sleepy and can fall asleep anywhere and anytime. When they fall asleep they can fall into REM sleep which is the sleep where individuals have rapid eye movement and is the state where dreams happen (McFerran, 2008). Sleep apnoea is a disorder in which the upper airway is either partially or completely obstructed which can cause breathing to stop for up to 10 seconds or longer. Some extrinsic factors that could disturb sleep are disorders that can affect the circadian rhythm. The circadian rhythm is the biological clock on a twenty four hour period and it knows when to go to sleep and when to wake up. Some other factors that can affect sleep are different drugs and medications. Some medications can be prescribed to help with sleep but this can only be affective for short periods of time doe to the fact that the body can get used of these medications and then they will become less efficient. Nurses can help assess a patient to whether help is needed for sleep with a patient
The nurse’s role in helping patients is important as they need to ask the right questions to help figure out what measures need to be taken to help these individuals. The nurse needs to look at five different stages which are biological, psychological, sociocultural, and environmental and politico economic (Holland et al, 2012 p 429). When assessing the patient, the nurse needs to ask questions to find out what sleeping patterns they have and to gather a history and what is normal to then as each individual has different sleeping patterns (Crisp et al, 2013 p. 1048). Some questions a nurse might ask to see what normal might be for the individual is ask them what time they might go to sleep each night, how long does it take them to fall asleep and if they wake up during the night and if they do why do they wake up, what time they get out of bed each morning and also how much sleep that they get each night. This can help with the assessment of sleep disorders (Crisp et al, 2013 p. 1051). A nurse also needs to take into consideration what stage of their lifespan are they in, the dependence of an individual, the independence of the individual and the factors affecting the sleep (Holland et al, 2012 p. 430). The nurse also needs to ask if that they have had any previous illness that could have affected these sleeping patterns which could be included in the nursing assessment. The nurse also needs to ask if anything is happening in their life at the moment that could be affecting their sleep like stress or emotions. These can be a factor in the sleeping quality of a person. Also environmental factors need to be taken into consideration on sleeping patterns. If the patient has been in a hospital for a long period of time and can’t get sufficient sleep due to the busyness of the hospital or even home life and maybe being cold and can’t get to sleep because of this. Once the nurse has gathered all the information form the patient, then nurse can go and diagnosis whether the patient has a sleeping disorder and what measures can be put into place to help get the patient on a better sleeping pattern so that their health improves.
Some ways in which a nurse can help a patient to get into better sleeping patterns is to look at new routines in which the patient can try before other interventions are taken. One way in which sleep could be improved is to ask the patient to change their room environment in which they sleep. They need to make sure that the room is dark and quiet and with no stimulates like the television to keep them awake (Crisp et al, 2013 p. 1054). Another way to help with sleep is to stop caffeinated drinks, nicotine into the system and also drinking alcohol as these can keep individuals awake for longer periods than normal. They can also go to bed at the same time every night and wake up at the same time every day to get into a routine of waking and sleeping and this could help fix the abnormal sleeping pattern. If all of this does not work then medications may be introduced to help with the aide of sleep. Doctors are reluctant to give medications but are only administered if other interventions do not work as efficient. Some medications that can be administered are hypnotics or tranquilisers like benzodiazepines which can have a side-affect to people with insomnia or anxiolytics which both id these help to induce sleep (Holland et al, 2012 p.418). Hypnotics can also be taken but these can only last for around 2 weeks before the body tolerates these medications. One side effect for people y=taking any medications like these is that individuals can become addicted to these if they are not taken, the individual can get side effects from not taking these medications so this is why that these need to be taken under the guidance of doctors and also nurses (Holland et al, 2012 p.418).
In conclusion, sleep and rest are very vital in everyday function of people and it must be quantity and quality sleep. If not enough sleep and rest is taken by an individual, then the health of the individual can be affected. All kinds of factors need to be taken into consideration at every stage in an individual’s life to how much sleep is needed from the time you are born to when you are an older individual. The nurses assessment is vital in whether a person may have an underlying sleeping disorder and what measures need to be taken to help get the individual into a better sleeping pattern, it could be as easy as just changing the routine of which the individual goes to sleep, changing the environment in which they sleep in, to also the patterns of what the individual does prior to going to sleep. If none of these help then medical help is needed. Sleep and rest are two different things, but both are needed to make sure that individuals lead a healthy life.

Reference List:-
Crisp J, Taylor C, Douglas C & Rebeiro G 2013, Potter and Perry’s Fundamentals of Nursing, Mosby Elsevier, Chatswood, New South Wales Australia

Holland K, Jenkins J, Solomon J & Whittam S 2012, Applying Roper Logan Tierney Model In Practice, Churchill Livingstone Elesvier, Philadelphia, USA
Levett-Jones, T & Bourgeois, S 2012, “The Clinical Placement”, 2nd Edition, Elsevier Australia
McFerran T 2008, Oxford Minidictionary for Nurses, 6th Edition, Oxford University Press, Oxford
Oxford dictionary online 2013, Oxford Dictionary, Oxford University Press, Oxford http://oxforddictionaries.com/definition/english/rest