SLEEP DISORDERSSLEEP DISORDERS

•Sleep disorders are commonly encountered in the elderly population with up to half of all older persons complaining about their ability to sleep.

Some sleep dysfunction are caused by psychological stressors, such as mandatory retirement, bereavement over the loss of a significant person in their life or the loss of physical health.

• Age-related changes with sleeping include falling sleep earlier awakening earlier and less tolerance of changes in the sleepwake cycle. Daytime naps may offset reduced nighttime sleep, but may also, contribute to poor nocturnal sleeping patterns.

•The elderly tend to have an increase in the time it takes to fall asleep, frequency of nightime awakenings, and decrease in REM sleep.

The most common sleep disorders found in the elderly are insomnia and sleep apnea. frequent awakening during sleep, awakening early in the morning, daytime fatique, irritability and difficulty with concentration.

• Other disorders include hypersomia or excessive sleep and nocturnal behaviour. Sleep apnea is characterized by cessation of breathing for periods of time during sleep, causing a decrease in oxygen concentration which then wakes the patient before completing the REM Sleep cycle.

The results in sleepiness, lethargy, and exhaustion.Because of the extreme oxygen desaturation that occur.Morbility increases in the obstructive sleep apnea if episodes occur more often than 10 times per hour.

• MEDICAL CARE:• Polysomnography: Used to do

overnight monitoring of patient's sleep cycles to reveal electrical activity and brain cerbral muscle,ribcage,abdominal and eye movements..

• Continuous Positive Airway Pressure – used in cases of severe obstructive sleep apnea to prevent oxygen desaturations by providing continuous positive pressure to keep airway open.

• SURGERY- tracheostomy may be required for patients with severe pain apnea when all

• other measures have failed. UVULOPALATOPHARNGOPLASTY maybe done to enlarge the pharngeal airspace by removal of excess tissue but is effective less than half the time.

Nursing Diagnoses• Ineffective breathing pattern

related to:• Tracheobronchial obstruction of

sleep apnea, decrease lung volume, decreased lung capacity, increased metabolic needs.

DEFINING CHARACTERISTICS

• Snoring, Apnea, Hypoxia, Cough with or without production .Increase respiratory rate, Tachycardia, Use of accessory muscles nasal flaring, Pursed-lip breathing.

Disturbed thought Process

• Related to: Sleep deprivation, sleep apnea, insomnia, psychological causes, depression, hypoxia.

DEFINING CHARACTERISTICS

• Inaccurate interpretation of environment, egocentricity, distractibility, inappropriate thinking, memory impairment, confusion, disorientation, lethargy.

DISTURBED SLEEP PATTERNS

• Related to: INTERNAL FACTORS OF DISEASE PROCESSES,DEPRESSION,CONFUSION, BOREDOM, ENVIRONMENT,STIMULI,OBSTRUCTIVE SLEEP APNEA.

DEFINING CHARACTERISTICS

• Related to : internal factors of disease processes, depression, confusion, boredom, environment, stimuli,obstructive sleep apnea.

ANXIETY• Related to: Sleep apnea, sleep

deprivation, threat of change in health status, life threatening crises, chronic nature of disease and effect on lifestyle, change in role functioning.

DEFINING CHARACTERISTICS

• Fear, restlessness ,muscle tension, helplessness communication of uncertainty and apprehension, feeling of suffocation, feelings of inadequacy.