This document defines and discusses sleep patterns, types of sleep, functions of sleep, factors affecting sleep, and common sleep disorders. It begins by defining rest and sleep and comparing their characteristics. There are two main types of sleep: non-rapid eye movement sleep (NREM) which has three stages, and rapid eye movement (REM) sleep. Key functions of sleep include energy conservation, thermoregulation, brain function, memory consolidation, and physical health benefits. Factors affecting sleep include age, illness, environment, lifestyle, emotional stress, and drugs/substances. Common sleep disorders discussed are insomnia, parasomnia, and narcolepsy. Conditions to promote healthy sleep are also outlined.

1. Sleep & Pattern
SHAHINA BANO
OBJECTIVES
 At the end of this unit, learners will be able to:
1. Define rest and sleep pattern.
2. Define terms related to sleep.
3. Compare the characteristics of sleep and rest.
4. Discuss the characteristic of two kinds of sleep.
5. Enumerate the function of sleep.
6. Discuss factor affecting sleep.
7. Identify common sleep disorder.
8. Identify conditions necessary to promote sleep.
9. Discuss nursing process for patient to promote sleep.
CONCEPT OF SLEEP
Sleep is a naturally recurring state of mind and body, characterized by altered consciousness, relatively inhibited
sensory activity, reduced muscle activity and inhibition of nearly all voluntary muscles during rapid eye movement
(REM) sleep, and reduced interactions with surroundings.

2. PURPOSE OF SLEEP
DEFINITIONS
REST: A condition in which body is in a decreased state of activity without emotional stress, and freedom from
anxiety.
(state of calmness and relaxation).
SLEEP: an altered state of consciousness in which the individual perception of and reaction to the environment are
decreased.
Sleep pattern: Circadian rhythm is the name given to your body's 24-hour “internal clock.” This internal clock
controls your body's sleep-wake cycle.
TERMS RELATED TO SLEEP
 Actiwatch: A non- invasive wristwatch like actimery sensor device used to monitor body movement that
is useful in accessing sleep wake cycles across consecutive days and nights.
 Bedtime: Time at which a person goes to bed.
 Sleep Diary: A daily log used to record sleep wake patterns that
 include episodes of sleep including naps, bed times, wake time
 and various other related factors.
TERMS RELATED TO SLEEP
 Sleep Latency: Minutes to fall sleep after light out and intending to sleep.
 Total sleep time: Total minutes of night time sleep.
 Wake after sleep onset: Some of minutes awake during nocturnal awakening.
COMPARE THE CHARCTERISTIC OF SLEEP

3. difference between rest and sleep is that Rest is considered a period of bodily inactivity such as relaxing at home
or on vacation and not doing much in terms of physical activity. Sleep is when the body shuts down to repair and
refresh itself.
COMPARE THE CHARACTERISTIC OF SLEEP AND REST
Sleep
State of altered consciousness.
Usually last for several hours.
Without proper sleep, you may
fall sick.
No Physical Activity involved.
Sleep involves Relaxing muscles,
building immunity, repairing
injuries, cleaning the body etc.
Rest
State of relaxation and
calmness.
Rest indicates less time than
sleep.
Rest is complementary to sleep.
Not much physical activity such
as reading a book.

4. Resting involves Relaxing of
muscles only.
TYPES OF SLEEP
There are two basic types of sleep:
1. Non-Rapid eye movement sleep.
 STAGE 1
 STAGE 2
 SATGE 3
2. Rapid eye movement (REM) sleep.
NON RAPID EYE MOVEMENT (NREM) SLEEP:
 First stage of sleep is known as NREM sleep.
 About 75% to 80% of sleep during night is NREM sleep.
 It consist of three stages
 Stage 1
 Stage 2
 stage 3
NREM SLEEP:
STAGE 1
 Stage lasts a few minutes.
 It includes lightest level of sleep.
 Gradual fall in vital sign and metabolism.
 General slowing of brain waves .
 Eyes tends to roll slowly from side to side.
 Sensory stimuli such as noise usually arouses person.
 Sleeper may deny that he/she is sleeping.

5. NREM SLEEP:
STAGE 2
 Last 10 to 20 minutes.
 It’s a period of light sleep before you enter deeper sleep.
 Relaxation progresses.
 Absent eye ball movements.
 brain waves become slower, with occasional bursts of rapid waves called sleep spindles.
 Body function continue to slow.
NREM SLEEP:
STAGE 3
 Stage lasts 15 to 30 minutes.
 It occurs in longer periods during the first half of the night.
 Initial stage of deep sleep.
 Muscles completely relaxed.
 Your heartbeat and breathing slow to their lowest levels during sleep.
 Rarely movements.
Rapid eye movement (REM) sleep:
REM sleep first occurs about 90 minutes after falling asleep.
 Dreaming occurs in this stage.
 Eye moves rapidly, fluctuating heart and respiratory rate, increased or fluctuating blood pressure, loss of
skeleton muscles tone and increase of gastric secretion.
 Memory consolidation most likely requires both non-REM and REM sleep.

6. FUNCTIONS OF SLEEP
 Conservation of energy.
 Thermoregulation.
 Increase attention and creativity.
 Regulation of emotions- sleep deprivation causes emotional disorder like irritability, anxiety, depression
etc..
 Memory and learning.
Functions of sleep
Brain function and sleep
 Sleep plays an important role in the function of the brain,.
 Adequate sleep helps to improve memory and learning, increase attention and creativity, and aid in
making decisions.
 Lack of sleep is also associated with depression, suicide and risk-taking behavior.
FUNCTIONS OF SLEEP
Memory and sleep
 Sleep plays an essential role in the consolidation of memory and the selection of important information
and stimuli received throughout the day.

7. sleeping is thought to help clear out toxins that accumulate in the brain throughout normal daily activities
FUNCTION OF SLEEP
Physical Health and Sleep
 Sleep is also essential for the maintenance of the physical health of the body, particularly in the healing
and repair of cells.
 It also helps to maintain the balance of hormones in the body, such as ghrelin and lepton, which regulate
feelings of hunger .
 The processes of growth and development are also intricately involved with sleep. Deep sleep triggers the
release of growth-promoting hormones, which boost muscle mass and repair cells and tissues in the body.
 The immune system also relies on sufficient quantity and quality of sleep and deficiency in sleep is linked
to difficulty fighting infection and increased risk of sickness.
NORMAL SLEEP REQURIMENTS
FACTORS AFFECTING SLEEP
• Both the quality and quantity of sleep or affected by a number of factor.

8. • sleep quality is a subject of characteristic.
• quantity of sleep is a total time individual sleeps.
 AGE
 ILLNESS
• illness that caused mean a physical distress( E.g. Arthritis, back pain) can be result in sleep problems.
 Example:
• respiratory conditions .
• Pain.
• Need to urinate during night
FACTORS AFFECTING SLEEP
 ENVORIMENT:
• Environment can promote or hinder sleep
• Any change for example noise in the environment can inhibits sleep.
• The absence of usual stimuli or the presence of unfamiliar stimuli can prevent people from sleeping.
• Discomfort from environmental temperature (example to hot or cold )and lack of ventilation can affects
sleep.
FACTORS AFFECTING SLEEP
 Exercise and fatigue
 Excess fatigue resulting from exhausting or stressful exercise/work makes falling asleep difficult.
LIFESTYLE:
 Following and irregular morning and night time schedule can affect life.
 Night shift workers frequently obtain less sleep than other workers and have difficulty falling asleep.
FACTORS AFFECTING SLEEP
EMOTIONAL STRESS:
 Stress is considered to be the major cause of short term sleeping difficulties.
 a person preoccupied with personal problems (example school or job-related pressure family or marriage
problems) may be unable to relax sufficiently to get to sleep.
DRUG AND SUBSTANCES:

9.  Medications alter sleep and weaken day time alterness
SLEEP DISORER
 Depression :Feeling of sadness and loss of interest that disturb you doing your normal functioning.
 Anxiety: It is due to muscle tension and worried thoughts that increases blood pressure.
 Sleep apnea: It is a serious disorder that happens when a person breathing is interrupted during sleep.
People with untreated sleep apnea will stop breathing.
 Headache:Headache is a pain in any region of the head, it may occur one or both sides of head.
SLEEP DISORDER
There are many sleep disorder but we will discuss 3 types of disorder.
1. Insomnia.
2. Parasomnia.
3. Narcolepsy.
SLEEP DISORDER
 Insomnia refers to lack of sleep or reduction in sleeping or wakening at night during sleep. It can be
caused by stress and anxiety. It can be problematic for your overall health and quality of life. It causes
Depression, weight gain, impaired work .
Insomnia are of three types
1. Chronic: When insomnia happens as a regular basis for atleast one month.

10. 2. Intermittent :When it occurs periodically.
3. Transient : Insomnia that usually lasts less than a week and does not recure.
SLEEP DISORDER
➢ Treatment of insomnia:
Cognitive behavioral therapy for insomnia (CBTI)CBTI controls negative thoughts, reduce anxiety and depression.
Management of time for sleep.
Exercise with regular for 30 minutes.
➢ Effective Drugs:
Antidepressant and Triazolem.
SLEEP DISORDER
Parasomnia: It is a class of sleep disorders causing abnormal movement and behaviors during sleep. This include
sleep talking Groaning, Nightmare, teeth grinding and jaw clench.
 Parasomnia is due to undesirable thoughts due to sleep state instability .
➢ Treatment of parasomnia:
Avoid alcohols.
Topiramate.
Levodopa.
SLEEP DISORDER
Narcolepsy: Narcolepsy is a chronic sleep disorder characterized by overwhelming day time, drowsiness and
sudden attacks of sleep.
 Narcolepsy is due to lack of brain chemical called hypocretin.
 hypocretin also known as orexin. The deficiency is thought to be the result of immune system mistakenly
attacking parts of the brain that produces hypocretin.
➢ Treatment of narcolepsy: The use of drugs that make CNS active ,these drugs are the primary treatment
to help people with narcolepsy stay awake during day. It is also reduced by nutrition includes vitamin B
complex.
CONDITIONS NECESSARY TO PROMOTE SLEEP
 Listening to soothing music
 Finish eating at 2-3 hours prior to your regular bedtime

11.  Remove all distractions from the bedroom
 Sleep in a room that is dark, quiet, comfortable, and cool
 Sleep on a comfortable mattress and pillow
 Be consistent.
 Minimize light and sound. These two environmental factors can impact your quality and quantity of sleep.
 Exercise regularly
 A warm bath or shower
CONDITIONS NECESSARY TO PROMOTE SLEEP
• Stick to a sleep schedule.
• Pay attention to what you eat and drink. Don't go to bed hungry .
• Create a restful environment. Create a room that's ideal for sleeping.
• Limit daytime naps.
• Include physical activity in your daily routine.
• Manage worries.
NURSING PROCESS FOR A PATIENT TO PROMOTE SLEEP
SCENERIO: A 36-year-old male has been admitted to your medical surgical floor for 23-hour observation due to
exhaustion. The patient reports difficultly falling asleep and then staying asleep for the past 5 months. He states
that ever since he started his new job 5 months ago working the night shift he is getting less and less sleep. In
addition, he states that since his 5th child was born it is loud in his house and he can’t sleep when he gets home
from work. He states he is sometimes pulling 16 hours shifts straight and may be gets 3 hours of sleep before he
has to go back in. Pt admits to dozing off frequently especially on the job which is why he is came to the hospital
because he states he think he has “narcolepsy or something”. He also reports being very agitated at the slightest
things and that him and his wife have been fighting a lot. Pt states his wife says it is like his is a different person.
You note the patient looks very tired with dark circles underneath his eyes.