Comfort promotion: Promoting rest and sleep

As a nursing assistant, one of your most important tasks is to ensure your clients are resting properly and having high-quality sleep.

That’s because insufficient rest and sleep can take a huge toll on your clients’ physical and emotional health. For example, poor sleep reduces their pain tolerance and makes them more susceptible to infections, heart problems, and diabetes.

These clients can end up feeling really tired during the day which can make physical activities like walking down the hall more challenging and dangerous, with clients being more likely to sustain a fall injury.

Often, the fatigue can also lead to irritability and difficulty focusing, present challenges remembering and processing information, and can worsen feelings of depression and anxiety.Now, the approximate amount of sleep needed in a 24-hour period varies greatly according to the client’s age group.

The older they are, the less sleep they need. So, newborns might get up to 17 hours of sleep per day, whereas, for adults, the recommended sleep range is typically 7 to 9 hours.

For older adults, it might be a bit more difficult to achieve this many hours of sleep without interruption through the night which is why naps during the day may help.Poor sleep duration or quality is usually caused by factors that interrupt the sleep cycle, which is a period of sleep that lasts about 90 minutes, during which we move through five stages.

Over the course of the night, there are four or five sleep cycles. The first four stages make up non-rapid eye movement, or NREM sleep, which is roughly 80% of the sleep cycle, while the fifth part is rapid eye movement, or REM sleep, which accounts for the last 20% of the sleep cycle.

Across the four stages of NREM, we move from very light sleep during Stage 1 to very deep sleep in Stage 4. During NREM there’s minimal muscle activity, and our eyes don’t move much.

During REM sleep, the eyes dart around, and this is where dreaming occurs, memories are consolidated, and we get the most rest.

Several factors can contribute to poor sleep duration or quality. Starting with environmental factors, which are probably the most common ones, these include any change in the client’s usual environment from lighting and noises to bed and pillows.

Often, inadequate sleep might be a result of various stressors related to their health condition, financial hardships, or being apart from their loved ones.

It can also accompany lung diseases with difficulty breathing, kidney or bladder problems with increased frequency of urination, and a whole variety of conditions that might cause pain.Okay, when sleep problems become a regular occurrence and interfere with daily life, that’s a sign of a sleep disorder: the most common of which are insomnia and sleep apnea.

In insomnia, clients have a hard time falling asleep or wake up throughout the night and can’t go back to sleep. It’s important to find out the cause.

Occasionally, medications can be used to treat this disorder, but they are generally used only for a short period of time because these can often have side effects, like making the client dizzy or lightheaded and thus more prone to falls.The next sleep disorder is sleep apnea.

This is characterized by irregular breathing and snoring patterns that can ultimately cause sleep apnea which is when the client momentarily stops breathing altogether.

There are numerous types of sleep apnea, the most common one of which is obstructive sleep apnea. This develops when there’s a blockage of the airways by things like swollen adenoid glands, or tonsils, or the back of the tongue.

Overweight clients are most commonly affected by sleep apnea. That’s because too much weight in the soft tissues of the neck can weigh down the airway, especially when a person is lying down, making it more likely to get a bit squashed or obstructed during the night.

The most common symptom of sleep apnea is severe sleep deprivation, resulting in daytime drowsiness, difficulty concentrating, headaches, and fatigue.

Sleep apnea episodes are usually preceded by loud snoring which can interrupt the sleep of other people as well. Managing sleep apnea starts with losing the excess weight and avoiding things like sleeping pills and alcohol because they can relax the throat muscles around the airway and make the airways more likely to collapse during sleep.

However, many clients benefit from the use of a continuous positive airway pressure device, or a CPAP device for short. This machine forces the airways open with a steady stream of pressurized air delivered through a face mask, nasal prongs, or helmet.When assisting clients with getting proper rest and sleep, there are some general considerations to keep in mind.

First of all, encourage them to go to sleep and wake up at approximately the same time every day; reduce alcohol and caffeine intake, especially in the evening; avoid long daytime naps; and get plenty of daily physical activity if possible.

Keep in mind that exercise should be avoided late in the evening. Establish a pre-bedtime routine which may include helping the client with elimination and personal hygiene, like brushing teeth or having a soothing bath; serving a light snack; and encouraging activities they enjoy, like reading a book or listening to music that the client likes.

Ensure that the sleep environment is calm, quiet, cool, and dark and that there isn’t anything agitating them or causing stress.

Help them assume a proper sleep position. Finally, it’s also important to minimize interruptions while they sleep or nap, if possible.

There are a few things you should report to the nurse right away, such as when you notice that the client can’t seem to fall asleep or wakes up regularly through the night or if they get up frequently to urinate.

Do the same if they seem upset or worried; express any pain or discomfort; or complain about having trouble falling or staying asleep, especially due to an environmental factor like excess noise or light.

Make sure you also report any daytime sleepiness or fatigue.Alright, as a quick recap... Proper rest and sleep are essential for the client’s physical and mental health.

The amount of sleep recommended for a client decreases with age. Factors that may contribute to poor sleep include environmental ones, like noises or bright lights; physical conditions, like those causing pain; stress; and sleep disorders, such as insomnia and sleep apnea.

To assist a client with better sleep and rest, set up a relaxing pre-bedtime routine, ensure a proper sleep environment, assist them into a comfortable position when they’re in bed, and try not to disrupt their rest.

Finally, report any unusual observations to