Nurses & Sleep: A Good Fit
By Dr. Lucille C. Gambardella, PhD, APN-BC, CNE, ANEF
At some time in everyone’s life there is an occasion for interaction with a nurse. Perhaps it is while in a hospital having a tonsillectomy, or during elementary or secondary school years with the school nurse, or as an adult attending a health fair in the community, or maybe a neighbor or a family member is a nurse you often go to for health care advice. Let’s face it, nurses are the largest component of our health care system and are at the front line providing care, teaching, monitoring or evaluating the status of one’s health throughout the lifespan. Given that scenario, it is only logical to believe that nurses are an appropriate choice for educating patients about sleep hygiene.
Poor sleep can affect many of our body’s systems such as cardiovascular, respiratory, musculoskeletal, neurological, and endocrine. Poor sleep patterns or serious disorders such as obstructive sleep apnea or chronic insomnia can complicate diabetes, heart disease, COPD, pain management, and even pregnancy. Children with sleep problems are less attentive and productive in school and often display behavioral changes. In addition, poor sleep can create dangerous drowsy driving, workplace injuries, and other safety concerns in our communities.
Nurses are a part of every health care environment from the home to complex health care settings like intensive care units and emergency rooms. Opportunities are abundant to assess the sleep status of patients and to teach patients about sleep hygiene and methods of improving sleep. During physical assessment, which every nurse completes on every patient cared for regardless of setting, it is important for the nurse to ask the patient about their sleep status. Questions like: How many hours of sleep do you get each night? Do you wake up often during the night and can’t get back to sleep? Do you have trouble falling asleep? Do you snore? Do you have a sleep partner that snores and keeps you awake? Do you wake up still feeling tired or drowsy? Do you do shift work? All of these questions can provide the nurse with valuable information indicating a sleep problem that needs intervention or a referral to a sleep center for further screening and diagnosis.
Some of the key elements of good sleep hygiene include: 1) Establishing a sleep routine for going to bed and waking up at the same time daily; 2) Avoiding caffeine after 5pm each day; 3) Creating a bedroom or sleep environment that is relaxing, dark, quiet and conducive to sleep; 4) Turning off electronic equipment (TVs, computers) and cell phones at least one hour prior to sleep to allow for a decrease in the stimulation they provide; 5) Participating in a quiet activity such as reading or listening to soft music or “white noise” to encourage a calm atmosphere and; 6) Participating in sufficient day time activity and getting plenty of sunlight each day. The nurse can help the patient understand that utilizing these principles of sleep hygiene are preferred over the use of sleep medications that can be habit forming and/or cause unwanted side effects such as nightmares, a morning “hangover” and others. Nurses are also at the front line when teaching parents about a child’s sleep problems. The school nurse often has children come to the health office having fallen asleep in class because they have not slept the night before. If this is a pattern, the nurse can further assess such elements as “how the child gets ready for sleep,” “where the child sleeps,” and “how many hours does the child sleep.” The school nurse is in an ideal position to determine a plan of action to improve the child’s sleep habits, with parental input as appropriate.
About the author:
Lucille C. Gambardella is an expert nurse educator and advanced practice nurse with over 45 years of experience. Dr. Gambardella has presented both nationally and internationally for nursing education and practice, including completed research in the area of sleep education. She is both a certified nursed educator and clinical specialist in psychiatric/mental health nursing and has been honored in Delaware as a Nurse Educator of the Year and as the first Delaware Nurse Legend. Dr. Gambardella recently developed the Nursing Education Sleep Series (NESS) and NESS: In Practice, a 6-module self-paced online learning tool for nursing students and practicing nurses. This teaching tool is the first of its kind for preparing both nursing students and practicing nurses to assess, identify and implement care for patients experiencing sleep issues. Dr. Gambardella can be contacted at [email protected].
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