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Episode 12 – Sleep (Full)

Overview Full walkthrough of sleep physiology, stages, factors that disrupt sleep, major disorders (especially obstructive sleep apnea), assessment, and evidence-based nursing interventions in both community and hospital settings.

Key Topics Covered

  • Circadian rhythm and homeostatic sleep drive
  • NREM stages (N1, N2, N3) and REM sleep — functions of each
  • Age-related changes in sleep architecture
  • Factors affecting sleep (illness, meds, environment, lifestyle, stress)
  • Common disorders: insomnia, obstructive sleep apnea (OSA), narcolepsy, parasomnias, restless legs
  • Nursing assessment (sleep history, Epworth Sleepiness Scale, environmental review)
  • Hospital-specific strategies to protect sleep
  • Non-pharmacologic and pharmacologic approaches

Clinical Pearls

  • OSA risk factors: obesity, large neck, male sex, age, alcohol → screen and refer for sleep study
  • Hospitals are high-risk for sleep disruption — cluster care, dim lights, reduce noise
  • CBT-I is first-line for chronic insomnia (more effective long-term than meds)

NCLEX-Style Questions Reviewed

  1. 55-year-old with BMI 38, snoring, daytime sleepiness, hypertension → Screen for OSA and facilitate sleep study
  2. Correct sleep hygiene teaching → Keep bedroom cool, dark, and quiet
  3. Restless postop patient requesting sleeping pill at 2 a.m. → Assess pain and other discomforts first

Takeaway Sleep is a physiologic necessity, not a luxury. Protect it the same way you protect airway and skin integrity.

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