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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
- 55-year-old with BMI 38, snoring, daytime sleepiness, hypertension → Screen for OSA and facilitate sleep study
- Correct sleep hygiene teaching → Keep bedroom cool, dark, and quiet
- 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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