Last updated on May 16th, 2022 at 07:15 pm
Impaired Sleep Pattern Nursing Care Plans Diagnosis and Interventions
Impaired Sleep Pattern NCLEX Review and Nursing Care Plans
Impaired Sleep Pattern is a nursing diagnosis which means that a person is not receiving enough sleep or has sleep disruption.
Most people have had the experience of not getting enough sleep as a result of a variety of causes and related circumstances.
This condition frequently occurs when someone has stayed out too late with friends, stayed up all night reading a book or watching a movie, and then has to go to work early the next day.
An impaired sleep pattern could also be linked to a medical condition like chronic pain, breathing problems, or cardiac problems, as well as a psychological condition like anxiety or depression.
Sleep deprivation can have a significant impact on a human’s body on several scales, as our bodies require sleep to rejuvenate, recover, and develop.
The body can’t function at its best if it doesn’t get enough sleep. Consider what would happen if this impaired sleep pattern persisted night after night with no relief. This type of impaired sleep pattern may necessitate nursing care and even medical intervention.
5 Stages of Sleep
Many individuals are familiar with the two types of sleep: rapid eye movement (REM) and non-rapid eye movement (non-REM). Most people are unaware, however, that non-REM sleep is divided into four stages that individuals cycle through during the night.
The number of hours spent in each of these stages, as well as the stage from which people awaken, can have a significant effect on how well people sleep and how much energy people have during the day. The five stages of sleep and their importance are outlined underneath.
- Stage 1 of non-REM sleep. This non-REM sleep stage marks the shift from wakefulness to sleep lasting only for a few minutes.The slow movement of the eyes behind the eyelid, as well as the relaxation of muscle movement and the slowing down of the heartbeat and breathing, are all signs of this condition. This is the lightest stage of sleep in which a person is likely still aware of some of the events around them and can be awakened by sounds or other disruptions.
- Stage 2 of non-REM sleep. This is the stage when individuals are completely sleeping and unaware of their surroundings, and it accounts for the majority of the entire sleep time. The heart rate and breathing decrease, the body temperature drops, and the eye movements slow or cease completely during stage 2.
- Stage 3 of non-REM sleep. In stage 3, brain waves slow down, with only a few periods of activity. This is the stage in which the muscles relax and the breathing slows even more. This stage of sleep is difficult to wake up from, and if an alarm or other disruption wakes someone up, he may feel disoriented.
- Stage 4 of non-REM sleep. This final stage of non-REM sleep is much deeper, with brain waves slowing even further and sleepers finding it difficult to wake up. Arousal from sleep is difficult at this stage, and the heartbeat and breathing are at their lowest. There are no eye movements, and the body is completely relaxed. It is also during this period that tissue repair and cell regeneration take place, as well as the immune system becoming tougher.
- Stage 5: REM sleep. REM sleep is the final stage of sleep, and it is during this cycle that individuals dream. During REM sleep, blood pressure and pulse rate rise, and the arms and legs become immobilized, preventing sleepers from acting out their dreams. This stage is believed to trigger the brain’s memory, as well as provide a means for the brain to retain and categorize information. REM sleep starts in around 90 minutes in the sleep cycle.
The duration of each cycle varies during the night, but the average sleeper will go through each stage repeatedly before waking up.
The deeper depths of sleep may not be reached as frequently as they should be for persons with sleep disorders, which can result in the body’s inability to repair the damage, fewer dreams, and increased exhaustion upon awakening all through the day.
Signs and Symptoms of Impaired Sleep Pattern
Signs and symptoms vary according to the severity and kind of sleep disorders which resulted in impaired sleep disorder. They may also differ if it is caused by other medical conditions. However, the following are some of the common signs of a sleep disorder and impaired sleep pattern.
- having trouble falling or staying asleep
- exhaustion during the day
- a great desire to rest during the day
- breathing patterns that are peculiar
- strange or uncomfortable movement while asleep or falling asleep
- alterations in sleep/wake routine that are not planned
- Anxious or easily irritated
- employment or school performance is negatively affected
- inability to concentrate
- increased in body weight
Types of Sleep Disorders
Most people have trouble sleeping from time to time attributable to stress, busy schedules, and other external factors. These concerns, on the other hand, may suggest a sleeping disorder if they occur regularly and interfere with everyday life.
Sleep disorders can sometimes be an indication of another medical or mental health problem. Once the underlying cause is identified and treated, the sleeping disturbances may disappear.
On the other hand, when a sleep issue is not caused by another medical issue, it is usually treated with a combination of medical interventions and lifestyle adjustments.
Below is a list of the different types of sleep disorders.
- Insomnia. It pertains to a person’s difficulty to fall or stay asleep. Jet lag, stress and anxiety, hormones, and gastrointestinal issues are all possible causes. It could also be a sign of something else. Insomnia can have a negative impact on a person’s physical health and wellbeing, leading to sadness, difficulties concentrating, irritability, weight gain, and poor performance at work or school. The condition is more prevalent in older persons and women, and it is very widespread.
Insomnia is usually divided into three categories:
- Chronic insomnia. It is defined as insomnia that occurs on a regular basis for at least one month.
- Intermittent insomnia. Types of insomnia that strike periodically.
- Transient insomnia. It is when the insomnia only takes a few nights at a time.
- Sleep Apnea. It’s a serious medical disorder marked by breathing pauses while sleeping. Sleep apnea involves a reduction in oxygen intake and might cause a person to wake up during the night.
Sleep apnea is divided into two categories.
- Obstructive sleep apnea, the flow of air is interrupted because the airway space is congested or too narrow
- Central sleep apnea, caused by the disturbance in the connection between the brain and the muscles that control the breathing
- Narcolepsy. Narcolepsy is a sleep disorder marked by excessive daytime sleepiness and sleep attacks. This implies that an individual will become incredibly exhausted and fall asleep unexpectedly. Sleep paralysis, which occurs when a person is physically unable to move after waking up, is another symptom of this condition. Narcolepsy makes it difficult for people to stay awake for lengthy periods of time, which can cause major disturbances in their everyday lives. Although narcolepsy can occur by itself, it is also connected to other neurological conditions including multiple sclerosis.
- Parasomnias. Sleepwalking, sleep talking, groaning, nightmares, bedwetting, and teeth grinding or jaw clenching are all characteristics of parasomnias, which are a group of sleep disorders that involve abnormal movements and activities during sleep.
- Restless leg syndrome. Restless leg syndrome (RLS) is characterized by a strong desire to move one’s legs when sleeping, which is occasionally accompanied by a tingling sensation. These symptoms are typical at night but may happen at any time of day. RLS is frequently linked to health issues such as attention deficit hyperactivity disorder (ADHD) and Parkinson’s disease, but the precise reason isn’t always understood.
Causes of Impaired Sleep Pattern
An impaired sleep pattern can be caused by a variety of circumstances, diseases, and disorders, and are frequently the outcome of an existing health concern.
- Chronic pain. It can be harder to fall asleep if someone is in constant pain. It has the potential to wake someone up even after they have fallen asleep. Arthritis, chronic fatigue syndrome, fibromyalgia, inflammatory bowel disease, persistent headaches, and severe back pain are some of the most frequent causes of chronic pain. Sleep disturbances can also increase chronic pain in some circumstances.
- Nocturia. Frequent urination can interrupt sleep by causing an individual to wake up during the night. Hormonal imbalances and urinary tract infections may play a role to the development of this disorder.
- Anxiety and Stress. Sleep quality is frequently affected by stress and anxiety. It can be challenging to fall asleep or stay asleep for some people having too much stress.
- Allergies and respiratory conditions. Having allergies, colds, and upper respiratory infections can contribute to sleeping disorders. Sleeping disturbances can also be caused by an inability to breathe through the nose.
- Environmental issues. Sleep disturbances can be caused by a variety of factors, including extreme weather/temperature, excessive noise, or too bright lighting.
Related Factors to Sleep Disorders
- Genetics. The majority of narcolepsy instances are sporadic, meaning they occur in people who have no family history of the illness. Although there is no apparent pattern of inheritance for the illness, a significant fraction of instances have been documented to run in families.
- Working at night. People who work at night commonly suffer from sleep difficulties because they are unable to fall asleep when they become sleepy. Their actions are in direct contrast to their biological clocks.
- Drugs. Several medications, including antidepressants, blood pressure medications, and over-the-counter cold medicine, can disrupt sleep.
- Old age. Sleep disorders affect around half of all persons over the age of 65. It’s unclear if this is a normal component of aging or the result of the medications that many older individuals take.
Treatment for Impaired Sleep Pattern
- Medical Interventions. Sleeping pills, melatonin supplements, allergy or cold medication, or other drugs for any underlying health conditions may be prescribed as a medical treatment for sleep disturbances. Depending on the specific sleep disorders a patient has, a physician may prescribe a breathing device or surgery, usually for sleep apnea, or a dental guard for teeth grinding.
- Lifestyle Modifications. Lifestyle changes, especially when combined with medical treatment, can significantly improve sleep quality. The following are a few points to consider in getting a good night’s sleep.
- Increasing the number of veggies and fish in the diet, as well as lowering overall sugar consumption
- Exercising and stretching can help to relieve stress and anxiety
- Establishing and maintaining a consistent sleeping routine
- Lesser fluid intake before going to bed
- Intake of caffeine should be limited, particularly in the late afternoon and evening.
- Reducing tobacco and alcohol consumption
- Before bedtime, eat smaller low-carbohydrate meals
- Keeping a healthy weight in accordance with the doctor’s advice
Impaired Sleep Pattern Nursing Diagnosis
Impaired Sleep Pattern Nursing Care Plan 1
Menopause
Nursing Diagnosis: Impaired Sleep Pattern related to discomfort secondary to the symptoms of menopause as evidenced by interrupted sleep, anxiety, and decreased rapid eye movement (REM) sleep.
Desired Outcome: The patient will be able to sleep soundly and express feelings of being well-rested.
| Nursing Interventions for Impaired Sleep Pattern | Rationale |
| Evaluate the patient’s sleep patterns and variations, naps, activity level, awakenings and frequency, and symptoms of sleep deprivation. | This data provides information on how to treat sleep deprivation as a result of age-related changes, as well as how to develop and implement a care plan. |
| Check the patient for any signs of pain or discomfort. | The understanding of the reasons that cause frequent awakenings aids in the adjustment of sleep habits. |
| Close the curtains and adjust the lights to create a calm, quiet environment for the patient. | It contributes to the creation of a sleep-friendly environment. Because sleep is normally of lower intensity in elderly patients, external stimuli may interfere with falling asleep and increase awakenings. |
| As directed, administer drugs to maintain normal sleep patterns. | Medications such as tranquilizers that lower anxiety or hypnotics that induce sleep may be necessary to obtain sleep while in the hospital. |
| Teach the patient to breathe slowly and deeply, as well as other relaxation strategies when a hot flash occurs. | Relaxation and deep breathing can help the patient cope with the pain of a hot flash. |
| Offer warm drinks, extra cover, and a warm bath prior to bedtime. | Ritualistic practices can help to keep established patterns intact while also providing comfort and relaxation before bedtime. |
| Ask the patient to avoid stimulants such as caffeinated drinks, stressful activities, and so on before going to sleep. | Overstimulation hinders the patient from sleeping. |
| Assist the patient with relaxation techniques such as guided visualization, muscular relaxation, and meditation. | Sleep is frequently aided by relaxation practices. |
Impaired Sleep Pattern Nursing Care Plan 2
Older Adult/ Geriatric Patient
Nursing Diagnosis: Impaired Sleep Pattern related to unfamiliar surroundings and hospital routines/interruptions secondary to old age as evidenced by complaints of difficulty falling asleep, and dissatisfaction with the quality of sleep.
Desired Outcome: The patient will verbalize fulfillment of adequate rest within 24 hours of interventions.
| Nursing Interventions for Impaired Sleep Pattern | Rationale |
| Gather information from the patient’s significant others or caretaker to assess and document the patient’s sleeping habits. | Old patients sleep less than they did when they were younger and are frequently awakened during the night. |
| Gather data on the activity level and nap time of the patient. | People who have a low level of activity and frequently nap only get 4 to 5 hours of sleep per night. |
| Schedule the activities such as vital signs taking, medicine administration, and toileting together. | This reduces the number of interruptions while also encouraging rest and sleep. |
| Instruct the patient not to drink caffeinated coffee, cola, or tea. | Increased alertness, sleeplessness, and frequent overnight urination are among the side effects of stimulants. |
| Reduce disturbances during sleep hours by creating a peaceful and quiet environment. | Sleep deprivation can be caused by bright lighting, needless noises, snoring roommates, and loud talking. White noise sound producers may help the patient sleep better. |
| Administer pain meds as directed, give a back rub, and have a pleasant discussion at bedtime. | These therapies improve sleep quality by promoting comfort. |
Impaired Sleep Pattern Nursing Care Plan 3
Ileostomy/Colostomy Patient
Nursing Diagnosis: Impaired Sleep Pattern related to psychological stress secondary to ostomy care as evidenced by complaints of interrupted sleep and feeling of tiredness.
Desired Outcome: The patient will sleep between disturbances and report an improved sense of well-being and feeling rested.
| Nursing Interventions for Impaired Sleep Pattern | Rationale |
| Explain why it is important to watch for intestinal function in the first few days after surgery. | If the patient is aware of the importance of treatment, he is more likely to stand hospital staff interruptions. |
| Provide the pouching system that is necessary, and empty the bag before bedtime, and on a predetermined frequency. | Possible leak is reduced by emptying the bag before sleep. |
| Assure the patient that his or her stoma will not be damaged while sleeping. | If the patient is comfortable with his stoma and ostomy function, he can sleep better. |
| Limit caffeine-containing foods and beverages | Caffeine can make it difficult for a patient to fall asleep and interfere with REM (rapid eye movement) sleep, leaving them feeling tired. |
| Encourage the continuity of bedtime rituals. | Relaxes the body of the patient and prepares it for sleep. |
| Find out what is causing the excessive flatus or effluent. If the patient is on a diet, talk to a dietician about food restrictions. | The identification of the problem allows for the implementation of corrective measures that may help the patient sleep or relax better. |
| As needed, give the patient analgesics and sedatives at bedtime. | Pain can make it difficult for a patient to fall or stay asleep. Taking medicine as soon as possible after surgery will help the patient rest and sleep better. Pain pathways are near the sleep region of the brain and affect waking up. |
Impaired Sleep Pattern Nursing Care Plan 4
Nursing Diagnosis: Impaired Sleep Pattern related to disease progression secondary to dementia as evidenced by interrupted sleep, waking up early, and difficulty getting a sleep.
Desired Outcome: The patient will attain and preserve soothing restful sleep.
| Nursing Interventions for Impaired Sleep Pattern | Rationale |
| Ascertain that the patient’s sleeping quarters are quiet, soothing, and pleasant. | Unpleasant surroundings make it difficult for a patient to fall asleep and may cause repeated awakenings. |
| Assist in routine activities such as a warm drink, extra and clean linens, or warm baths before going to sleep. | Prevents sleep disruption by promoting comfort and relaxation before going to bed. |
| Offer backrubs, music, and other relaxation techniques to the patient. | These activities reduce anxiety and tension while assisting in relaxing prior to sleep. Patients with Alzheimer’s disease also respond effectively to therapeutic touch. |
| Avoid situations that induce irritation, agitation, or sensory overload. | Allows the patient to cope with stimuli and avoids unpredictable reactions. |
| Advise the patient and his or her family about the patient’s and family’s plans for rest and activity throughout the day. | It encourages social contact and physical activity. |
| Guide the family on how to establish a regular bedtime routine. | Promotes sleep and aids in the prevention of sleep deprivation-related frustration and disorientation. |
Impaired Sleep Pattern Nursing Care Plan 5
Depression
Nursing Diagnosis: Impaired Sleep Pattern related to negative thoughts at night secondary to depression as evidenced by interrupted sleep, general tiredness, sleepiness during the day, and difficulty getting a sleep.
Desired Outcome: The patient will obtain sufficient sleep as evidenced by the absence of exhaustion, verbalization of feeling rested, and improvement in sleeping patterns.
| Nursing Interventions for Impaired Sleep Pattern | Rationale |
| Assess the patient’s understanding of the nature of sleep difficulties and possible solutions to help with treatment. | This information will be used to decide the best course of treatment. |
| Examine and analyze the timing and effects of any medications that may have an impact on sleep. | The patient’s sleeping pattern may be affected by drug schedules that demand a lot of supervision. |
| Inform the patient on healthy food and fluid intake, such as the importance of avoiding large meals, alcohol, caffeine, or smoking before night. | Having a heavy meal right before night can cause stomach distress and delay the onset of sleep, while caffeine-containing beverages such as coffee, tea, chocolate, and colas stimulate the neurological system which may make it difficult for the patient to relax and fall asleep. Alcohol, on the other hand, causes drowsiness and may help a person fall asleep faster, but it interferes with REM sleep. |
| Advise the patient to maintain a consistent daily rest and sleep pattern. | Regular routines help regulate the circadian rhythm and reduce the amount of energy required to adapt to shifts. |
| Encourage the patient to write a journal about his problems before going to bed. | Doing so allows the patient to put his problems aside and other mental activities before going to bed. |
| Make a recommendation for a relaxing setting. | Most people prefer to sleep in a cool, dark, and quiet atmosphere. |
Nursing References
Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. Buy on Amazon
Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon
Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier. Buy on Amazon
Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. Buy on Amazon
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