Content area
Full Text
Many people experience problems sleeping as they get older. Irene Gilsenan describes some practical strategies that nurses can use to help patients achieve a good night's rest in hospital
Abstract
Insomnia or disturbed sleep is experienced by many older people and has adverse effects on physical and psychological health. Nurses should be aware of insomnia and how they can help patients to get a good night's sleep. This article first examines normal sleep patterns and then insomnia. It discusses what nurses can do to assess sleep disturbances and suggests practical strategies to promote quality sleep in inpatients and care home residents.
Keywords
Insomnia, sleep assessment, sleep disturbances
WE SPEND around one third of our lives asleep (Hayter 1986, Humphries 2008, Patel et al 2008). Although its primary function is not known, sleep is considered to be vital for survival in humans (Patel et al 2008) and one that is necessary for fundamental health and social functions (Hodgson 1991, Humphries 2008). Sleep disturbances, whether in the hospital setting or in their own environment, can have severe consequences for people's health and wellbeing, such as risk of myocardial infarction, diabetes, fatal accidents at work, hormonal imbalances (Akerstedt and Nilsson 2003), obesity, cardiovascular morbidity and traffic accidents (Banks and Dinges 2007).
This article reviews literature on insomnia spanning the past 25 years, with particular reference to older people. An initial primary search of the CINAHL, MEDLINE and PubMed databases using the terms 'health promotion', 'sleep' and 'inpatients' uncovered much literature that was supplemented by secondary and manual searches as the review continued.
As well as older people, literature that focused on care of patients with cancer, post-operative patients, critically ill patients and pregnant women was included in the search because management strategies for those groups could be applied to care of older people.
Sleep disturbances other than insomnia are not discussed in this article because they are often long-standing conditions that require specialist assessment and treatment.
'Owl' or 'lark'?
It is recognised that sleep is crucial for our survival (Patel et al 2008). Sleep disturbances or insomnia can be defined as: 'Difficulty initiating or maintaining sleep, or sleep that is not refreshing or of poor quality with negative effect on daytime function' (Wade 2010). Insomnia can be...