Fundamentals - Practice & Skills, part 7: Sleep, Sleep Disorders, and General Adaptation Syndrome

by Meris Shuwarger July 28, 2021 Updated: July 29, 2021

Full Transcript

Hi, I'm Meris, and in this video, I'm going to be talking to you about sleep basics, sleep disorders, and General Adaptation Syndrome. I'm going to be following along with our Fundamentals of Nursing flash cards. These are available on our website, If you already have a set for yourself, you can follow along. I'm starting on card 62. Let's get started.

Okay, so starting off, we're going to talk about the circadian rhythm. So you'll hear this thrown around a lot in nursing school. The circadian rhythm is the natural wake and sleep cycle of the human body. So this what regulates why we wake up in the morning and why we go to sleep at night. So this is affected by light exposure, your environment, your age, and things like illnesses or disease processes. So moving onto the stages of sleep. You'll see here, we have stage one through three. I would encourage you to look at these more in depth, but the ones that I really want to compare are going to be stage three and REM sleep. One through three are kind of just going from light to deeper sleep. But when you get to stage three, you're in very deep sleep, and the vital signs of your patient are at their lowest. So lowest vital signs in stage three, compared to when we are in REM sleep. That stands for rapid eye movement. This is going to be about 90 minutes after you fall asleep, you're going to be in REM sleep, and this is where you're going to actually see the eyes moving rapidly, rapid eye movement. But the thing to note here is that vital signs are going to increase. This is also the phase of sleep where vivid dreaming occurs. So we're going to have difficultly to wake in stage three and in REM sleep, but vital signs will go up in REM sleep versus going down in stage three. Also very vivid dreaming in REM sleep.

Okay, so moving onto sleep disorders. Now, let me tell you, as someone who struggles with a sleep disorder and has since I was six years old, it really, really impacts your patient's life, and it impacts their ability to recover from illnesses, and it impacts their ability to deal with pain and symptoms. So three big sleep disorders on here, and I would know them all. Insomnia, sleep apnea, and narcolepsy. So I am a lifelong insomniac. I have difficulty falling asleep, but some insomniacs can fall asleep okay, have difficulty staying asleep, or both. Narcolepsy, on the other hand, is going to be your patient with excessive daytime sleepiness, and they may be inadvertently falling asleep while they are awake. Now, sleep apnea, this is going to be a patient who stops breathing for a period of time during their sleep, and they may have kind of an irregular breathing pattern during sleep. So that is a very common one, and you'll see people using different devices to help them treat their sleep apnea, such as CPAP - continuous positive airway pressure - to help keep that airway open. Now, here's my least favorite thing because I am very, very bad at following this advice. Sleep hygiene. So this very important patient teaching for you to tell your patients how to get better sleep. So in this instance, I'm going to say, "Do as I say, not as I do," because I have terrible sleep hygiene. So the first is you want to follow a regular sleep schedule. Very important to maintain that regularity. Routine is important. You want to sleep in a cool, dark, and quiet environment. So cool temperature, very little light, very little noise, best for sleep. The other thing on here you're going to see is avoid naps in the afternoon. So when you're looking at those test questions, ask yourself, "Is this an early morning nap, or is this an afternoon nap?" Afternoon nap is going to delay my sleepiness in the future. I'm going to avoid alcohol and caffeine later in the day. For me, personally, I do have to avoid caffeine starting at about noon, or else I will be up all night. And then, exercise regularly, but there's a very important point on here. We don't exercise within three hours of bedtime. So exercise will help me sleep better, but not if it is within three hours of my bedtime. Okay, very important there. There's a few more, be sure to look them over.

Okay, now, we're going to talk about General Adaptation Syndrome, GAS. So this is the physiological changes that happen during periods of stress, like, I don't know, maybe nursing school. So the alarm reaction is going to happen first. Alarm first, right? Sound the alarm. This is going to be your fight or flight response, right? This is going to be my heart rate. My blood pressure is going to go up. My cortisol levels are going to go up. This is where I'm going to feel really panicked, and frenzied, and stressed, right? After that, I'm going to have the resistance phase. My body is going to get used to it. I'm going to be able to function again, right? My vital signs are going to normalize. My hormone levels might normalize some. But I may have some poor concentration, irritability, and frustration. I know we have all been there in nursing school. So I completely get it, and I feel like you completely get it too.

And then lastly, we have the exhaustion phase. Eventually, my body can't keep up anymore, right? Eventually, it's going to say, "I can't do this anymore," and we are going to tire out. And this is where we're going to have fatigue, and depression, anxiety, maybe even disease because we might have impaired immunity from that prolonged stress. So very important that you educate your patients on this, and how to mitigate their stress levels. How to bring down their stress levels so that they don't end up affecting themselves in that way. Okay, so that is it for basic sleep disorders and General Adaptation Syndrome. If that was a helpful review for you, please like this video, and I would love it if you leave a comment below, letting me know how you remember things or tell me about your experience when you have had nursing school stress. Did you reach the exhaustion phase? Or did you find a way to deal with your stress?

Okay, be sure to subscribe to the channel too because in my next video, we are going to be covering some really important stuff, like types of comfort care, the difference between hospice and palliative care. We're also going to talk about the stages and types of grief. So be sure to subscribe so that you're the first to know. Thanks so much and happy studying. Okay, all right. I can dig it. I'm very cool and hip with the kids, as you can tell.

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