-

SLEEP DISORDERS
INTRODUCTION
Reference to ICD 10 classification of mental and behavioural disorders Geneva 1992 Oxford University Press Dehi Bonbay Calcultta Madras Non-Organic Sleep disorders are group of disorders which includes:-
a.      Dysomnias: Primarily psychogenic conditions in which the predominant disturbance is the amount, quality or timing of sleep due to emotional causes i.e insomnia, hypersomnia and disorder of sleep –wake

b.     Parasomnias: Abnormal episodic events occurring during sleep in childhood these are related mainly to the child’s development while in adulthood they are predominantly psychogenic i.e sleepwalking, sleep terrors and nightmares.

DEFINITION
Sleep disorder simply means disturbance of sleep or inability to attain sleep naturally to the number of hours scientifically agreed upon which is between 7-8 hours for adult and 6-9 hours for children in 24 hours.

CAUSES/PREDISPOSING/PRECIPITATING FACTORS
1.     Weather Condition: Hot or hermarthan
2.     State of Health of an individual – Pains
3.     Environmental conditions- Noise, smoke
4.     Psychological – Fear of unknown, rumors of war, type of occupation, facing examinations, pre-marriage preparations, depression, anxiety, disappointment, death of loved one, unemployment, loss of job.
5.     Stress, business failure
6.     Disease conditions- any feverish painful conditions i.e malaria, typhoid, cancer, diabetes etc.
7.     Individual lifestyle- alcoholism
8.     Antenatal and post natal stage of women.

TYPES
1.     Non-organic sleep disorder:
This happen without any medical condition a situation when one is not satisfy with the quality or quantity of ones sleep may be due to increase life-stress, psychologically disturbed common among women

2.      Non –Organic Hypersomnia:
Is a condition of either excessive daytime sleepless and  sleep attack this condition usually associated with mental disorder it is often found to be a symptom of a bipolar affective disorder currently depressed.

3.     Sleep Walking:
Is a state of altered consciousness in which phenomena of sleep and wakefulness are combined during a sleepwalking episode the individual arises from bed, usually during the first third of nocturnal sleep and walks about. A sleep walker will sometimes leave the bedroom and at times may actually walkout of house thus exposed to risks of injury during the episode

4.     Sleep terrors (night terrors)
Sleep terrors and sleep walking are closely related genetic development. Sleep terrors are nocturnal episode of extreme terror and panic associated with intense vocalization, motility and high levels of autonomic discharge. The individual sits up or gets up with a panicky scream, usually during the first third of nocturnal sleep often rushing to the door as if trying to escape. Upon awaking there is usually no recollection of the episode.

5.     Nightmares
Nightmares are dream experiences loaded with anxiety or fear of which the individual has very detailed recall. The dream experiences are extremely vivid and usually include themes involving threats to survival, security or self-esteem. Upon awaking the individual rapidly becomes alert and orientated.

6.     Sleep wake
This disorder may be either Psychogenic or of organic origin, depending on the relative contribution of psychological or organic factors. Individuals with disorganized and variable sleeping and waking times most common among psychiatric conditions such as personality disorders and affective disorders. In individuals who frequently change work shifts or travel across time zones.

SIGNS AND SYMPTOMS
1.     Restless
2.     Anxiety
3.     Weak
4.     Lose of Energy
5.     Lose of Memory
6.     High blood pressure
7.     Palpitation
8.     Confusion
9.     Irritable
10.  Weight lose
11. Irrational behaviour
12. Feeling tense
13. Worried
14.  Headache
15.  Dizziness
16. Hallucinations- visual or auditory
17. Persecutory delusion

COMPLICATIONS
•      Lose of weight
•      Hypertension
•      Depression
•      Injury
•      Fainting
•      Dizziness
•      Loss of friends
•      Heart Attack
•      Dehydration
•      Congestive Cardiac Failure

a.     Management (Nursing)
1.     Admission
2.     Counseling
3.     Reassure
4.     Psychotherapy
5.     Diversional Therapy i.e Recreation
6.     Observe vital signs
7.     Family therapy
8.     Health education
9.     Social – Integration
10.  Occupational Therapy
11.   Order Laboratory investigation
12.    Open sleep pattern chart
13.     Suicidal caution chart
14.     Weigh patient daily or regularly
15.     Close Observation
16.     Improve patient diet
17.     Increase fluid intake
18.    Give warm bath to bed/ Beverage intake.

b.    Medication
•      Prescribe mild neuroleptic i.e tab Diazepan 5mg- 0-10mg nocte

PREVENTIVE MEASURES
1.     Proper Health Education on Physiology of sleep
2.     Room arrangement, well lay bed
3.     Importance of well ventilated room
4.     Avoidance of nose or smokes
5.      Avoid watching terrify films
6.     Taking dinner earlier before going to bed
7.     Avoid intake of too much water at night
8.     Change occupation if necessary
9.     Avoid alcohol intake and other substance
10. Afford moderate lifestyle Take light diet to bed
11.   Shower with warm  water and take a cup of beverage
12.  Use dim light in your bedroom
13.   Never bottle things in mind always ventilated your mind
14.   Make peace with your Neighbour
15.   Maintain personal and environmental hygiene
16.   Report any signs or symptoms on time to the hospital
17.   Avoid self-medications
18.   Know the friends you are moving  with
19.   Allay patient fears


Comments

Post a Comment

Popular posts from this blog

ANATOMY OF THE EYE

-
Image
Special senses  [ EYE] These are organs in the body that performs specialised functions. They contain sensory receptors which receives sensory impulses and pass them to the appropriate centers in the brain for interpretation.   ➡️ Types of Sensory Receptors - based on the type of stimuli they detect: 1. Mechanoreceptors - pressure receptors, stretch receptors, and specialized mechanoreceptors involved  in movement and balance.  2. Thermoreceptors - skin and viscera, respond to both external and internal temperature.  3. Pain receptors - stimulated by lack of O2, chemicals released from damaged cells and inflammatory  cells.  4. Chemoreceptors - detect changes in levels of O2, CO2, and H+ ions (pH) as well as chemicals that  stimulate taste and smell receptors  5. Photoreceptors - stimulated by light ➡️ Distribution of Receptors in the body: Special Senses • mediated by relatively complex sense organs of the head, innervated by cranial ...
Read more

VENTRICLES OF THE BRAIN

-
Image
 The ventricular system is a set of communicating cavities within the brain. These structures are responsible for the production, transport and removal of cerebrospinal fluid, which bathes the central nervous system. FUNCTIONS OF CEREBROSPINAL FLUID  Cerebrospinal fluid is an ultrafiltrate of plasma that surrounds the brain and spinal cord. It serves three main functions : ➡️ Protection : acts as a cushion for the brain, limiting neural damage in cranial injuries. ➡️Buoyancy : by being immersed in CSF, the net weight of the brain is reduced to approximately 25 grams. This prevents excessive pressure on the base of the brain. ➡️Chemical stability : the CSF creates an environment to allow for proper functioning of the brain, e.g. maintaining low extracellular K+ for synaptic transmission. VENTRICLES OF THE BRAIN  The ventricles are structures that produce cerebrospinal fluid, and transport it around the cranial cavity. They are lined by ependymal cells, which fo...
Read more

FLORENCE NIGHTINGALE

-
Image
Born: May 12, 1820 Florence, Italy Died: August 13, 1910 London, England English nurse The English nurse Florence Nightingale was the founder of modern nursing and made outstanding contributions to the knowledge and improvement of public health. EARLY YEARS AND STUDY  Florence Nightingale was born in Florence, Italy, on May 12, 1820; she was named after the city of her birth. Her father, William E. Nightingale , was a wealthy landowner who had inherited an estate in Derbyshire, England. Like many members of the wealthy class, he and Florence's mother, Fanny , dedicated themselves to the pursuit of active social lives. Florence and her sister, Parthenope , were tutored by their father in languages, mathematics, and history. Though Florence was tempted by the idea of a brilliant social life and marriage, she also wanted to achieve independence, importance in some field of activity, and obedience to God through service to society. In 1844 Nightingale decided that she want...
Read more