Sleep Deprivation

[gwenith, BSN, RN]

I had a case the other day. Little old lady on a looong wean off the ventilator. Hadn't been caring for her for a couple of days but she had been slowly improving. Night nurse hands over - "Had a dreadful shift patient did not sleep a wink - rational when spoken to - quiet for two minutes and then flailing arms around pulling at tubing which caused coughing = patient awake all night.

I asked the patient if she was cold - she nodded "yes" so I put a blanket on her - in two minutes she was sound asleep.

Now I know there are patients out there who only sleep during the day, or for the next shift at least, after giveing YOU a hard time but there are also some basic non-pharmaceutical methods to induce sleep.

I started this thread to get an exchange of ideas going on how you get sleep deprived patients off to sleep.

Here are some of my tips

1. Ensure they are comfortable and warm

2. "Relaxation" or "soothing" background music (drowns out ICU noise)

3. For those able to have oral intake - glass of milk

4. Move patient to a "Quiet" area in ICU (which is like trying to find a quiet spot in the middle of a busy freeway!)

5. Lights out as much as possible

6. When I have time I might try talking in a monotonous and quiet voice - as near "hypnotic" as you can manage repeating relaxation techniques.

My unit also likes to try to take the long termers outside to expose them to daylight to reset the pineal gland and re-establish sleep/wake cycles.