student question... are vital signs slower during sleep?...cont'd

RN92 · Sep 19, 2004

In deep sleep, it can be slightly different.There is no "set" number. Remember, everybody is different. Every situation is different. You cant base any decisions on it.

begalli · Sep 19, 2004

Hi mitchsmom,

Yes, generally speaking vital signs are slower when one sleeps. I have seen a wide range of changes in people's heart rate, respiratory rate, blood pressure, and temperature.

The most significant change I remember is a guy who when awake, his heart rate was in the 80-100 range. When asleep, his rate dropped into the high 50's. This was normal for him.

Our respiratory systems also slow. I've seen people drop as low as 6-8 breaths/min while asleep. Sleep apnea of course is another story.

Everyone is unique.

I work nights and I make many many decisions about the care I deliver based on my patients sleeping vital signs. There is no way I'm going to give a scheduled beta-blocker at midnight if my patient is asleep and their systolic pressure is not adequate or their heart rate is less than or equal to 60. I also titrate drips using the same principle. And give them blankets if they're cold!

Also, if I notice a rise in vitals when a patient is asleep, I suspect pain (the 5th vital sign) and investigate that further as well.

I tried to find a website for you to look at but gave up after a few minutes (I'm too lazy ).

Just remember than in general your body does slow down during sleep which means you will see a change in vital signs reflecting that slow down.

begalli · Sep 19, 2004

Here ya go, I did find a little something:

From http://www.findarticles.com/p/articles/mi_m0826/is_n4_v11/ai_17000747

"In slow-wave sleep, brain activity, heart rate, respiration, blood pressure, and metabolism (vital signs) slow down as a deep, restful state is reached. Sleep begins with NREM, during which brain waves gradually lengthen through four distinct stages.

Stage 1--characterized by lighter sleep, a slowing down of brain activity and vital signs with dreamlike thoughts.

Stage 2--characterized by slightly deeper sleep and slower vital signs.

Stages 3 and 4 (delta level)--characterized by deep sleep, depressed vital signs, and slow, low-frequency, high-amplitude brain activity known as delta waves."

mitchsmom · Sep 19, 2004

Thanks guys!

RN92 · Sep 21, 2004

I work nights and I make many many decisions about the care I deliver based on my patients sleeping vital signs.

Granted....but I understood the question to mean, do vs slow down with sleep, as opposed to rising or staying baseline. You cant say a pt is abnormal because their vs dont change. Isnt it strange how people can read the same paragraph but all get something different out of it.? :)

kathy_79 · Sep 21, 2004

i just had lecture today on it so what i learned is:

1.pre-sleep or sleepiness

2. NREM sleep (stage I )- eye roll slightly, muscle relax but tone is maintained, last about 10 min, respiration is even, pulse rate decrease, person see idle images,

3. NREM sleep (stage II) - loss of eye roll, person may awake easily and say she or he just was thinking or daydreaming

4. NREM sleep (stage III/IV) - more retorative, secretion of Growth Hormone and Serotonin, respiration is even, muscle relaxed, BP, Pulse, T, urine output and oxygen consumption decrease

5.REM sleep muscle flaccid, dreams occur, respiration is irregular, oxygen consumption, BP, cerebral blood flow, lady partsl secretion, erection in males, increase

thermoregulation is lost,

i hope it helps

good luck to you too, :)

zenman · Sep 21, 2004

Depends on what...or who you're dreaming about! :)