Sunday, January 15, 2006

insomnia

Insomnia is the inability to sleep during the period when sleep should normally occur. It may vary in degree from restlessness or disturbed sleep to curtailment of the normal length of sleep or absolute wakefulness. The causes of insomnia are varied but some of the most common are anxiety, renal failure, drug-induced insomnia, physical discomfort, and physical inactivity. If insomnia is a result of anxiety, short-acting minor tranquilizers are usually very effective. They are used only for a relatively short period of time.
Urinary tract disturbances play a significant role in insomnia in the older person. Reduction of high levels of urea nitrogen and creatinine through lower intake of protein or dialysis bring sleep patterns more toward normal. Coffee, tea, and caffeinated soft drinks should be avoided after late afternoon and consumption of all liquids should be reduced in the evening.
Some patients may suffer insomnia as a result of being overmedicated. A review of the medications is indicated to be sure the dosages are within tolerance. Physical discomforts such as back or neck pain or being too hot or too cold will interrupt sleep. These patients could be given mild analgesics and attention should be directed to regulating temperature control in their rooms.
The elderly frequently take naps during the day. These should be limited so that sleeping at night is not affected. Physical activities may help eliminate insomnia.
Scherer, J. C. Introductory Medical-Surgical Nursing. 3rd ed. Philadelphia: J. B. Lippincott Co., 1982.
Steinberg, F. U. Care of the Geriatric Patient. 6th ed. St. Louis: C. V. Mosby Co., 1983.

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