In many nursing homes and assisted living communities, nighttime sleep disruption is a common occurrence. Whether because of conversations between staff, hall lights, alarms, staff waking residents to reposition them or change incontinence products, or other factors, it can be difficult for residents to get a good night’s sleep.
This year’s QCC (Quality Care Community) Conference engaged participants in a wide-ranging exploration of issues related to sleep. Our keynote speaker, Sue Ann Guildermann, RN and Director of Education for Empira, generously shared her wisdom and 30-plus years of experience in an enthusiastically received presentation titled “Restorative Sleep Vitality Program: A Key to Healthier and Safer Nursing Homes.”
Many factors impact our ability to experience restorative sleep. Here are some takeaways from the conferences that can be applied to your work with residents–and your personal life:
- The top five disturbances to sleep are noise, light, sleeping environment (surface, bedding and aroma), too many naps and administering medications that increase wakefulness at night, and/or administering meds that make people sleepy during the day.
- Adults require an average of 7 or 8 hours of uninterrupted sleep each night.
- Our sleep is done in 90- to 120-minute cycles. The brain and body experience different types of healing at different points in the sleep cycles. If our sleep is continuously interrupted so we cannot complete full sleep cycles, we will not feel truly rested even if we wind up sleeping for a total of 7 or 8 hours, or even longer.
- When adults do not get enough sleep, they can experience excessive tiredness, memory loss, decreased alertness and disorganization.
- Sleep deprivation is bad for your health. Effects include irritability, heightened risk of Type 2 Diabetes, heart disease, obesity and a shortened life span. “We have sleep-deprived people who have hallucinations,” Guildermann says. “Their immune systems are shot. They become irritable and hyper-reactive.”
- Sleep deprivation is also a leading risk factor in the falls that plague many nursing homes. “For the whole day, we see falls reduced if we take alarms off at night,” said Guildermann of a study she conducted on nursing home residents and sleep. “Why? Because they slept better.”
- It’s easy to avoid waking incontinent residents during the night for a change, Guildermann says: just push more liquids early in the day and don’t offer any after dinner.
- Our sleep-wake cycles are guided by our circadian rhythm, the body’s internal clock. Adults need 30 minutes of direct, full sunlight each day to set our circadian rhythms.
- The hormone melatonin helps us sleep and the biochemical serotonin helps us stay awake. Blue, violet, green light stimulates the production of serotonin and keeps us awake. Lights of this color—which include the screens of our TVs, phones, and other electronic devices—should be avoided within two hours of sleep. Red, amber, yellow lights are stimulate production of melatonin, calming to our brains and helping us sleep.
- We sleep better at night when we have been physically active during the day.
- The food we eat can impact the quality of our sleep. High-protein foods (yogurt, eggs, meat) and foods rich in vitamin B (brown rice, wheat germ, whole-grain cereals, yeast extracts) are best for staying awake. Foods high in carbohydrates and potassium support sleep.
- Aromas can also help wake us up in the morning or put us to sleep at night. Citrus is good for waking and lavender for sleeping.
- An afternoon nap can make us feel rejuvenated and energized, but it is important that it not last more than 30 or 40 minutes. Otherwise, it could make it more difficult to sleep at night.