130 likes | 142 Views
腫瘤病患睡眠障礙及評估工具介紹 市立萬芳醫院 湯梅芬護理長. Introduction. Sleep is an inevitable part of human existence and a part of the dynamic of quality of life. Introduction. Promotes health and comfort through its effects on • Tissue restoration • The immune system
E N D
腫瘤病患睡眠障礙及評估工具介紹 市立萬芳醫院 湯梅芬護理長
Introduction • Sleep is an inevitable part of human existence and a part of the dynamic of quality of life.
Introduction • Promotes health and comfort through its effects on • Tissue restoration • The immune system • Psychological functioning
Introduction • Sleep deprivation leads to • Increased fatigability, mood changes • Lowered the threshold for experiencing negative stimuli and feelings :pain tolerance
Normal Sleep • The sleep –wake cycle follows a circadian rhythm • Sensitive to the light-dark cycle and the pineal hormone melatonin
Factors Contributing to Sleep Disturbance • Environmental factors • Noise • bright lights • frequent nocturnal disturbances • hospital admission
Factors Contributing to Sleep Disturbance • Physical factors • Pain • Fatigue • medication • Respiratory disorders • Gastrointestinal disorders
Factors Contributing to Sleep Disturbance • Psychological factors •Depression • Anxiety • cognitive impairment disorders
Evaluation of Sleep Disturbance 1. Identify the primary complaint : insomnia, Excessive sleepiness, sleep-wake schedule disturbance 2. Characterize the complaint : chronic drowsiness, difficult initiating sleep, insufficient total sleep 3. Document the sleep-wake cycle : sleep logs, naps, activities, medications
Evaluation of Sleep Disturbance 4. Identify possible precipitants of disturbance information from patient and family members 5. Consider the particular sleep requirements of the patient : Variation in sleep habits with age and situation 6. Medical and neuropychiatric history : 7. Substance use : medication, alcohol, drugs, caffeine, nicotine
Measurements • Physiologic sleep assessment tools 1. Polysomnography : EEG, EOG, ECG, EMG 2. Multiple Sleep Latency Test (MSLT) : EEG, EOG, EMG 3. Maintenance of Wakefulness Test (MWT) : EEG, EOG, EMG
Measurements 4. Actigraphy : long-term movement detection(up to 2 weeks) 5. PSQI : 7 components, global PSQI score: 0-21 6. Epworth Sleepiness Scale(ESS) : 8 items ,range from 0-3
Thank you for Your Attention