Sleep disorder

The Plan of Care for Sleep Disorders
Sleep disorder is a condition that is marked by trouble staying or falling asleep. The objective of this paper is to create a plan of care for sleep disorders of three patients. The first patient is an 18-year old college student residing far from home. The second patient is a 53-year-old menopausal woman and lastly, a 58-year-old obese truck driver. A sleep diary of the three patients is paramount to evaluate the nighttime signs of sleep disorders. In addition, the sleep diary assists in assessing the sleep behaviors and the progress in therapy (Manber & Carney, 2015).
An 18-year old college student suffers from sleep disturbances because of the change in the environment. A college student living far from home experiences much stress because he is responsible for self-care. The causes of sleep difficulties include use of stimulants, stress related to change in lifestyle, poor sleep hygiene and learning demands (Altevogt & Colten, 2006). In most cases, teenagers suffer from chronic sleep disorder. In this case, the goal of the care plan is to help the eighteen-year-old get adequate sleep. The nurse educates the patients on how to attain sleep hygiene. The patient is put on behavioral therapy to treat the disorder. He is advices to avoid activities that increase arousal before bedtime, for example, excessive caffeine, stimulating games and movies (Mattice, Brooks & Lee-Chiong, 2012).
A 53-year-old menopausal woman will likely suffer from insomnia sleep disorder. The lack of sleep is caused by mood disorders, incidents of obstructive sleep apnea and pain disorders. In addition, sleep is disrupted by hot flashes, movement disorders, and inadequate sleep hygiene. The plan of care is HRT therapeutic intervention. The treatment consists of medroxyprogesterone and oral conjugate equine estrogen (Attarian & Viola-Saltzman, 2013).
The 58-year old patient could be suffering from insomnia. In most cases, patients suffering from insomnia complain of fatigue. In addition, people with insomnia suffer from daytime impairments and trouble in performing simple tasks. Moreover, the individuals have poor memory and concentration (Manber & Carney, 2015). According to Antony & Barlow (2011), it is proven that obese men between the age of 30 and 60 years suffer from sleep apnea that include loud snoring (p. 650). The care plan goal for this patient is to reduce the weight because the obesity could be the one causing the sleep apnea. To achieve weight loss, a change in lifestyle and diet is necessary. The nurse educates the patient on physical activities and nutritional values. The patient ought to sleep in an upright position and stop smoking. He should also avoid sedatives and alcohol 4-6 hours before bedtime. In addition, he should avoid sleep withdraw. The patient is expected to follow the instructions while at home and visit the clinic for assessment after six weeks and three months thereafter (Buchwald, Cowan & Pories, 2007).
The difference between an 18-year old college student and 53-year-old menopausal woman is seen in various factors. For instance, the menopausal woman experiences a reduction in melatonin levels because of degenerating hypothalamic nuclei. In addition, a decrease in sleep homeostasis causes the sleep disorder in the menopausal woman. On the other hand, the young college student experience brief awakenings that happen in REM sleep transition. It caused by the protective mechanism to keep from awakening that reduces with age (Colten, Altevogt & Institute of Medicine, 2006).
The DOT guidelines direct the provider to examine for alcoholism, drug use, hearing, vision, mental disorders and epilepsy. In addition, a health profession should assess on vascular diseases, respiratory dysfunction, hypertension, cardiovascular and sleep-disordered breathing. The DOT recommends that a driver with excessive daytime somnolence is temporarily disqualified until successfully examined and treated (James, 2009).
References
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Antony, M. M., & Barlow, D. H. (2011). Handbook of assessment and treatment planning for
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Buchwald, H., Cowan, G. S. M., & Pories, W. J. (2007). Surgical management of obesity.
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Colten, H. R., Altevogt, B. M., & Institute of Medicine (États-Unis). (2006). Sleep disorders and
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James R. (2009, March). Quick Reference Guide For Dot Physical Examinations. Retrieved
March 7, 2015, from http://www. fapaonline. org/files/DOT_Guidelines. pdf
Manber, R., & Carney, C. (2015). Treatment plans and interventions for insomnia: A case
formulation approach.
Mattice, C., Brooks, R., & Lee-Chiong, T. L. (2012). Fundamentals of sleep technology.
Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health.