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Pain and Sleep (Unit 6) (Types of Pain (Acute (Pain < 3 months),…
Pain and Sleep
(Unit 6)
Types of Sleep
Rapid-Eye-Movement (REM)
Occurs every90 minutes
Lasts 5-30 minutes
Dream
Distinct eye movement
HR and resp. are often irregular
Gastric secretions increase
Non-Rapid-Eye-Movement (NREM)
Stage 1: very light, only a few minutes, HR and respiratory rate change minimally
Stage 2: eyes are generally still, HR and Resp. will decrease slightly, more intense stimuli to wake
Stage 3: Deepest stage, HR and resp. drop 20-30%, muscle relax, reflexes diminish, snoring occurs here, this stage helps restore energy and releases growth hormone
4-6 cycles per night
7-8 hours in a night
Sleep Disorders
Insomnia: inability to fall asleep or remain asleep
Hypersomnia: significant sleep at night, but can't stay awake during the day (not psychological)
Narcolepsy: day time sleepiness; falling asleep anywhere
Sleep apnea: stop breathing while asleep
Parasomnia: sleep walking, talking, etc.
Medical Treatments for Sleep
Encourage rituals
Sedative hypnotics (benzos and non-benzos)
Anti-anxiety medications
Types of Pain
Acute
Pain < 3 months
Chronic
Pain > 3 months
Neuropathic
Nerve Damage
Visceral
Coming from internal organs
Somatic
Superficial or deep, originate from bone, joint, muscle, skin, or connective tissue
Referred
starting somewhere and ending somewhere else
Pain Responses
Sympathetic
ACUTE pain: Increased HR, BP, Respiration, diaphorisis, dilated pupils, restlessness, anxiety, verbal, behavioral/non- verbal responses
Parasympathetic
CHRONIC pain: VS stable, skin warm/dry, no complaining, pupils are not dilated, depressed/withdrawn
Medical Management for Pain
Step 1:
Non-opioid
NSAID (Motrin)
Step 2:
Opioid mild to moderate +/- adjuvant
Norco
Step 3:
Moderate to Severe Pain
Opioid +/- adjuvant
Morphine, Dilaudid (6x more potent than morphine)-Narcan is the antidote
Adjuvant
Antidepressant
Steroid
Litoderm patch