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Non-pharmacological treatment of hospital patients with sleeping problems - the nurse perspective Abstract., Background: Elderly patients suffer from sleep disturbances during hospitalization. These patients often receive hypnotics and sedatives; despite of the known risks and although non-pharmacological treatments are available., Aim: The study investigates the experiences of nurses when using non-pharmacological treatments for elderly patients with sleeping problems., Methods: Semi-structured interviews with 13 nurses from a general hospital were analyzed according to Mayring's qualitative content analysis., Results: Nurses used a variety of non-pharmacological treatments for elderly inpatients with sleeping problems: (1) structural measures (regulation of temperature and light), (2) organizational measures (more time for conversation during the nightshift), (3) nursing measures (asking about night-time routines) and (4) household remedies. From the nurses' perspective, the more intensive contact required when applying non-pharmacological treatments can lead to higher patient satisfaction and a lower bell frequency during the night shift. Barriers result from limited time and personnel, a lack of standards and individual patient needs., Conclusion: Nurses know several kinds of non-pharmacological treatments to help elderly inpatients sleep better. A lack of resources as well as a lack of professional consensus about the treatment of temporary sleeping disturbances can be an obstacle to their use. A professional climate should restrict the use of drugs for sleeping problems as far as possible.

Background: Sleep disorders are common among nursing home residents. However, the possible involvement of psychological factors has been given little attention up until now. We investigated nursing home residents' perspective on psychological factors and sleep disorders within the nursing home environment., Materials and Methods: We conducted a qualitative interview study comprising episodic interviews with 30 nursing home residents in five different nursing homes. The data was analysed by thematic coding., Results: Nursing home residents require peace of mind in order to sleep well. Ruminations and thoughts disturb inner peace and are, in turn, caused by psychological factors. Of particular relevance is the end-of-life situation of the residents. Nursing home residents possess only limited strategies to relax and achieve inner peace., Conclusion: Psychosocial factors play a central role in sleep disturbances among nursing home residents. Nurses and physicians who treat nursing home residents with sleep disorders should consider the possible psychosocial causes. Counselling and treatment should be given on an individual basis, for example by educating in relaxation techniques.

Sleep disorders in children are very common and their impact on emotional and cognitive functions is considerable. Various pathogenetic factors have to be considered, especially a disturbed sleep-wake rhythm but also organic or psychiatric causes. Symptoms and pathogenetic factors for sleep disorders in children are quite different from adults. In children especially parent-child interactional factors and developmental aspects of the sleep architecture have to be taken into account what necessitates a different diagnostic approach. This article describes systematically typical sleep disorders in children and gives practical advices for an anamnestic and diagnostic access to the subject.

Many mental and behavioural disorders during childhood and adolescence are associated with sleep difficulties. A polysomnography is seldom needed but indicated in following cases: In a general view when there is suspected obstructive sleep apnea syndrome (OSAS), excessive daytime sleepiness or suspected nocturnal seizures. Specific mental disorders with indication of polysomnography are: Diagnostic unclear and dangerous parasomnias, emotional disorders in case of differing sleep perception, Attention-deficit Hyperactivity Disorder (ADHD) and Tourette Syndrome with suspected (additional) OSAS, Restless Legs Syndrome (RLS) or Periodic Limb Movement Disorder (PLMD). Further indications are -therapy-resistant insomnia and sleep-wake-rhythm-disorders.

The objective of this article is to present a literature review of German and English literature concerning sleep disturbances of critically ill adults in intensive care units. It represents mainly nursing research-based studies which focused on characteristics and possible causes of sleep disturbances. The literature revealed that patients suffer from moderate to severe sleep deprivation characterized by a decrease of total sleep length and quality, and by sleep fragmentation. The causes are multifactorial. Nurses have an important role to play in recognizing and assessing factors that contribute to sleep deprivation and in intervening to reduce the effects of sleep deprivation. The research studies in this review represent the positivistic scientific perspective where sleep deprivation research has been objectified and controlled. A broader, more indepth understanding is needed, however, so that the subjective view of critically ill persons can be represented.