Disturbed Sleep Pattern

Time-limited disruption of sleep (natural periodic suspension of consciousness)

Defining Characteristics:
  • Prolonged awakenings; 
  • sleep maintenance insomnia; 
  • self-induced impairment of normal pattern; 
  • sleep onset >30 minutes; 
  • early morning insomnia; 
  • awakening earlier or later than desired; 
  • verbal complaints of difficulty falling asleep; 
  • verbal complaints of not feeling well-rested; 
  • increased proportion of Stage 1 sleep; 
  • dissatisfaction with sleep; 
  • less than age-normed total sleep time; 
  • three or more nighttime awakenings; 
  • decreased proportion of Stages 3 and 4 sleep (e.g., hyporesponsiveness, excess sleepiness, decreased motivation); 
  • decreased proportion of REM sleep (e.g., REM rebound, hyperactivity, emotional lability, agitation and impulsivity, atypical polysomnographic features); 
  • decreased ability to function
Related Factors:
  • Ruminative presleep thoughts; 
  • daytime activity pattern; 
  • thinking about home; 
  • body temperature; 
  • temperament; 
  • dietary; 
  • childhood onset; 
  • inadequate sleep hygiene; 
  • sustained use of antisleep agents; 
  • circadian asynchrony;
  • frequently changing sleep-wake schedule; 
  • depression;
  • loneliness; 
  • frequent travel across time zones; 
  • daylight/darkness exposure; 
  • grief; anticipation; 
  • shift work; 
  • delayed or advanced sleep phase syndrome; 
  • loss of sleep partner, life change; 
  • preoccupation with trying to sleep; 
  • periodic gender-related hormonal shifts; 
  • biochemical agents; 
  • fear; 
  • separation from significant others; 
  • social schedule inconsistent with chronotype; 
  • aging-related sleep shifts; 
  • anxiety; 
  • medications; 
  • fear of insomnia; 
  • maladaptive conditioned wakefulness; 
  • fatigue; 
  • boredom
  • Environmental
  • Noise; unfamiliar sleep furnishings; ambient temperature, humidity; lighting; other-generated awakening; excessive stimulation; physical restraint; lack of sleep privacy/control; interruptions for therapeutics, monitoring, lab tests; sleep partner; noxious odors
  • Parental
  • Mother's sleep-wake pattern; parent-infant interaction; mother's emotional support
  • Physiological
  • Urinary urgency, incontinence; fever; nausea; stasis of secretions; shortness of breath; position; gastroesophageal reflux
NOC Outcomes (Nursing Outcomes Classification)

Suggested NOC Labels
  • Sleep
  • Rest
  • Well-Being
  • Psychosocial Adjustment: Life Change
  • Quality of Life
  • Pain Level
  • Comfort Level
Client Outcomes
  • Wakes up less frequently during night
  • Awakens refreshed and is not fatigued during day
  • Falls asleep without difficulty
  • Verbalizes plan to implement bedtime routines
NIC Interventions (Nursing Interventions Classification)

Suggested NIC Labels
  • Sleep Enhancement

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