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Aktivitas dan Istirahat

Raisa Farida Kafil


http://chinmay.tumblr.com/
Istirahat

 Saat seseorang beristirahat biasanya merasakan


mentalnya juga dalam kondisi rilex
 Istirahat tidak identik dengan tidak beraktivitas
 Tergantung masing-masing individu : membaca buku,
praktik relaksasi, atau jalan-jalan santai
Tidur
 Ketika seseorang tidur, ia akan merasa energi tubuh
tersimpan
 Para ahli juga menyatakan bahwa selain penyimpanan
energi pada saat tidur juga terjadi pemulihan dan
perbaikan sistem tubuh.
 Sehingga pada saat terbangun menjadi lebih segar, lebih
sehat dan sangat nyaman
 Restorasi aktif (fisik
& mental)
 Usia dengan kecepatan
metabolisme tinggi atau masa
berkembang butuh > banyak
• During sleep protein
synthesis occurs, restoring
the muscles ofthe body
• It is viewed as an electric milk
float, it recharges overnight.

 Adaptif
 Fungsi tidur  Jumlah tidur tergantung pada
kebutuhan
 Dibutuhkan untuk keselamatan
Fisiologi tidur
 Aktivitas tidur diatur dan dikontrol oleh dua system pada
batang otak,yaitu Reticular Activating System (RAS) dan
Bulbar Synchronizing Region(BSR). RAS di bagian atas
batang otak diyakini memiliki sel-sel khusus yang dapat
mempertahankan kewaspadaan dan kesadaran, memberi
stimulus visual, pendengaran, nyeri, dan sensori raba,serta
emosi dan proses berfikir. Pada saat sadar, RAS melepaskan
katekolamin,sedangkan pada saat tidur terjadi pelepasan
serum serotonin dari BSR
Regulasi tidur
 Regulasi dan kontrol berdasarkan hubungan antara 2
mekanisme antagonis di otak:
 SAR (Sistem Aktivasi Retikular)
 Berlokasi batang otak teratas: mempertahankan kewaspadaan
& terjaga.
 SAR menerima stimulus sensori visual, auditori, nyeri,dan
taktil. Saat terbangun mrp hasil dari neuron dlm SAR yg
mengeluarkan katekolamin
 BSR (Bulbar Synchronizing Region)
 Mengambil alih yang menyebabkan tidur. Disebabkan oleh
pelepasan serum serotonin.
Irama sirkadian (siklus 24 jam)
 Suprachiasmatic nucleus
of hypothalamus
 Control the timing of
sleep
 Biological Time Clock
and Circadian Rhythms

 The Drive to Sleep is


Regulated by Biology
The term circadian rhythm refers to a person's internal sleep and
wake-related rhythms that occur throughout a 24-hour period.
The sleep-wake cycle is dictated by an inherent biological clock or
circadian rhythm. Disruptions in individual sleep patterns can
disrupt the circadian rhythm and impair the sleep cycle.
Why Do We Feel Sleepy?
The 2-Process Model

2 processes combined determine sleep propensity


and the duration of sleep
 Homeostatic sleep drive (S Factor)
• Process driven by amount of time awake
• Linear and cumulative—one gets progressively more
tired with each passing hour (―sleep load‖increases)
 Circadian rhythm (C Factor)
• Process driven by biological clock (time of day)
• Cyclical—periods of sleepiness occur at roughly the
same times each day
Brain Waves
 Normal brain function involves continuous electrical activity
 An electroencephalogram (EEG) records this activity
 Patterns of neuronal electrical activity recorded are called
brain waves
 Each person’s brain waves are unique
Types of Brain Waves

 Alpha waves – low-amplitude, slow, synchronous waves indicating


an ―idling‖brain
 Beta waves – rhythmic, more irregular waves occurring during the
awake and mentally alert state
 Theta waves – more irregular than alpha waves; common in
children but abnormal in adults
 Delta waves – high-amplitude waves seen in deep sleep and when
RAS is damped
Types of Brain Waves

Figure 12.20b
Brain Waves: State of the Brain

 Brain waves change with age, sensory stimuli, brain disease,


and the chemical state of the body
 EEGs can be used to diagnose and localize brain lesions,
tumors, infarcts, infections, abscesses, and epilepticlesions
 A flat EEG (no electrical activity) is clinical evidence of
death
Types of Sleep
 The stages of sleep occur in a repeated pattern or cycle of NREM
followed by REM, with each cycle lasting approximately 90 minutes.
 The sleep cycle is repeated four to six times during a 7- to 8-hour
sleep period.
 There are two major types of sleep:
 Non-rapid eye movement (NREM)
 Rapid eye movement (REM)
 One passes through four stages of NREM during the first 30-45
minutes of sleep
 REM sleep occurs after the fourth NREM stage has been achieved
Types and Stages of Sleep: NREM
 NREM stages include:
 Stage 1 – eyes are closed and relaxation begins; the EEG shows alpha
waves; one can be easily aroused
 Stage 2 – EEG pattern is irregular with sleep spindles (high-voltage
wave bursts); arousal is more difficult
 Stage 3 – sleep deepens; theta and delta waves appear; vital signs decline
 Stage 4 – EEG pattern is dominated by delta waves; skeletal muscles are
relaxed; arousal is difficult
Types and Stages of Sleep: REM

 REM sleep is characterized by


 EEG pattern reverts through the NREM stages to the stage 1 pattern
 Vital signs increase
 Skeletal muscles (except ocular muscles) are inhibited
 Most dreaming takes place
Sleep Cycle
Sleep requirements and pattern
 8 hours of sleeps every night has been the accepted standard
 Despite variations, some generalities can be state.On
average :
 Infant 14 to 20 hours each day
 Children 10-14 hours each day
 Adult 7-9 hours each day although a 4-hour range has been
observed in many normal adult
Factor affecting Sleep
1. Developmental consideration
DEVELOPMENTAL CONSIDERATIONS

 Newborn and Infant


 Sleep cycle shorter
 REM is higher
 Must establish sleep pattern with environment
 4-5 sleep periods at 3 months
 Decrease to 3 at 6 months
 Sleep time 14-17 hours per day
 Toddler and Pre-school

 1-2 Naps per day


 Some sleep disturbance probably from rapid
developing mental ability
 Getting them to sleep is the biggest problem
 2 yrs-14 hours
 5 yrs- 12 hours
CHILD AND ADOLESCENT
 Adolescent require more sleep because of slowly developing
cardiac and respiration systems which causes fatigue from
inadequate oxygenation
 Sleep and Rest patterns fluctuate
ADULT AND OLDER ADULT

 Breast feeding Mothers require adequate sleep to increase secretion of prolactin


 Adults vary in hours required-dependent on the person-can be as little as 5-7
hours
 REM becomes more even Naps and bed-times increase as we age and we have a
tendency to go to bed earlier and rise earlier
Factor affecting Sleep
2. Physical activity
 Activity and exercise influence sleep by increasing fatigue
Factor affecting Sleep
3. Psychology stress
 Illness and stress in daily living that cause psychologyc stress to
disturb sleep
 Generally psychologyc stress effects sleep in two ways :
 The person experiencing stress tend to find it difficult to obtain the
amount of sleep he or she needs
 REM sleep decreases in amount, which tens to add to anxiety and stress
Factor affecting Sleep
4. Motivation
 A desire to be awake and alert helps overcome sleepiness and
sleep.
 Contoh: Jika seseorang karena lelah enggan untuk bangun dari
tidurnya maka rasa mengantuk dan tidur juga akan
menyesuaikan.Tetapi jika seseorang ingin bangun untuk tujuan
tertentu biasanya juga rasa mengantuk dan tidur juga akan
menyesuaikan
Factor affecting Sleep
5. Cultural Implication
 Bedtime ritual
 Sleeping place
 Pattern of sleep may vary according to culture (herbal tea,
sleeping medication to promote relaxation and sleep)
 Cultural orientation (privacy and quiet)
Factor affecting Sleep
6. Diet
 Dietary amino acid L-triptophan act to promote sleep
 A small protein snack before bedtime was frequently
recommended to client with insomnia
 Protein may actually increase brain energy alertness and
concentration, while carbohydrates appear to have an effect on
brain serotonin levels and promote feelings of calmness and
relaxation
Factor affecting Sleep
7. Alcohol intake
 Alcoholic beverages seem to induce sleep in some people
 Large quantities have found to limit REM and delta sleep
Factor affecting Sleep
8. Caffeine containing beverage
 Caffeine is a central nervous system stimulant
 Coffee, tea, most cola drink,chocolate
Factor affecting Sleep
9. Smoking
 Smoking has stimulating effect an smoker usually have more
difficult time falling a sleep.
Factor affecting Sleep
10. Environment factors
 Most people sleep best in their usual home environments
 Sleeping in a strange or new environment tends to influence
both REM and NREM sleep for most
Factor affecting Sleep
11. Lifestyle
 Various lifestyles affect the ability to sleep well
 Shift work
 Excessive exercise
Factor affecting Sleep
12. Illness
 Illness acts as a physiologic and psychological stressor and as
result, influences sleep
 Gastric secretion increased
 The pain associated with diseases of the coronary arteries and
the occurrence myocardial infarct
Factor affecting Sleep
13. Medication
 Sleep quality is also influenced by certain drugs
 Drugs that decreased REM sleep are barbiturates, amphetamines,and
antidepressant
 Drugs that causes of sleep interference are diuretic, anti Parkinson, some
antidepressant, anti hypertension, steroid, decongestants, caffeine, and
asthma medication
 Drug that influence the quality of sleeps least and promote normal sleep are
chloral hydrate, zolpidem tartrate (Ambien)
FACTORS AFFECTING SLEEP others

 Need  Relationships
 Fluctuates according to individual,  Parenting
development and situation  Disruptions
 Develop own pattern  Bereavement

 Environment  Security Needs

 Noise-Light-Temperature  Nutrition-Metabolism
 ShiftWork  Hunger

 Changes in schedule  Foods containing


 Rhythm disturbed L-tryptophan help sleep (beef,milk,
eggs)
FACTORS AFFECTING SLEEP others
 Elimination Patterns
 Lifestyle – Habits
 Need to void
 Bedtime rituals
 Limiting fluid intake  Regular time for rising
 Vigilance  Illness
 Perceived need to hear such as for  Acute-chronic-causes loss of sleep
babies.  Medication-Chemicals
 Exercise-Thermoregulation  Alcohol, hypnotics induce Caffeine
delays
 Habitual contributes to deeper-longer
sleep  Mood Status-Anxiety
 Sauna-Increases sleep
TERIMAKASIH SELAMAT BELAJAR