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Symptoms

Sleep

SLEEP DISTURBANCE
This is a very common symptom and should be expected during the course of hospice care
Defined as change in sleep pattern: difficulty falling asleep, difficulty maintaining sleep, excess daytime
drowsiness

Common Causes

Pain

Shortness of breath

Anxiety

Depression

Restless legs

Excess caffeine, alcohol

Medication side effects

Disruption of prior routine/environment:
New bed

Different room

Excess noise, heat, light

What to do first

Ask about pain and give pain medication if present
Ask about excess anxiety and give anxiety medication if present
Avoid excess caffeine, stimulation prior to sleep
If appropriate, ask about comfort of new sleeping arrangement
If you are comfortable asking- “Is there something bothering you that you want to talk about”

Medications
A
Lorazepam is one of the core ‘comfort pack’ medications you received on day of admission to hospice.
Its purpose is to relieve anxiety and should be used as directed

B

Pain can be a common cause of disrupted sleep. Morphine (Opioid) medications are part of the core
‘comfort pack’ medications and should be used as directed if pain is present. Morphine (Opioids) can
also given for increasing shortness of breath

C
You are concerned about possible medication side effects
You would like to consider additional medications to help with sleep

What to discuss with Hospice

If any of the following are experienced, note them for the next visit from the Hospice Team.

A
Increasing distress from sleepless nights

B
You are concerned that a new problem has arisen causing the problem and need help treating

C
You are concerned about possible medication side effects
You would like to consider additional medications to help with sleep