March 2021 • Volume 15, No. 3
From the Editor
It is a common experience that a problem difficult at night is resolved in the morning after the committee of sleep has worked on it.
~ John Steinbeck
Everybody knows that sleep is the great healer—vital not only for healing from illness or injury but also for repairing daily wear and tear on our bodies and minds, and for keeping us alert for tasks like driving and work.
But millions of people find sleep hard to come by, especially in these stressful days (and nights). Some of those people might be you and your patients.
The sleeping aids market, which includes everything from sleep-inducing pharmaceuticals and sleep apnea devices to special pillows and mattresses, has grown to $78.7 billion worldwide and is projected to only keep growing over the next decade. Especially in the wake of the coronavirus pandemic, sleep difficulties pose pressing challenges to our physical and mental health.
The World Sleep Society, an international association of sleep medicine and sleep research experts, celebrated World Sleep Day on March 19, which inspired the choice of this topic. In this issue, we look at the importance of healthful sleep for healthcare workers and their patients, as well as at related surgeries.
Our Student in the Spotlight is Perry Colley, APRN, FNP-C.
Scroll down for jobs we’ve collected for you and NIFA’s favorite links.
Wishing you plenty of restful sleep,
Julie Lancaster, Editor
Tired nurse photo above: Adobe Stock
Getting Better Sleep
There’s a veritable explosion of books, articles, blogs and even podcasts about how to improve bedtime habits and get better sleep for you and your family. Start with this short but straightforward list of tips from the Mayo Clinic.
Diving into the Subject of Sleep
The Dangers of Sleep Deprivation
“Research shows skimping on sleep is linked to numerous health problems, including stroke, obesity and Alzheimer’s disease,” reads an article from the American Heart Association. The article looks at sleep disorders and notes, “. . . inability to sleep is not always a medical problem. It could simply be a matter of poor sleep hygiene, such as bad habits that lead to later bedtimes.” Read more…
History of Sleep Science
Approaches for studying and regulating sleep have ranged from blood-letting and chanting in early civilizations through studying narcoleptic Dobermans at Stanford in the 1970s. This light-hearted but serious article in The Guardian summarizes some of the high points. Read more…
Sleep – How Important Is It for Health Care Workers?
This article looks at the impact sleep deprivation and SWSD (shift work sleep disorder) can have on patient care, and some helpful techniques to manage the effects of SWSD. Read more…
The Benefits of Naps and Sleep Rooms for Night Shift Nurses
The importance of sleep, the benefits of napping, and how to request a napping room at your facility. Read more…
Finally, here is a link to a page with many journal articles on PS Net (Patient Safety Network) about fatigue, sleep deprivation and patient safety. Read more…
Sleeping woman photo by Hernan Sanchez on Unsplash
Unobstructed airflow and steady breathing are important factors in healthful sleep. Many surgical procedures have been developed to treat sleep apnea and snoring; see this list from the American Academy of Sleep Medicine. Below, we look at two such procedures.
UPPP surgery is done to remove obstructing tissues in the throat, such as tonsils or adenoids, or to re-shape tissues in the throat, such as the uvula, soft palate and pharynx. It may be combined with surgeries that target other sites in the upper airway.
Upper Airway Stimulation Therapy
One key factor in ensuring that airflow is the activity of the genioglossus muscle, the primary muscle responsible for protruding the tongue. A few years ago, a new approach emerged for treatment of obstructive sleep apnea (OPA). It involves implantation of an impulse-generating device beneath the clavicle, a tunneled breathing-sensing lead placed between the intercostal muscles, and a tunneled stimulation lead that is attached to a branch of the hypoglossal nerve. The company that developed this treatment was Inspire Medical Systems, and the treatment may be referred to as Inspire. Read more…
Uvulopalatopharyngoplasty (UPPP)- Lateral Expansion Pharyngoplasty Variant with Uvulopalatal Flap
This 13-minute video from the Mayo Clinic demonstrates a UPPP procedure done on a CPAP-intolerant patient with obstructive sleep apnea (OSA), performed and narrated by Dr. Michael D. Olson.
UPPP – Lateral Expansion Pharyngoplasty
This 50-minute video from Stanford is another view of a UPPP lateral expansion technique, performed by Dr. Robson Capasso at Stanford University.
Hypoglossal Nerve Stimulator Implantation for Obstructive Sleep Apnea
This 12-minute video from the Mayo Clinic demonstrates the implantation of a hypoglossal nerve stimulator for obstructive sleep apnea (OSA) performed by Dr. Michael D. Olson and Dr. Andrew J. Goates.
Student Spotlight: Perry Colley
Current student in NIFA’s RNFA program
City & State
Nurse practitioner at Baptist Health Medical Group, Paducah, KY
Where did you get your RN degree?
West Kentucky Community Technical College – RN
University of Wyoming – BSN
Frontier Nursing University – MSN
How did you come to choose perioperative nursing?
I have always been interested in medicine and surgical procedures but never had interest in going through the steps of being an MD. When I became a nurse I was interested in the OR but wanted to be more hands-on in patient care in the ICU. My second APRN job landed me in a surgical specialty where I was able to get into the OR and use new skills.
What is a memorable moment you’ve experienced at the table?
When I was a nursing student I was able to be part of an organ harvesting procedure where kidneys, liver, and tissues were harvested. That was an OR experience I’ll never forget.
What is one technique or RNFA trick you’ve learned from NIFA that you will use for life?
Loop lock technique will be something I will always have in my pocket for use in situations when there is high tension and a large area of approximation to be handled. Sub-Q closure is something my surgeon does every case so it will be invaluable to know how to do it and do it well.
How do you feel having your RNFA will impact your life/career?
This training will allow me to utilize these skills both now in my current role in the OR and for possible future opportunities in other operative areas.
Click here for the RNFA job postings we’ve collected for you this month.
NIFA – Office Hours
Monday-Thursday, 8:00am – 4:00pm
Friday, 8:00am – 3:00pm
Here are several of the most-in-demand sites for our students, prospective students and grads:
Disclaimer: The views expressed in this newsletter are strictly those of their respective authors and do not necessarily represent the views of NIFA. NIFA does not give any express or implied warranty as to the accuracy of statements made by our contributors and does not accept any liability for error or omission. It is the responsibility of all perioperative personnel to work within and adhere to their facility bylaws and individual scope of practice.