A nurse is discussing sleep-related movement disorders with a client. Select all of the following factors that can contribute to restless legs syndrome (RLS).

Choice A rationale:

Medication (short-term use) is not the commonly recommended intervention for a sleep disorder characterized by excessive daytime sleepiness despite adequate nighttime sleep. While medication might be considered in certain cases, it is usually not the first-line treatment option for this condition. Medications can have side effects and may not address the underlying causes of the sleep disorder.

Choice B rationale:

Relaxation techniques can be helpful for improving sleep quality and managing stress, but they are not typically the primary intervention for excessive daytime sleepiness despite adequate nighttime sleep. Relaxation techniques focus more on promoting relaxation and reducing stress, which might indirectly improve sleep patterns but may not directly address the specific disorder described.

Choice C rationale:

Cognitive behavioral therapy (CBT) is commonly recommended for a sleep disorder characterized by excessive daytime sleepiness despite adequate nighttime sleep. CBT for insomnia (CBT-I) is an evidence-based approach that addresses the psychological and behavioral factors contributing to sleep disturbances. It focuses on improving sleep hygiene, modifying negative thought patterns about sleep, and establishing a consistent sleep schedule. CBT has shown effectiveness in treating sleep disorders without the potential side effects of medications.

Choice D rationale:

Avoiding alcohol and caffeine is generally a good practice for promoting healthy sleep, but it alone is not the commonly recommended intervention for a sleep disorder characterized by excessive daytime sleepiness despite adequate nighttime sleep. While avoiding alcohol and caffeine can help prevent sleep disturbances, it might not fully resolve the underlying disorder causing excessive sleepiness.

Choice A rationale:

Providing the patient with caffeinated beverages in the evening is counterproductive to promoting a safe sleeping environment. Caffeine is a stimulant that can interfere with the ability to fall asleep and stay asleep.

Choice B rationale:

Encouraging the patient to exercise vigorously right before bedtime can actually hinder sleep. Exercise increases alertness and releases adrenaline, making it harder for the body to relax and prepare for sleep. It's recommended to finish vigorous exercise at least a few hours before bedtime.

Choice C rationale:

The correct choice, this action is essential for promoting a safe sleeping environment. Noise and disturbances can disrupt sleep and prevent the patient from achieving restful sleep. Minimizing noise and disturbances can involve measures such as using earplugs, ensuring a comfortable room temperature, and darkening the room to reduce light exposure.

Choice D rationale:

Administering medications to induce sleep at the patient's desired time might lead to dependence on medications for sleep initiation. It's important to address the underlying causes of sleep disorders and use medications judiciously under medical supervision, as stated in Choice D.