ch 17 - sleep Flashcards
aging related changes to sleep
- circadian rhythm becomes less responsive to external stimuli
- decreased production melatonin
- REM sleep is short and less intense
- frequent awakenings
most common sleep disorder worldwide
insomnia
risk factors for sleep disturbances in older adults
- comorbidities
- pain
- polypharmacy
- lack of exercise
- excessive napping
- sleep disorder
- depression/anxiety/psychosis
- loneliness/loss of partner
- poor sleep hygiene
- caregiving for dependent older adult
- limited exposure to sunlight
meds that may affect sleep
- antiarrhythmics
- antihypertensives
- anticholinergics
- corticosteroids
- diuretics
- levodopa
- meds containing alcohol or caffeine
- nicotine replacement products
- opioids
- phenytoin
- sedating antihistamines
- SSRIs
- stimulants for ADHD
- theophylline
- thyroid hormone
contributing factors to poor sleep
- pain
- meds
- chronic illness
- alcohol use
- depression/anxiety
what diseases are related to untreated OSA
- HF
- cardiac dysrhythmias
- stroke
- T2 DM
- osteoporosis
- death
sleep disorder: Loss of normal voluntary muscle atonia
during REM sleep, associated with complex
behavior while dreaming
REM sleep behavior disorder
assessment tool for sleep
-pittsburg sleep quality index (PSQI)
nursing recommendations to promote good sleep
- use bedroom for sleep and sex only
- have regular bedtime and wake up times
- avoid caffeine and alcohol before bed
- comfortable temp
- avoid active exercise before bed
- free of noise and distractions
- develop regular bedtime routine
criteria for diagnosis of insomnia
- difficulty falling asleep for >1 month
- impaired daytime functioning
stages of sleep
NREM: most of night, N1-N3 N1: light sleep N2: onset of sleep N3: deepest sleep, relaxation REM: dreams, body immobile
what should be recorded on a sleep diary (2-4 weeks)
- go to bed
- go to sleep
- wake up
- get out of bed
- take naps
- exercise
- drink alcohol
- drink caffeine
what sleep aid meds should be avoided
- OTC meds that contain benadryl
- benzodiazepines (-pam/-lam)
good options for sleep aid meds
benzo agonists:
- zolpidem
- eszopiclone
- zaleplon
- ramelteon
what meds/others should pts taking sleep aid avoid (3)
- alcohol
- anti-anxiety meds
- narcotics
