!! Ch. 34: Rest and Sleep Flashcards
Definition of rest:
a decreased state of activity, with the consequent feeling of being refreshed.
Definition of sleep:
- a state of rest accompanied by altered consciousness and relative inactivity.
- a period of restoration of mental and physical function.
What is “wake” in the sleep-wake cycle?
Wakefulness is a time of mental activity and energy expenditure.
What does the Reticular activating system do?
- it facilitates reflex and voluntary movements
- controls cortical activities related to state of alertness
What does the Bulbar synchronizing region do?
takes over and cause sleep
What is the control center for sleeping and waking?
Hypothalamus
How many NREM stages are there?
- 1 and 2; 5-50% of sleep (light-sleep)
- 3 and 4; 10% of sleep (deep-sleep)
What is REM sleep and what happens during it?
- Rapid Eye Movement
- 20/25% of a person’s nightly sleep time
- pulse, respiratory rate, blood pressure, metabolic rate, and body temperature increase; skeletal muscle tone and deep tendon reflexes are depressed
How does the sleep cycle work?
Goes from stage 1 to 4, then backwards. so from 4 to 3 to 2 to REM sleep (instead of 1) then back to NREM at stage 2 and then to 3 and 4 etc.
What factors affect sleep?
- developmental considerations
- motivation
- culture
- lifestyle and habits
- environmental factors
- psychological stress
- Illness
- medications
What are some illnesses associated with sleep disturbances?
- Gastroesophageal reflux
- Coronary artery disease
- Epilepsy
- liver failure and encephalitis
- hypothyroidism
- end-stage renal disease
What is Insomnia?
- Characterized by difficulty falling asleep, intermittent sleep or difficulty maintaining sleep, despite adequate opportunity and circumstances to sleep.
- 30 to 35 percent of adults
- people with depression are more likely to get insomnia
- related to disruptions in circadian rhythms.
- may be short-term or chronic
Obstructive Sleep Apnea (OSA)
Characterized by 5+ predominantly obstructive respiratory events such as: the absence of breathing [apnea], diminished breathing efforts [hypopnea], respiratory effort-related arousals during sleep that are accompanied by sleepiness, fatigue, insomnia, snoring, subjective nocturnal respiratory disturbance, and/or observed apnea and associated health disorders
Idiopathic hypErSomnia
- Characterized by excessive sleep, particularly during the day.
- BUT the nap doesn’t relieve the symptoms for hypersomnolence
What is Narcolepsy?
- Characterized by excessive daytime sleepiness and frequent overwhelming urges to sleep or inadvertent daytime lapses into sleep.
- Up to 70% of people with narcolepsy also experience cataplexy, the sudden, involuntary loss of skeletal muscle tone lasting from seconds to one or two minutes.
What is cataplexy?
the sudden, involuntary loss of skeletal muscle tone lasting from seconds to one or two minutes.
What are the primary causes of Circadian Rhythm Sleep-Wake Disorders?
- A sleep–wake disturbance
- An alteration in the internal circadian timing system or misalignment between the internal circadian rhythm and the sleep–wake schedule
- Associated distress or impairment, (chronic) lasting for a period of at least 3 months
What is a Parasomnia and what are some?
- a waking behavior during REM and NREM sleep that occur.
- Ex: Somnambulism, REM sleep behavior disorder, sleep terrors, nightmare disorder, sleep enuresis, and sleep-related eating disorder.
People with restless legs syndrome (RLS) :
cannot lie still and report unpleasant creeping, crawling, or tingling sensations in the legs.
What’re examples of Nonpharmacologic treatments?
Tobacco, alcohol, Tylenol, Motrin, hot or cold application, relaxation techniques, magnesium, etc all done or taken before bed can help.
What does a sedative do?
Slows down your brain activity
What are hypnotics?
a sleep-inducing drug
What are some sleep restrictions and sleep hygiene measures?
Restriction: Making sure you don’t sleep during the day so you will sleep at night
Hygiene: Making sure the TV is off, and that you don’t drink caffeine after a certain time etc
What do you want to find out when obtaining a Sleep History?
- Nature of problem
- Cause of problem
- Related signs and symptoms
- When the problem began and how often it occurs
- How the problem affects everyday living
- Severity of the problem and how it can be treated
- How the patient is coping with the problem and success of treatments attempted
What are 5 sleep characteristics to assess?
Restlessness Sleep postures Sleep activities Snoring Leg jerking
What information is recorded in a sleep diary?
- Time patient retires
- Time patient tries to fall asleep
- Approximate time patient falls asleep
- Time of any awakening during the night and resumption of sleep
- Time of awakening in morning
- Presence of any stressors affecting sleep
- Record of food, drink, or medication affecting sleep
- Record of physical and mental activities
- Record of activities performed 2 to 3 hours before bedtime
- Presence of worries or anxieties affecting sleep
What are some key findings of physical assessment?
- Energy level
- Facial characteristics
- Behavioral characteristics
- Physical data suggestive of sleep problems
What are some common etiologies (cause) for Nursing Diagnoses?
- Physical or emotional discomfort or pain
- Changes in bedtime rituals or sleep environment
- Disruption of circadian rhythm
- Exercise and diet before sleep
- Drug dependency and withdrawal
- Symptoms of physical illness
What are some nursing interventions to promote sleep?
- Prepare a restful environment.
- Promote bedtime rituals.
- Offer appropriate bedtime snacks and beverages.
- They say carbs are better to eat because they can help with sleep.
- Promote relaxation and comfort.
- Respect normal sleep–wake patterns.
- Schedule nursing care to avoid disturbances.
- Use medications to produce sleep.
- Teach about rest and sleep
