Ch 42. Sleep

Question 1

Sleep Controlled by three distinct processes:

Answer 1

Ultradian process: non–rapid eye movement (NREM) and rapid eye movement (REM) 
Homeostatic process (process S): sleep–wake cycle
Circadian process (process C): maintaining wakefulness

Question 2

Sleep is regulated by

Answer 2

a sequence of physiological states integrated by central nervous system activity (e.g., hypothalamus, anterior pituitary)

Question 3

Stages of Sleep

Answer 3

Stage 1: Non–rapid eye movement
Lightest level of sleep (2–5% of adult sleep time)

Stage 2: Non–rapid eye movement
Sound sleep (45–55% of adult sleep time)

Stage 3: Non–rapid eye movement
Deepest sleep (10% of adult sleep time)

Rapid eye movement sleep
Dreams (25% of adult sleep time)

Question 4

What does the sleepy cycle look like?

Answer 4

Presleep period (10–30 min)
Four to five complete cycles (stages 1, 2, 3 NREM and REM) lasting 90–120 minutes/cycle
Newborns and children spend more time in stage 3 NREM sleep

Question 5

3 Functions of sleep

Answer 5

1) Full understanding is unclear
2) Physiological and psychological restoration
3) Maintenance of biological functions
4) Dreams
A mental activity that occurs while individuals are asleep
Occurs mostly during REM sleep but can also occur in NREM sleep
Important for learning, memory, and adaptation to stress

Question 6

How much sleep per age?
Neonates -
Infants/Toddlers/Preschool - 
School-aged children -
Young  adults -

Answer 6

Neonates -16 hours per day
Infants/Toddlers/Preschool - 12 to 14 hours per day
School-aged children - 9 to 10 hours per night
Young adults - 6 to 8½ hours per night

Question 7

*Factors that Effect Sleep?

Answer 7

• Drugs and substances (Hypnotics, diuretics, antidepressants, alcohol, caffeine, narcotics, -blockers, benzodiazepines, anticonvulsants, anti-parkinsonians)
• Lifestyle (Work schedule (shift work), social activities, routines)
• Usual sleep pattern
• Emotional stress (Worries, physical health, death, losses)
• Environment (Noise, routines)
• Exercise and fatigue
• Food and caloric intake (Time of day, caffeine, nicotine, alcohol)

Question 8

Evaluation of Sleep interventions

Answer 8

• Only the patient will know whether sleep problems have improved and which interventions or therapies are most successful in promoting sleep.
• To evaluate, the nurse makes comparisons with baseline sleep assessment data.
• The nurse determines whether expected outcomes have been met.

Question 9

Implementing Sleep Strategies

Answer 9

Environmental controls
Promoting bedtime routines
Promoting safety
Promoting comfort
Establishing periods of rest and sleep
Stress reduction
Bedtime snacks
Pharmacological approaches