comfort, rest, and sleep

Question 1

what is sleep essential for

Answer 1

• Sleep is essential for health and healing. Without quality sleep, the body is not adequately able to rejuvenate.

Question 2

what does inadequate sleep do

Answer 2

• Inadequate sleep will affect almost
  every system in the body, potentially leading to chronic health problems such as depression, heart disease, hypertension, and
  diabetes.

Question 3

what is the circadian rhythm

Answer 3

Internal process that controls the
sleep-wake cycle.
* Occurs approx. every 24 hours.
* Regulates a client’s biological clock and causes them to be sleepy at night and wake on their own in the morning.
* Synchronizes with environmental cues such as light and temperature; however, the body
will maintain circadian rhythms without prompts.

Question 4

what is sleep-wake homeostasis

Answer 4

Assists the body to remember to sleep after a given time.
* Regulates the level of sleep according to the amount of sleep deprivation a client is
experiencing.
* Affected by factors such as the lighting in a room, medications, caffeine, foods, sleep environment, and stress.

Question 5

the brain structures that are essential to sleep

Answer 5

• Hypothalamus
• Suprachiasmatic Nucleus:
• Brain Stem:
• Thalamus:
• Pineal Gland:

Question 6

the hypothalamus being essential to sleep

Answer 6

commands nerve cells, affecting sleep and arousal

Question 7

the Suprachiasmatic Nucleus being essential to sleep

Answer 7

controls behavioral rhythm directly from the
eyes through light exposure

Question 8

the brain stem being essential to sleep

Answer 8

controls shift between wake and sleep; pons and medulla oblongata influence rapid eye
movement (REM)

Question 9

the thalamus being essential for sleep

Answer 9

blocks out external distractions during sleep; transmits images, sounds, and sensations
during REM sleep

Question 10

the pineal gland being essential for sleep

Answer 10

manufactures melatonin (a natural substance that helps the body prepare for sleep)

Question 11

stages of sleep: stage 1

Answer 11

• The wake stage/lightest stage of sleep.
• Consists predominantly of alpha and
  beta electrical brain waves.
• Alpha waves are electrical brain waves in the frequency range of 8 to 12 hertz.
• Beta waves are electrical brain waves in the frequency range of 12 to 30 hertz.
• When a person becomes drowsy and closes their eyes, the alpha waves dominate over the beta waves.
• Breathing is normal, and skeletal muscle tone is present.
• Can last from 1-5 minutes and is approx. 5% of total sleep cycle.

Question 12

the stages of sleep: stage 2

Answer 12

• Deeper sleep.
• Consists of sleep spindles or K- complex electrical waveforms that trigger the superior temporal gyri, anterior cingulate, insular cortices, and the thalamus.
• Client becomes challenging to awaken.
• Heart rate and body temperature decrease.
• First sleep cycle lasts approx. 25 minutes; however, it becomes progressively longer with each successive sleep cycle.
• Consumes approx. 50% of a total sleep cycle.
• Number of cycles increase with aging.

Question 13

the stages of sleep: stage 3

Answer 13

Deepest sleep.
* Consists of delta electrical brain waves, which are slower frequency, higher-amplitude signals.
* If awoken in stage three, clients may have mental cloudiness for 30 to 60 minutes.
* During this stage, immune system strengthens, and the muscles, tissues, and bones repair and regenerate.
* Number of cycles decline with aging.
* Can last up to 40 minutes.

Question 14

the stages of sleep: stage 4

Answer 14

• Includes REM, the dreaming stage.
• Looks like an awake cycle on an EEG; however, the skeletal muscles remain atonic (loss of muscle tone).
• Client’s breathing is irregular and erratic, and their heart rate may be elevated.
• Typically begins 90 minutes after falling asleep.
• Initial cycle lasts 10 minutes and will become longer as the night progresses.
• Can last up to 1 hour.

Question 15

sleep patterns in newborns and infants

Answer 15

• Newborns’ (birth to 28 days) and infants’ (1 month to 1 year) sleep patterns are separated into multiple sessions.
• Their non-rapid eye movement (NREM) and REM stages occur every 45 to 60 minutes, and their pattern remains mostly in stage three.
• Until 3 months of age, the infant’s sleep pattern is approx. 50% REM cycle.
• As sleep time gradually begins to decrease, at 5 to 6 months of age, the infant is sleeping at night with a daytime nap.
• After 1 year of age, the infant begins to progress towards an adult pattern of sleep.

Question 16

sleep patterns in adults

Answer 16

• Adults (20-35) spend 2-5% of their sleep time in stage one, 45-55% in stage two, 10-20% in stage three, and 20-25% in REM.
• These sleep cycles occur approximately 4-5 times, while the client is sleeping.

Question 17

sleep patterns in older adults

Answer 17

• Older adults (65+) have a decrease in stage three sleep cycles and an increase in stage
  two.
• They wake up more frequently and
  take longer to fall asleep.
• This pattern may cause older adults to stay in bed longer, leading to other health issues such
  as a worsening of musculoskeletal weakness, arthritis, and pulmonary disorders.

Question 18

recommended hours of sleep

Answer 18

• Newborns (birth to 28 days): 14 -17 hours
• Infants (1 month to 1 year): 12-15 hours
• Toddlers (1-3 years): 11-14 hours
• Preschool (3-6 years): 10-13 hours
• School-age children (6-12 years): 9-11 hours
• Adolescents (12-20 years): 8-10 hours
• Young adults (20-35 years): 7-9 hours
• Middle adults (35-65 years): 7-9 hours
• Older adults (65+): 7-8 hours

Question 19

what is sleep deprivation

Answer 19

• Sleep deprivation occurs when a client does not meet the body’s biological sleep requirements. Sleep deprivation can affect
  higher-order cognitive projects, impair judgment, decrease response time, and trigger seizure disorders, migraines, and tension
  headaches.

Question 20

ways to promote sleep

Answer 20

• Avoid stimulants, such as caffeine, alcohol, and nicotine at least four to six hours before bedtime.
• Remove unnecessary light and noise.
• Establish a bedtime routine, such as taking a warm shower or bath.
• Keep room dark, quiet, and at a comfortable, cold temperature.
• Go to bed only when tired.
• If no sleep in 20 minutes, go to another room and read or listen to music.
• Turn the clock away from view.
• Go to bed and wake up at same time each day.
• Keep naps short and before 3 p.m.
• Complete exercise at least three hours before going to bed.
• Remove work items and televisions from bedroom when possible. The bedroom should be for sleep and sexual activity only.

Question 21

insomnia

Answer 21

an ongoing inability to sleep despite having the opportunity to do so

Question 22

apnea

Answer 22

a condition in which there is an absences of inspiratory airflow for a minimum of 10 seconds

Question 23

hypopnea

Answer 23

associated with a decrease in oxygen saturation and lasts 10 seconds or longer

Question 24

obstructive sleep apnea (OSA)

Answer 24

is related to recurrent episodes of upper airway collapse and obstruction while sleeping combined with waking from sleep

Question 25

narcolepsy

Answer 25

a chronic sleep condition characterized by sudden sleepiness and sudden periods of sleep

Question 26

hypersomnia

Answer 26

a disorder of excessive daytime fatigue without improvement after more sleep

Question 27

restless leg syndrome (RLS)

Answer 27

also called Willis-Ekbom disease, is an uncontrollable urge to move the legs during sleep