Final Exam Flashcards
What is sleep and the purpose
Sleep is a basic human need, a universal biological process
Reasons/Purpose:
- Cope with stress
- prevent fatigue
- conserve energy
- Restore mind and body
- Enjoy life more fully
what hormones are involved in sleep
melatonin, growth hormone, and cortisol levels
What are the 3-4 sleep cycles?
Non-REM (NREM) sleep
- Stage N1: very light sleep, lasts a few minutes
- Slow eye movement and slow muscle activity
- Can be awakened very easily
- Stage N2: light sleep
- 50% of total sleep
- Body processes slow down
- Eye movement stops, brain waves slower
- Stages N3 and N4: deep sleep
- Sleeper difficult to arouse
- Eyes do not move, muscle activity stops
REM sleep occurs _____-_______ minutes after sleep begins
70-90 minutes
Newborn sleep pattern
Newborns (birth – 28 days)
* Irregular schedule
* Periods of 1–3 hours awake
* Enter REM sleep immediately
* Should be put to bed on back when sleepy but not asleep
* Exposure to light, activity can encourage sleeping less in daytime
* Should sleep on back to decrease risk of sudden infant death syndrome (SIDS)
Infants (1month to a year) sleep pattern
Wake every 3–4 hours, eat, go back to sleep
* Periods of wakefulness increase
* Sleep through the night, daytime naps by 6 months
* Half of time in light sleep
* Active during light sleep
* Putting to bed when sleepy but not asleep helps infants become self-soothers
Toddler (1-3 yr) sleep pattern
Need afternoon nap, decreasing need for morning nap
* May resist going to bed
* Nighttime fears, nightmares common
* Security object can help
* Consistent bedtime routine, sleep schedule promote good sleep habits
Preschooler sleep pattern
Need fluctuates in relation to activity, growth
* Dislike bedtime, may resist
* Restless, irritable if not enough sleep
* Maintain a consistent sleep schedule
* Relaxing bedtime routine
* Wake frequently at night, may fear dark or have night terrors, nightmares
* Limiting or eliminating TV can help
School-age children sleep pattern
- Most get less than optimal
- Demands of homework, sports, social activities
- Spend more time at the computer, TV
- Caffeinated beverages
- Consistent sleep schedule, routine help
Adolescent sleep pattern
Few get adequate sleep
Normal biological shift in sleep–wake patterns conflicts with daily schedule
Boys: nocturnal emissions – normal
Pregnant women sleep pattern
- Usually need more sleep during first trimester
- In late pregnancy, size of fetus can interfere with finding comfortable position
- Sleep on left side
- Pillows between knees, under abdomen
- Elevate head of bed
Adult sleep pattern
6–10 hours/night
* Individual variation
* Signs of not enough sleep
* Falling asleep or getting drowsy during non-fatiguing task
* Daytime sleepiness
* Inability to concentrate or remember information
* Unreasonable irritability
* Vulnerable to insufficient sleep
* Travelers
* Adults working long hours or multiple jobs
* Individuals with stress, depression, or chronic pain
* Parents of newborns
* Racial differences, women better sleep quality than men; women more at risk for insomnia
* Undiagnosed chronic conditions, sleep apnea
Older Adult sleep pattern
- Earlier bedtimes and wake times
- Increase in disturbed sleep – negative impact on quality of life
- Need to sleep does not decrease with age
- Better health – more likely to sleep well
- Adults with more medical condition – sleep problems
- Sleep disorder may be complicating other conditions
- Older adult patients with dementia
- Sundown syndrome: symptoms in late afternoon, can
last through night
Recommended hours of sleep per age group
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
Factors affecting sleep
sleep quality
- quantity
- exercise
- sleep schedule
- caffeine/alcohol
- diet
- smoking
- stress
Parasomnias
- unpleasant/undesirable behaviors that occur during sleep
Hypersomnia
- Severe form?**
- Sufficient sleep but still suffers daytime drowsiness
- **severe form: narcolepsy
what is daytime symptoms of someone who is drowsy?
drowsiness, irritability, fatigue
Dyssomnias **
– **Restless legs syndrome and periodic limb movement disorder
▪ Neurologic disorder
▪ Overwhelming urge to move legs while at rest
▪ Muscle twitches, jerking movements of legs
▪ Symptoms triggered by attempting to fall asleep
Which sleep disorder:
– Affects females more so than males
– Over age 60
– Mental health disorder
insomnia
Which sleep disorder:
– Obesity
– Large neck circumference
– Narrow airway
– Smoking
sleep apnea
Which sleep disorder:
– Children
– Drug or alcohol abuse contributes to night terrors in adults
parasomnias
Which sleep disorder:
– Onset before age 40
– Pregnancy
– Iron deficiency
– End stage kidney disease
– Neuropathy
Restless legs syndrome
Obstructive Sleep Apnea desc.
-Muscles in the back of throat relax, narrowing airways
-Breathing is cut off for 10 seconds or longer
-oxygen levels drop, CO2 levels rise
-Brain senses impaired breathing and wakes you so airway can reopen Awakening may be so brief person won’t remember
-Pattern can continue 30 or more times an hour
-Disruptions impair the ability to reach REM sleep
-Person usually unaware of waking frequently
what is the most common sleep related breathing disorder?
OSA
S and S of OSA
- Excessive daytime sleepiness
- Loud snoring (can have OSA w/o snoring)
- Observed episodes of stopped breathing during sleep
- Abrupt awakenings accompanied by gasping or choking
- Awakening with a dry mouth or sore throat
- Morning headache
- Difficulty concentrating during the day
- Mood changes, such as depression or irritability
- High blood pressure
- Decreased libido
what is used to diagnose OSA
polysomnography
OSA treatment
- For milder cases of obstructive sleep apnea,
your doctor might recommend lifestyle changes: - Lose weight if you’re overweight.
- Exercise regularly.
- Drink alcohol moderately, if at all. Don’t drink in
the hours before bedtime. - Quit smoking.
- Use a nasal decongestant or allergy
medications. - Don’t sleep on your back.
- Avoid taking sedative medications such as anti-
anxiety drugs or sleeping pills
What is Central sleep apnea
- Problem in brain function causes lapses in breathing and slow, shallow
breathing. Brain temporarily stops sending signals to the muscles that
control breathing
nonpharmacologic therapy for OSA
- weight loss
- less alcohol use
- avoid supine position for sleep
- CPAP or BiPAP use
For sleep disorders sleep sleep apnea, what can be done if CPAP is not tolerated?
Surgery (tonsillectomy, adenoidectomy, etc.)
What is comfort?
- A transient and dynamic state of
fulfillment across one or more domains
of the holistic experience:
-physical
-emotional
-psychospiritual
-sociocultural
-environmental
