interventions for alterations in rest and sleep Flashcards
rest
a state of mental, physical and spiritual activity that leaves a person feeling refreshed
sleep
rest that is accompanied by altered consciousness and relative inactivity
what is involved in physiology of sleep
reticular activating system (RAS) and bulbar synchronizing region, hypothalamus (circadian rhythm), neurotransmitters, hormones (melatonin)
function of sleep, important for
physiologic, emotional and cognitive function/ body tissue restoration, sorting and discarding of neurotransmitters, character reinforcement
stages of sleep
non-rapid eye movement sleep, rapid eye movement sleep
non-rapid eye movement sleep
75% of sleep time, PNS is in control. divided into 4 stages (stage 1&2 are light sleep, 3&4 are deep sleep)
rapid eye movement sleep
25% of sleep, fluctuation or increase in vital signs, increase in cerebral blood flood and oxygen consumption, relaxation of skeletal muscle, REM rebound
non-REM sleep stages, stage 1
transitional state between wakefulness and sleep (hyping jump), lasts only minutes
non-REM sleep stages, stage 2
asleep, but a light stage if sleep, easy awakened, makes up about half of all sleep
non-REM sleep stages, stage 3
deeper sleep, more difficult to awaken, increased relaxation -> snoring
non-REM sleep stages, stage 4
deepest stage, brain activity slows
sleep through lifespan: infancy
sleep 16 hrs, sleeps through night at 2-4 months, ABCs of safe sleeping
sleep through lifespan: toddlers/ preschool
sleep 11-14 hrs, transition from crib to bed
sleep through lifespan: young children
sleep 9-12 hrs, increased need for sleep related to growth spurts
sleep through lifespan: adolescents
sleep 8-10 hrs
sleep through lifespan: adults
sleep 7-9 hrs, decrease in non-REM stage IV sleep starts in middle age and is absent by older
impacts on insufficient sleep
obesity, anxiety, depression, GI complaints, type 2 diabetes, HTN, stroke, substance abuse, motor vehicle accidents
insomnia
common in people over 60, acute or chronic, tx: non pharmacologic cognitive behavioral therapy
sleep related breathing disorder: obstructive sleep apnea (OSA)
frequent mini arousals during sleep, decreased SWS and REM 10sec-2min apnea episodes (cause HR to increase, BP to increase -> SNS takes over awakens patient)
sx of obstructive sleep apnea (OSA)
excessive sleepiness, fatigue, depressed mood, difficulty concentrating, poor memory
tx for obstructive sleep apnea (OSA)
CPAP, surgery, weight loss, position changes
risks of obstructive sleep apnea (OSA)
linked to CV disease and cognitive impairment
central disorders of hyper somnolence
hypersomnia and narcolepsy
hypersomnia
excessive (daytime) sleep, naps do not relieve symptoms (awaken disoriented, irritated, slowed thoughts and speech)
narcolepsy
excessive daytime sleepiness and frequent overwhelming urges to sleep, most also experience cataplexy (involuntary loss of skeletal muscle tone)
circadian rhythm sleep wake disorders
shift work disorder, jet leg
shift work disorder
25-33% of shift works experience problems with adequate sleep
tx for circadian rhythm sleep wake disorders
CBT (avoid naps, maintaining regular sleep wake tome, avoid stimulation within several hours of bedtime), shifting sleep wake cycle by an hour or 2 over derail weeks is ideal
somnambulism
sleep walking
REM behavior disorder (RBD)
acting out dreams
sleep terrors
occurs in deepest sleep stage (children sit up screaming but not able to reason)
nightmares
vivid and disturbing dreams
bruxism
teeth grinding
enuresis
bed wetting
sleep related eating disorder
consumes food but had no recollection
sleep related movement disorders
restless legs syndrome (RLS) aka willis ekbom disease (WED)
restless legs syndrome (RLS) aka willis ekbom disease (WED)
cannot lie still, unpleasant creeping crawling or tingling sensation/ massage, walking stretching helps/ leads to chronic sleep loss
a nurse caring for patients in a busy hospital environment should implement which recommendation to promote sleep
keep the room cool
A nurse caring for patients in a long-term care
facility is implementing interventions to help
promote sleep in older adults. Which action is
recommended?
increase physical activities during the day
A nurse working in a sleep lab observes the developmental factors
that may affect sleep. Which statements accurately describe these
variation? Select all that apply
by the age of 8 most children no longer than daily naps, many adolescents do not get enough sleep, Total sleep decreases in adults, with a decrease in stage IV non-
REM sleep, sleep is less sound in older adults and stage IV sleep may be absent
