Rest and Sleep Flashcards
Diminished state of activity, calmness, relaxation without emotional stress; freedom from anxiety
Rest
Is a cyclical physiological process that alternates with longer periods of wakefulness.
Sleep
it influences and regulate physiological function and behavioral responses
sleep-wake cycle
(also known as diurnal) a 24-hour, day-night cycle. It influences the pattern of major biological and behavioral functions
Affecting factors:
Light
Temperature
Social activities
Work routines
Others
Circadian rhythm
Sleep involves a sequence of physiological states maintained by highly integrated CNS activity. It is associated with changes in the peripheral nervous, endocrine, cardiovascular, respiratory and muscular systems.
Sleep regulation
major sleep center in the body
It secretes hypocretins (orexins) that promote wakefulness and rapid eye movement (REM)
Prostaglandin D2 L-tryptophan, and growth factors control sleep
Hypothalamus
maintains a state of wakefulness and mediates some stages of sleep. Sleep is an active process involving the RAS
- And a dynamic interaction of neurotransmitters.
Reticular Activating System (RAS)
is a major neurotransmitter associated with sleep. It is derived from its precursor tryptophan. Other neurotransmitters- acetylcholine and norepinephrine appear to be required for the REM sleep cycle.
serotonin
a naturally occurring amino acid. It decreases activity of RAS, thereby inducing and sustaining sleep.
tryptophan
proposes that there are centers that cause sleep by inhibiting other brain centers.
Active theory of sleep
states that the RAS of the brain simply fatigues and therefore becomes inactive thus sleep occurs.
Passive theory of sleep-
A phase of normal sleep
A sleeper progresses through four stages during a typical 90-minute sleep cycle
The quality of sleep from stage 1 through stage 4 becomes increasingly deep
Stages 1 and 2 is characterized by lighter sleep, person is more easily aroused
Stage 3 and 4 involve a deeper sleep (slow-wave sleep)
Nonrapid eye movement (NREM) sleep
Stage lasts a few minutes
Lightest level of sleep
Decreased physiological activity begins with gradual fall in vital signs and metabolism
Sensory stimuli such as noise easily arouse a person
When awakened, person feels as though daydreaming has occurred
Stage 1
Stage lasts 10 – 20 minutes
It is a period of sound sleep
Relaxation progresses
Body functions continue to slow
Arousal remains relatively easy
Stage 2
Stage lasts 15 to 30 minutes
It involves initial stages of deep sleep
Muscles are completely relaxed
Vital signs decline but remain regular
Sleeper is difficult to arouse and rarely moves
Stage 3
Stage lasts approximately 15 to 30 minutes
It is the deepest stage of sleep
If sleep has occurred, sleeper spends considerable part of night in this stage
Vital signs are significantly lower than during waking hours
It is very difficult to arouse sleeper
Stage 4
Stage usually begins about 90 minutes after sleep has begun
Duration increases with each sleep cycle and averages 20 minutes
Vivid, full color dreaming occurs in other stages
Stage is typified or fluctuating BP, loss of skeletal muscle tone and increase in gastric secretion
It is very difficult to arouse a sleeper
Rapid Eye Movement (REM) sleep
contributes to body tissue restoration
NREM Sleep
increases in synthetic processes in the brain
REM
A symptom that patients experience when they have chronic difficult falling asleep, frequent awakenings from sleep and/or short sleep or nonrestorative sleep
Associated with poor hygiene or practices that a patient associates with sleep
Tx: sleep-hygiene measures, biofeedback, cognitive techniques, relaxation techniques
Insomnia
Dysfunction of mechanisms that regulate sleep and wake states
Overwhelming sleepiness
Uncontrolled REM
Narcolepsy “Sleep Attack”
Is a disorder characterized by the lack of airflow through the nose and mouth for periods of 10 seconds or longer during sleep
Periodic cessation of breathing during asleep. It characterized by snoring
Sleep apnea
Excessive sleep (daytime or nighttime)
Related to psychologic problem, CNS damage, metabolic disorders
Hypersomnia
Problem many patients experience as a result of dysomnia. Causes includes symptoms caused by illnesses, emotional stress, medications, environmental disturbances and variability in the timing of sleep because of shift work
Sleep deprivation
Disorders of Arousal
Somnambulism: sleep walking
Parasomnias
After having slept for few hours, the child bolts upright in bed, shakes and screams, appears pale and terrified
Night terrors
Bedwetting
Nocturnal enuresis
Sleep talking
Soliloquy
“Wet dreams” usually experienced by adolescents males
Nocturnal erections
Clenching and grinding of teeth during sleep. May erode or diminish the height of dental crowns and may cause the teeth to become loose
Bruxisms
up to the age of 3 months averages about 16 hours of sleep a day, sleeping almost constantly during the first week
Neonates
usually develop a nighttime pattern of sleep by 3 months of age; several naps daytime, sleeps average of 8-10 hours during the night; total daily sleep 15 hours
Infants
by the age of 2, usually sleep through the night and take daily naps. Total sleep averages 12 hours a day
Toddler
average sleep 12 hours at night
preschoolers
6 years old – 11- 12 hours nightly; 11 years old sleeps 9-10 hours
Schoolage
majority takes 7 hours of sleep or less per night
Adolescents
average 6-8 ½ hours;
Young adults
total amount of sleeping time decreases
Middle adults
awakens more often during the night and it takes more time to fall asleep
Older adults
Factors influencing sleep
Drugs and substances
Lifestyle
Usual sleep patterns
Emotional stress
Environment
Exercise and fatigue
Food and caloric intake
Nursing interventions to promote sleep
Helping nurse-patient relationship
Promote comfort and relaxation
Create restful environment
Attend to bedtime rituals
Adequate exercise (at least 2 hours before sleep to enhance NREM; not immediately before sleep)
High protein food
Observe habits of sleep periodicity and wake-up time
Avoid caffeine and alcohol in the evening
If sleepy, go to bed
Bed is used mainly for sleep
