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NURS 402: Lecture > Rest and Sleep > Flashcards

Rest and Sleep Flashcards

Exam 3

1
Q

Rest

A

Rest refers to a condition in which the body is in a decreased state of activity, with the consequent feeling of being refreshed

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2
Q

Sleep

A

Sleep is a state of rest accompanied by altered consciousness and relative inactivity

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3
Q

What is sleep a part of?

A

Sleep is part of what is called the sleep–wake cycle

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4
Q

What is sleep a period of?

A

Sleep is a period of inactivity and restoration of mental and physical function

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5
Q

Wakefulness

A

Wakefulness is a time of mental activity and energy expenditure

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6
Q

Reticular activating system (RAS) facilitates what?

A

Facilitates reflex and voluntary movements

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7
Q

Reticular activating system (RAS) controls what?

A

Controls cortical activities related to state of alertness

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8
Q

What is the control center for sleeping and waking?

A

Hypothalamus

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9
Q

Non-rapid eye movement (NREM)
How many stages?

A

Consists of four stages

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10
Q

Stages I and II of NREM:

A

Stages I and II: 5% to 50% of sleep, light sleep

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11
Q

Stages III and IV of NREM:

A

Stages III and IV—10% of sleep, deep-sleep states (delta sleep)

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12
Q

Delta sleep

A

Deep sleep states

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13
Q

Rapid eye movement (REM)- how long is it?

A

20% to 25% of a person’s nightly sleep time

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14
Q

What happens physiologically during REM

A

Pulse, respiratory rate, blood pressure, metabolic rate, and body temperature increase;

skeletal muscle tone and deep tendon reflexes are depressed

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15
Q

How does someone pass through the stages of sleep in NREM

A

The person passes consecutively through four stages of NREM sleep

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16
Q

After someone does through the four stages of NREM consecutively, what happens?

A

The pattern is then reversed

Return from stage IV to III to II

Enter REM sleep instead of re-entering stage I

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17
Q

What occurs during NREM when four stages are occurring in order? (I–>IV)

A

The person re-enters NREM sleep at stage II and moves on to III and IV.

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18
Q

Effects of Insufficient Sleep in children?

A

May affect normal growth and development in children

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19
Q

Effects of Insufficient Sleep in children and adults?

A

May increase obesity risk in both children and adults

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20
Q

Effects of Insufficient Sleep in adults?

A

Lowers leptin levels and elevates ghrelin levels

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21
Q

Leptin

A

hormone that tells the brain to stop eating

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22
Q

Ghrelin:

A

promotes continued eating

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23
Q

Factors Affecting Rest and Sleep

A

Developmental considerations
Motivation
Culture
Lifestyle and habits
Environmental factors
Psychological stress
Illness
Medications

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24
Q

How does exercise affect sleep?

A

Activity and exercise increase fatigue and can promote relaxation followed by sleep; increases both REM and NREM sleep; contributes to a more restful sleep

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25
Dietary habits: affect of sleep
Amino acid L-tryptophan promotes sleep Small protein snack combined with a healthy complex carbohydrate before bed improves sleep Large quantities of alcohol limit REM and delta sleep Caffeine blocks the ability of adenosine to cause drowsiness
26
What is associated with poorer sleep?
Smoking and nicotine are associated with poorer sleep
27
Psychological Stress: What causes it?
Can be caused by illness or life situations
28
Psychological Stress: How does it affect sleep?
Disturbs sleep Difficult to obtain the amount of sleep needed REM sleep decreases, leading to anxiety and stress
29
What happens to REM sleep during psychological stress?
Difficult to obtain the amount of sleep needed REM sleep decreases, leading to anxiety and stress
30
ICSD Classification of Sleep Disorders
Insomnia Sleep-related breathing disorders Central disorders of hypersomnolence Circadian rhythm sleep–wake disorders Parasomnias Sleep-related movement disorders Other sleep disorders
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Insomnia
Characterized by difficulty falling asleep, intermittent sleep or difficulty maintaining sleep, despite adequate opportunity and circumstances to sleep
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What percent of Americans complain of Insomnia?
As many as 30% to 35% of adults in the United States complain of insomnia
33
Who is most likely to experience insomnia?
People with a history of depression are more likely to experience insomnia
34
Many cases of insomnia are related to what?
Many cases of insomnia are related to disruptions in circadian rhythms
35
How long is insomnia?
Insomnia may be short term or chronic in nature
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Sleep-Related Breathing Disorder: Obstructive Sleep Apnea (OSA)
Characterized by five or more predominantly obstructive respiratory events
37
Five or more predominantly obstructive respiratory events called OSA are:
(apnea) (hypopnea) Respiratory effort-related arousals during sleep, accompanied by sleepiness, fatigue, insomnia, snoring Subjective nocturnal respiratory disturbance Observed apnea and associated health disorders Gasping for air during sleep
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Apnea
The absence of breathing
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Hypoapnea
Diminished breathing efforts (hypopnea)
40
Central Disorders of Hypersomnolence
1. Idiopathic hypersomnia 2. Narcolepsy
41
Idiopathic hypersomnia
Characterized by excessive sleep, particularly during the day
42
Narcolepsy is characterized by what?
Characterized by excessive daytime sleepiness and frequent overwhelming urges to sleep or inadvertent daytime lapses into sleep
43
____% of people with narcolepsy also experience________
Up to 70% of people with narcolepsy also experience cataplexy,
44
Cataplexy
the sudden, involuntary loss of skeletal muscle tone lasting from seconds to one or two minutes
45
Characteristics of Circadian Rhythm Sleep–Wake Disorders
Chronic or recurrent pattern of sleep-wake rhythm disruption
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Primary causes of chronic or recurrent pattern of sleep- wake disruption include an alteration of:
An alteration in the internal circadian timing system or misalignment between the internal circadian rhythm and the sleep-wake schedule desired or required
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Other Primary causes of chronic or recurrent pattern of sleep- wake disruption include an alteration of:
1. A sleep wake disturbance (ex; insomnia or excessive sleepiness) 2. Associated distress or impairment, lasting for a period of at least 3 months (except for jet lag disorder)
48
Parasomnias
Somnambulism REM sleep behavior disorder (RBD) Sleep terrors Nightmare disorder Sleep enuresis Sleep-related eating disorder
49
Sleep-Related Movement Disorders/Restless Legs Syndrome (RLS)
Restless legs syndrome (RLS), also known as Willis–Ekbom disease (WED),
50
Restless legs syndrome (RLS), also known as Willis–Ekbom disease (WED) affects who?
is a common sleep-related movement disorder that affects up to 15% of the population, most often middle-aged and older adults
51
What happens to people with RLS?
People with RLS cannot lie still and report unpleasant creeping, crawling, or tingling sensations in the legs
52
What is the treatment for RLS?
Nonpharmacologic treatments
53
Obtaining a Sleep History
Nature of problem Cause of problem Related signs and symptoms When the problem began and how often it occurs How the problem affects everyday living Severity of the problem and how it can be treated How the patient is coping with the problem and success of treatments attempted
54
Screening Tools to Assess Sleep Disturbances
Sleep Diary The Epworth Sleepiness Scale The Pittsburgh Sleep Quality Index (PSQI) STOP-Bang Questionnaire (OSA) Stanford Sleepiness Scale
55
Information Recorded in a Sleep Diary #1
Time patient retires Time patient tries to fall asleep Approximate time patient falls asleep Time of any awakening during the night and resumption of sleep Time of awakening in morning Presence of any stressors affecting sleep
56
Information Recorded in a Sleep Diary #2
Record of food, drink, or medication affecting sleep Record of physical and mental activities Record of activities performed 2 to 3 hours before bedtime Presence of worries or anxieties affecting sleep
57
Sleep Characteristics to Assess
Restlessness Sleep activities Sleep postures Snoring Leg jerking
58
Key Findings of Physical Assessment
Energy level Facial characteristics Behavioral characteristics Physical data suggestive of sleep problems
59
Nursing Interventions to Promote Sleep
Prepare a restful environment Promote bedtime rituals Offer appropriate bedtime snacks and beverages Promote relaxation and comfort Respect normal sleep–wake patterns Schedule nursing care to avoid disturbances Use medications to produce sleep Teach about rest and sleep
60
Treatment for Dyssomnias
Pharmacologic therapy Nonpharmacologic therapy
61
Pharmacologic therapy for Treatment for Dyssomnias
Sedatives Hypnotics
62
NonPharmacologic therapy for Treatment for Dyssomnias
Cognitive behavioral therapy (CBT)
63
NonPharmacologic therapy for Treatment for Dyssomnias: Cognitive behavioral therapy (CBT)
Progressive muscle relaxation measures Stimulus control Sleep restriction; sleep hygiene measures Biofeedback and relaxation therapy
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NURS 402: Lecture (17 decks)

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