Rest and Sleep

Question 1

What’s involved in the physiology of sleep?

Answer 1

Circadian rhythms, sleep regulation, sleep cycle, stages of sleep

Question 2

What is the purpose of sleep?

Answer 2

The purpose remains unclear. Physiological and psychological restoration. Maintenance of biological functions.

Question 3

When do dreams occur?

Answer 3

Nonrapid eye movement (NREM) and rapid eye movement (REM) sleep. REM dreams are more vivid and elaborate.

Question 4

What factors can influence sleep?

Answer 4

Physical illness, lifestyle, emotional stress, exercise and fatigue, drugs and substances, usual sleep patterns that may be disrupted, environment, food and calorie intake

Question 5

Disorders related to difficulty falling asleep, frequently waking from sleep, short periods of sleep, or sleep that is nonrestorative.

Answer 5

Insomnias.
Adjustment sleep disorder (acute insomnia), inadequate sleep hygiene, behavioral insomnia of childhood, insomnia caused by a medical condition

Question 6

A disorder characterized by lack of airflow through the nose and mouth for periods of ten seconds or longer during sleep.

Answer 6

Sleep apnea. Central, obstructive, and mixed. Obstructive is most common.
Primary central sleep apnea, central sleep apnea caused by a medical condition, obstructive sleep apnea syndromes, excessive daytime sleepiness

Question 7

A dysfunction of mechanisms that regulate sleep and wake states.

Answer 7

Narcolepsy.
Cataplexy (sudden muscle weakness) during intense emotions occurs at any time of the day. Sleep paralysis. Symptoms tend to first appear in adolescence.

Question 8

Sleep deprivation?

Answer 8

Emotional stress, medications environmental disturbances, symptoms

Question 9

Undesirable behaviors that usually occur during sleep.

Answer 9

Parasomnias.

Somnambulism (sleep walking), night terrors, nightmares, nocturnal enuresis, body rocking, bruxism

Question 10

How much sleep do neonates require a day?
Infants?
Toddlers?

Answer 10

16 hours a day
8-10 hours a night for a total of 15 hours per day
Total 12 hours a day

Question 11

How much sleep do preschoolers require in a day?

School age?

Answer 11

12 hours a night

9-10 hours

Question 12

How much sleep do adolescents get?
Young adults?
Middle and older adults?

Answer 12

About 7.5 hours
Get 6-8.5 hours
Total number of hours declines as the person ages

Question 13

What’s included in a sleep history?

Answer 13

Sleeping problems, usual sleep patterns, current life events, physical and psychological illness, emotional and mental status, bedtime routines, bedtime environment, behaviors of sleep deprivation

Question 14

What are possible nursing diagnoses for sleep?

Answer 14

Anxiety, ineffective breathing pattern, acute confusion, compromised family coping, ineffective coping, insomnia, fatigue, sleep deprivation, readiness for enhanced sleep

Question 15

What herbal/supplemental products may be used for sleep?

Answer 15

Valerian, chamomile, melatonin, Kava

Question 16

What hypnotics/sedatives may be used for sleep? Who are they bad for?

Answer 16

Benzodiazepines (xanax, valium)
Nonbenzos (ambient, lunesta)
Hazardous in the elderly

Question 17

Sleep deprivation behaviors?

Answer 17

Mood changes, anger, depression, irritability, slurred speech, slower thoughts, difficulty forming logical conclusions, increased opportunity to eat, severe yawning

Question 18

What does rest contribute to?

Answer 18

Mental relaxation, freedom from anxiety. State of mental, physical, and spiritual activity

Question 19

Sleep disturbances that result in daytime sleepiness and are not caused by disturbed sleep or alterations in circadian rhythms.

Answer 19

Hypersomnias

Narcolepsy, menstrual related, caused by a medical condition

Question 20

Sleep disorders caused by a misalignment between the timing of sleep and individual desires or the societal norm.

Answer 20

Circadian rhythm sleep disorders

Question 21

Occurs when muscles or structures of the oral cavity or throats relax during sleep. The upper airway becomes partially or completely blocked, diminishing nasal airflow (hypopnea) or stopping it (apnea) for as long as thirty seconds.

Answer 21

Obstructive sleep apnea.
The effort to breathe results in arousal from deep sleep often to the stage 2 cycle. Excessive daytime sleepiness (EDS) and fatigue are the most common complaints.
Risk factors are obesity and hypertension.

Question 22

Involves dysfunction in the respiratory control center of the brain. The impulse to breathe fails temporarily, and nasal airflow and chest wall movement cease.

Answer 22

Central sleep apnea. Most common in pts with brainstem injury, muscular dystrophy, and encephalitis. Tend to awaken during midsleep and therefore complain of insomnia.