Rest & Sleep T5 Flashcards
Not enough sleep
Inability to concentrate
Poor judgment
Moody
Irritability
Chronic sleep loss
Obesity Depression Hypertension Diabetes mellitus Heart attack Stroke
NERM
Non-rapid eye movement sleep
Stage 1 NERM
Light sleep Few minutes Muscle relaxation Loss of awareness Vital signs and metabolism decrease Awakens easily Drowsy
Stage 2 NERM
Deeper sleep 10-20min Vital signs and metabolism slow Slightly more stimulation to awaken Increased relaxation
Stage 3 NERM
Slow wave sleep/delta Vital signs decreasing More difficult to awaken Psychological rest Reduced sympathetic activity
REM
Rapid eye movement sleep
What does REM involve?
Vivid dreaming 90 min after falling asleep Longer with each sleep cycle Avg length 20min Very difficult to awaken Cognitive restoration
Infant and toddlers average amount of sleep:
9-15 hr/day
Adolescences:
9-10 hr/day
Adults:
7-8 hr/day
Insomnia
Most common sleep disorder Inability to get the required amount of sleep Difficulty falling asleep Staying asleep Awakening to early Not refreshing sleep
Acute insomnia
Few days
Personal or situational stressors
Chronic insomnia
A month or more
Women and older adults more prone
Intermittent insomnia
Sleeping well for a few days then having insomnia a few days
Sleep apnea
More than 5 breaths lasting longer than 10 seconds per hr
Decreased arterial saturation levels
Can be a single disorder or combination of central or obstructive
Central sleep apnea
Central nervous system dysfunction
Brain fails to trigger breathing during sleep
Obstructive sleep apnea
Structures in mouth and throat relax
Occlude the upper airway
Narcolepsy
Sudden attacks of sleep
Happens at inappropriate times
Increases risk for injury
Hypersomnolence disorder
Excessive daytime sleepiness
At least 3 months
Impaired social and vocational activity
Increased risk for accidents
Assessment/Data collection
Sleep patterns, history, new changes
Usual sleep requirements
Factors that interfere with sleep
Physiologic disorders Current life events Emotional stress Mental illness Exercise Sleep environment Medication Substance use
Nursing actions
Bedtime routine Help with personal hygiene CPAP for sleep apnea patients Melatonin,valerian,chamomile Last resort-benzodiazepine
Client education
Exercise at least 2hr before bedtime Bedtime routine Sleep environment for comfort limit Alcohol,caffeine,nicotine 4 hrs before Limit fluids 2-4hrs before bedtime Muscle relaxation if anxious or stressed
Decrease narcolepsy
Exercise regularly Eat small meals high in protein Avoid activities that increase sleepiness Take naps when drowsy Take prescribed stimulants
Decrease hypersomnolence disorder
Maintain regular sleep-wake schedule
Provide ample sleep opportunities
Take prescribed stimulants
Alpha waves
High frequency
medium amplitude
irregular waves
Drowsy stage
Beta waves
High frequency
Low amplitude
Irregular waves
Periods of wakefulness
Delta waves
Low frequency
High amplitude
Regular waves
Deep sleep
Theta waves
High amplitude Common in children Rare in adults Occur with delta waves Transitioning to a deeper sleep stage
Spindles/k-complexes
Peaked
Irregular waves
Earlier phase of NREM
RAS
Reticular activating system
Nerve cell bodies
Within the brain stem
Reticular formation and cortical neurons
Reticular formation
Maintains wakefulness
Activated by stimuli from cerebral cortex
EEG
Record electrical activity of neurons in the brain
Electrodes attached to scalp
5 different wave patterns
Parasomnias
Sleepwalking Sleep talking Bruxism Night terrors REM sleep behavior disorders Nocturnal enuresis
Bruxism
Grinding and clenching of teeth
Stage 2 REM
Can erode tooth enamel and loosen teeth
Nocturnal enuresis
Bed wetting
Past toilet training stage
Secondary sleep disorders
Depression
Hyperthyroidism or hypothyroidism
Pain
Sleep-provoked disorders
Coronary artery disease Asthma COPD Diabetes Gastric and intestinal ulcers Epilepsy
