Sleep Flashcards
(98 cards)
1
Q
why is sleep important?
A
it is important to health
healing and restoration
concentration, making judgments, and participating in daily activities
2
Q
what do patient require?
A
an individualized approach
3
Q
The major sleep center is in the __________ of the brain, which controls wakefulness and rapid eye movement (REM) sleep.
A
hypothalamus
4
Q
The ______ ________ _______ ___located in the brainstem releases catecholamines (norepinephrine) that help us stay awake and alert.
A
reticular activating system (RAS)
5
Q
The ________ ______ __ _______ _____(process S) regulates length and depth of sleep. (Gets stronger the longer we are awake and declines during sleep).
A
homeostatic process or sleep drive
6
Q
what is the major sleep center
A
hypothalamus of the brain
7
Q
hat does the hypothalamus control?
A
wakefulness and rapid eye mvm (REM) sleep
8
Q
what can be affected by sleep/wake cycle
A
light, temperature, social activities, and work routines. Different people function better at different times of the day.
9
Q
what is sleep regulated by…
A
physiological changes in the peripheral nervous, endocrine, cardiovascular, respiratory, and muscular systems which are maintained by the central nervous system.
10
Q
_____ ______ are physical, mental, and behavioral changes that follow a 24-hour cycle. Sleep and waking periods are the most common example of this.
It influences the patterns of body temperature, heart rate, blood pressure, hormone secretion, sensory acuity and mood, so maintaining _________ _________ is important to proper functioning biologically and behaviorally.
A
circadian rhythms
11
Q
how long do sleep cycles last
A
around 90 to 110
12
Q
how may stages of the sleep cycle are there?
A
2 primary stages of a sleep cycle: non-rapid eye movement (NREM) and rapid eye movement (REM).
13
Q
what is the sleep cycle determined by?
A
depends of the total length of time that they sleep; the amount of time spent in each stage the sleep cycle varies
14
Q
what is there before sleep?
A
pre-sleep period
15
Q
what is the pre-sleep period
A
where the person gradually becomes sleepy. This usually lasts 10 to 30 minutes, but longer if the person is having trouble falling asleep.
16
Q
How many stages are the in NREM
A
3 stage; occurs once the person is asleep and lasts around 90 minutes
17
Q
what is N1
A
lightest sleep and lasts only a few minutes. Gradual decrease of vital signs/metabolism. Can easily be awoken by noise.
18
Q
what is N2
A
sound sleep. relaxation is progressing. Brain and muscle activity continue to decrease. Can still easily wake the person
19
Q
what is N3
A
Slow-wave sleep. Deepest sleep stage. Brain and muscle activity significantly decreased. More difficult to wake the person and they rarely move.
20
Q
when does NREM occur
A
once the person is asleep and lasts around 90 min
21
Q
when does REM sleep occur
A
after N3
22
Q
what does REM do
A
increases with each sleep cycle
23
Q
how long does REM avg
A
20 minutes
24
Q
what happens in REM
A
Vivid, full-color dreaming occurs. Very difficult to wake the person.
Eyes rapidly move, and the heart rate, respiratory rate, and blood pressure fluctuate.
Loss of skeletal muscle tone.
Gastric secretions increase.
25
______ helps us restore our functioning, consolidate our memories, and prepares us for the next period of wakefulness, which is usually our next day.
sleep
26
what happens during NREM sleep
As our heart rate, respirations, blood pressure, temperature, and muscle tone decrease during ____ _____, this helps to preserve their related system’s functioning. The decrease in our metabolic rate helps to conserve our energy.
27
what happen during sleep
human growth hormones; which repairs cells in our bodies
28
when can dreams occur?
NREM and REM sleep stages; but they are move vivid in the REM stage
29
what can dreams assist with?
learning, processing memoreies, and adapting to stress
30
what is not the same as inactivity
rest
31
When at rest, people usually feel ____ and aren’t experiencing _____.
relaxed and anxiety
32
It is a state of mental, physical, and spiritual activity that leaves them refreshed.
rest
33
bedrest does not mean
the pt feel rested; emotional distress can prevent relaxation
34
______ up to the age of _ months sleep about ____. Usually ____ min. cycles, awakening every one to two cycles. __% is REM. Essential for their _______.
neonates
3
16 hr/day
40-50
50
development
35
_____ by _ months of age, usually sleep ____ hrs/night. Take several naps as well, to total ____. Often will awaken at _____.
infants
3
8-10 hrs/night
15 hrs/day
night
36
______ by age 2, sleep through the night and take daily naps. Total sleep is 12 hrs/day. After the age of 3, they often stop taking naps. Common to wake at night. Resist going to bed.
Toddlers
37
___________ Sleep about 12 hrs/night. May experience parasomnias and have trouble settling down at night. Partial awakenings followed by a normal return to sleep
Preschoolers
38
_______ _________Amount of sleep needed varies between 9 to 12 hrs/night. Older children resist sleep due to wanting to be independent or being unaware of their fatigue.
School-Aged Children
39
__________ 8-10 hrs/night recommended, but most only get 7 hrs or less due to their demanding schedules. Often results in EDS.
Adolescents
40
__________ _______ Average 6 to 8.5 hr/night. About 20% of that is in REM. If pregnant, women require additional sleep and rest; however, they also experience more sleep disturbances.
Young Adults
41
__________ ________ ______ it is recommended they get 8 to 9 hrs sleep/night. Insomnia is more common.
Middle Aged Adults
42
Chronic difficulty falling asleep, frequently waking from sleep, short sleep, and/or nonrestorative sleep. Experience excessive daytime drowsiness (EDS) and insufficient sleep quantity and quality.
- Often a sign of an underlying physical or psychological disorder.
- Often associated with poor sleep practices. During the day patients with chronic insomnia may feel sleepy, fatigued, depressed, and anxious.
Insomnia
43
_________ ________ Sleeping troubles increase with age, with 40% of older adults having sleep problems. REM shortens. There is more light sleep and less deep sleep. Awaken more at night and nap more in the day because of this.
Older Adults
44
Inability to breathe and sleep at the same time due to lack of airflow through the nose/mouth. This causes the patient to awaken to breathe. Snoring is common. Obstructive, central, or mixed.
sleep apnea
45
interruption in airflow despite the effort to breathe. The airway becomes partially or completely obstructed.
obstructive sleep apnea (OSA)
46
involves a dysfunction in the respiratory center of the brain and the impulse to breathe is not sent.
central sleep apnea (CSA)
47
Mixed?
both OSA and CSA
48
a type of hypersomnia. A dysfunction in the processes that regulate sleep and wake states. The person will fall asleep uncontrollably at inappropriate times. Often mistaken for laziness, lack of interest, or drunkenness.
narcolepsy
49
Condition resulting from a decrease in the amount, quality, and consistency of sleep. Acute or chronic. Can result from illness, emotional stress, medications, environmental disturbances, variability in timing of sleep, or from disorders like sleep apnea or insomnia.
sleep deprivation
50
what are symptoms of sleep deprivations
Ptosis, blurred vision, fine-motor clumsiness, decreased reflexes, slowed response time, decreased reasoning/judgment, decreased auditory/visual alertness, cardiac arrhythmias, confusion, disorientation, increased pain sensitivity, irritability, apathy, agitation, hyperactivity, decreased motivation, and excessive sleepiness.
51
sleep problems that occur during both NREM and REM
parasomnia; more common in children
52
Sudden infant death syndrome (SIDS), confusion when waking, sleep waking (somnambulism), night terrors, nightmares, nocturnal enuresis (bed-wetting), body rocking, and bruxism (teeth grinding).
Parasomnias
53
what should you do to prevent SIDS
it is recommended that healthy newborns and infants be placed supine (on their backs) to sleep
54
when is insomnia seen?
Often a sign of an underlying physical or psychological disorder.
Often associated with poor sleep practices. During the day patients with chronic insomnia may feel sleepy, fatigued, depressed, and anxious.
55
some _______ can make a person sleepy or fatigued, while others can cause insomnia. Some sleep meds can actually make sleep problems worse.
medications
56
______ only help with sleep _____ (1 week), can prevent deep sleep, can cause daytime drowsiness and fatigue, and may _____ sleep apnea in ____ adults.
hypnotics
temporality
worse
older
57
diuretics can cause
nocturia
58
what do antidepressants and stimulants decrease
REM and total sleep
59
what do beta blocker cause
nightmares, insomnia, and awakening form sleep
60
what drug can alter and increase sleep time but cause daytime drowsiness
benzodiazepines
61
rotating shifts, switching from days to nights can confuse our bodies
lifestyle; daily routines affect out sleep patterns
62
worrying about situations can make it hard to fall asleep, cause us to wake up frequently during sleep, or sleep too much.
stress
63
Some foods can ______ sleep. Those that contain L-tryptophan or protein, such as meats, cheese, and milk.
promote
64
Can affect our ability to fall asleep or stay asleep. Having good ventilation, the type of bed, noise and light levels, and room temperature. Also, if a person is used to sleeping next to someone else, it may be difficult for them to sleep alone. However, sleeping next to someone who keeps moving or snores can also interfere with sleep.
environment
65
only help with sleep temporarily (1 week), can prevent deep sleep, can cause daytime drowsiness and fatigue, and may worsen sleep apnea in older adults.
Hypnotics
66
decrease REM and total sleep time
Antidepressants and Stimulants
67
cause nocturia
Diuretics
68
Decrease REM and cause daytime drowsiness
Opiates and Anticonvulsants
69
alter REM and increase sleep time but cause daytime drowsiness
Benzodiazepines
70
can cause nightmares, insomnia, and awakening from sleep
Beta blockers
71
Keeping exercise within 2 hrs or more from bedtime can promote sleep. Too close to bedtime can prevent sleep, because the body needs time to cool down and relax. Having too much fatigue can make it difficult to fall asleep.
Exercise/fatigue
72
Some foods can promote sleep. Those that contain L-tryptophan or protein, such as meats, cheese, and milk
Food and intake
73
that cause pain, discomfort, anxiety, or depression can cause problems with sleep.
Illnesses
74
___________ illness can disturb sleep by altering the rhythm of breathing, or causing nasal congestion, sinus drainage, and sore throat. Patients may need to elevate their heads more with shortness of breath related to chronic lung disease.
Respiratory
75
Patients with ________ _______often experience problems with exchanging oxygen and carbon dioxide when they breathe during sleep. _________ can cause early-morning waking and fatigue.
heart failure
Hypertension
76
(awakening with sensation to urinate at night) disturbs sleep and makes it difficult to return to sleep.
Nocturia
77
such as peptic ulcer disease can wake patients at night
GI disorders
78
the patient will experience rhythmic movements of their feet and legs, which keeps them from rest and sleep
Restless leg syndrome (RLS)
79
assesses daytime sleepiness, with questions about the patient’s likeliness to be sleepy during specific activities
The Epworth Sleepiness Scale
80
assesses the quality of the patient’s sleep and their sleep patterns.
Pittsburgh Sleep Quality Index
81
______ _____ with 10 being the best or most sleep and 0 being the worst or no sleep.
numerical scale
82
the “best nights sleep” and the “worst nights sleep” at each end, then having the patient point to where their sleep is at on the line.
visual analog scale
83
Sleep is a __________ experience
subjective
84
encourage patients to stay physically active during the day. Exercise can help improve sleep; however, make sure it is 2-3 hours before bedtime.
promoting activity
85
limit disruptions to sleep by dimming the lights, conducting conversations quietly and away from pt rooms, or even providing the pt with a sleep mask and earplugs
Environmental Controls
86
Provide the patient with hygiene before bed, a fresh gown and linens, and clean/dry dressings, etc. Warm showers/ baths can be relaxing.
promoting comfort
87
Plan your care to limit sleep interruptions. Cluster your tasks, so that you complete as many as possible at once, instead of constantly going in and out of the room. Schedule as much as possible for waking hours.
Periods of Rest and Sleep
88
You can reduce pt anxiety and stress by communicating with them about their care. Some pts may require sedatives to manage their anxiety; however, these are for short-term use. The pt should be started on the lowest dose and it should be d/c’s asap. Remember that older adults are more sensitive to their effects.
Stress Reduction
89
___________ are given to induce sleep, while sedatives are given to calm a pt.
hypnotics
90
often used to treat sleep problems; however, long-term use of these medications can disrupt sleep. Use cautiously in older adults and children under 12 yrs. Contraindicated for infants under 6 mos. or during pregnancy and breastfeeding.
Benzodiazepines and benzodiazepine-like medications like Ambien
91
can be used instead of benzodiazepines in older adults
Low-dose trazadone (an antidepressant)
92
To help prevent symptoms of illness from disturbing the pt’s sleep, time the administration of their medications to control pain, nausea, or other symptoms so that they take effect at bedtime. Also, help position the pt for comfort or semi-fowlers for ease of breathing and reducing acid reflux.
Controlling physiological disturbances
93
Same interventions as in acute care. Try to limit the time they spend in bed and encourage activities. Serve their meals in the dining room. Suggest they limit daytime naps to 30 minutes or less. Try to get them some exposure to sunlight during the day to help their circadian rhythm.
Promoting comfort for restorative or continuing care
94
__________ __________ _________helps identify changes caused by sleep disorders and assists you in matching their sleep conditions in the healthcare setting to those in their home.
- Ask them what times they usually go to bed and wake up.
- Ask how much time it takes them to fall asleep and if they do anything special to help them fall asleep?
- Ask them how many times they wake up during the night and what they think the cause may be.
usual sleep pattern
95
Observe the patient for any behaviors that could result from sleep deprivation (irritability, disorientation, frequent yawning, slurred speech, or even delusions or paranoia with prolonged sleep deprivation)
Behaviors of sleep deprivation
96
This will help identify any changes or events in the person’s life that could be interfering with their sleep (occupation, new parent, social activities, recent travel, or mealtime schedules)
Current life events
97
__________ ______ ____________ _______This will help you identify any illness that may be interfering with their sleep.
physical and psychological illness
98
This will help identify any changes or events in the person’s life that could be interfering with their sleep (occupation, new parent, social activities, recent travel, or mealtime schedules)
Current life events
