Sleep Flashcards
rest
decreased state of decreased activity and result is feeling refreshed
sleep
state of rest accompanied by altered level of consciousness
decrease sleep affects what health
physical and psychlogic health
you need un___________ sleep
fragmented
unfragmented sleep leads to
increased energy, immune system, concentration, removed brain toxins
NREM
non rapid eye movement
how many stages of NREM
1-4
stage 1 of NREM
transition stage between wakefulness and sleep, very light and easy to arouse
stage 2 of NREM
light sleep, easily aroused
how much time is spent in stage 2 of NREM
50%
stage 3 of NREM
deeper sleep
stage 4 of NREM
deep sleep state (data sleep)
rapid eye movement
REM
how much of sleep is NREM
75%
how much of sleep is REM
20-25%
what happens to pulse in REM
increases
what happens to respiratory rate in REM
increases
what happens to blood pressure in REM
increase
what happens to metabolic rate in REM
increase
what happens to temp in REM
increase
what happens to skeletal muscle tone in REM
decrease
what happens to deep tendon reflexes in REM
decrease
what do you do in REM
dream
how long are we in REM for
5-45 mins
deep sleep and REM are important
restorative functions
deep sleep restorative functions
growth, physical renewal, hormonal regulation
REM restorative functions
brain
- storing memories
- learning
- mood
need how long of deep sleep to feel rested
hour to hour and a half
we go in and out of REM through what stage
2
adults need how much sleep
7-9
older adult needs how much sleep
6-7
what stage in older adults is absent or decreased
4
older adults have ____________ rem sleep
decreased
older adults have
difficulty falling asleep
difficulty staying asleep
increase meds/diagnosis can affect sleep
wake up more often because decrease time in deep sleep
5 illnesses associated with sleep disturbances
gastroesophageal reflux
coronary artery disease
epilepsy
liver failure and encephalitis
end stage renal disease
why do gastroesophageal reflux have sleep disturbances
increase gastric secretions during REM sleep
why do coronary artery disease have sleep disturbances
angina increased in REM sleep
why do epilepsy have sleep disturbances
increase seizures in NREM
why do liver failure and encephalitis have sleep disturbances
total disruption of sleep wake cycle
why do end stage renal disease have sleep disturbances
disturbed sleep, increased day time sleep
what are some environmental factors that affect sleep in acute care settings
noises, lights,
sleep best in own home
trouble sleeping in new environment which leads to decreased REM and NREM
what are some psychological stressors that can affect sleep
hospital and illness can decrease sleep and increase anxiety
what are some meds that can impact sleep
diuretics, asthma meds
caffeine is a
CNS stimulant
alcohol toxicity affects
REM sleep
smoking substances with nicotine
stimulant affect
why do obese people have difficulty sleeping
hormonal regulation, related to appetite feeling of satiated
DM2, CVA, Breast cancer
hormonal imbalance
DYSSOMNIAS
anything causing difficulty falling asleep/staying asleep/ excessive daytime sleep
what are some sleep disorders/DYSSOMNIAS
insomnia, sleep related breathing disorder, narcolepsy, circadian rhythm sleep-wake disorders
insomnia definition
difficulty falling asleep, intermittent sleep, early wakefulness
what is the most common sleep disorder
insomnia
who might be at risk for insomnia
older than 60, women after menopause, depression
acute insomnia
brief and due to life circumstance
what is insomnia often due to
disruptions in circadian rhythms or medications
what are some medications that lead to insomnia
antihypertensive, ADD, over counter cold and allergy
how do we treat insomina
behavior modification, medications, education
what is behavior modification
sleep rituals
what are some medications that can treat insomnia
muscle relaxants
what are some education we can tell our patient with insomnia
no napping, no exercise within 3 hours of sleep, only sleep when tired
who could be at risk for insomnia
shift workers, night shift
acute insomina
one time`
chronic insomina
3 times a week for 3 months
OSA
obstructive sleep apnea
OSA can be caused by
obesity and/or anatomical causes
signs and symptoms of OSA
excess daytime sleepiness, snoring, abnormal sleep study
OSA stay in what stage of sleep
1 and 2
what is an abnormal sleep study
polysonagram
treatment for OSA
weight reduction, CPAP, BiPAP
CPAP
continous positive airway pressure
- deliver pressure to keep airway open, difficulty exhale
BiPAP
biphasic positive airway pressure
- set with inspiratory pressure and cycle with exhalation
how does apnea affect sleep
increase CO2, so they wake up to catch breath and never get to REM
what is narcolepsy
uncontrolled desire to sleep
signs and symptoms of narcolepsy
sleep attacks, cataplexy, nightmares and hallucinations, sleep onset REM
what are sleep attacks related to
strong emotions
what is cataplexy
sudden loss of muscle tone, full body paralysis
narcolepsy always go to what type of sleep
REM
what is the treatment for narcolepsy
ritalin
who might have a misalignment between circadian rhythm and sleep wake cycle
shift work
jet lag
parasomnias
pattern of wakeful behavior that appears during REM/NREM
somnambulism
sleep walking
sleep terrors
deep stages of sleep and wake up screaming
nightmares
frightening dream
bruxism
grinding of teeth when asleep, indicator of stress
enuresis
nocturnal bed wetting deep sleep
what is a sleep related movement disorders
restless leg syndrome
what is restless leg syndrome
unpleasant creeping, crawling or tingling sensations in the legs while sleeping
treatment for restless leg syndrome
walking, massage to area, strethcing
restless leg syndrome can be related to
over the counter antihystamines
caffeine, nicotine, alcohol increase or decrease restless leg syndrome
increase
what to ask during interview of obtaining a sleep history
description of disturbance
sleep wake patterns
sleep wake habits
sleep aides
enegery level
how do we promote a restful environment
room dark
wrinkle free linens
temp is comftorable
close door
how do we promote bedtime ritual
stimulate at day, warm shower, tv read, pray and music at night
what should we offer before bedtime as a snack
carbs and protein, decrease fluid before bed
how do we promote relaxation and comfort
back rub and clean gown at night
we want to respect what as much as possible
normal sleep wake patterns
use meds to produce sleep
only useful first 1-2 weeks
hour of sleep is
10PM
teach about rest and sleep
avoid alcohol, caffeine, nicotine, no exercise 3 hours before bed, no daytime naps, avoid high fluid in evening, avoid disruptions in circadian rhythms
