Sleep Flashcards
What does the Reticular Activating system RAS do?
Sends impulses contributing to alertness to the limbic system and cerebral cortex. Once stimulated, it increases impulses leading to wakefulness.
what can happen if the hypothalamus is damaged?
Abnormal long sleep periods.
Which are the hormones involved in excitation?
Dopamine, Serotonin and Histamine.
What hormone is involved in inhibition?
GABA - causes drowsiness
Which hormone regulates the sleep-wake cycle and possibly the circadian rhythm?
Melatonin.
How many stages of non-rem/ NREM are there?
4
What characterizes Stage 1 of NREM, and what percentage of sleep occurs in this phase?
Light sleep state, can be easily woken - 5%
What characterizes Stage 2 of NREM, and what percentage of sleep occurs in this phase?
Light sleep, can be woken easily. Most sleep time happens in this phase - 50-55%
What characterizes Stage 3 of NREM, and what percentage of sleep occurs in this phase?
Deep sleep - you do not recall this sleep.
Parasympathetic nervous system dominates this phase and it also often referred to as Delta sleep or slow wave sleep. There is decrease in vital signs and metabolic rate however there is muscle movement.
10%
What characterizes Stage 4 of NREM, and what percentage of sleep occurs in this phase?
Deepest sleep - you do not recall this sleep.
Parasympathetic nervous system dominates this phase and it also often referred to as Delta sleep or slow wave sleep. There is decrease in vital signs and metabolic rate however there is muscle movement - Restorative sleep.
10%
What does REM stand for?
Rapid Eye Movement
What percentage of total sleep does REM sleep account for?
20-25%
What characterizes REM sleep?
The most vivid dreams occur in REM - You are able to remember your dreams. Brain waves resemble wakefulness and there is an increase in vital signs and metabolic rate. Skeletal muscles are depressed (REM atonia)
REM form a connection between short term memory and long term memory.
What does Polysomnia study?
Muscle activity, eye movement and brain activity during sleep.
What characterizes and older adults sleep pattern?
Frequently awaken at night
Don’t spend as much time in NREM stage 3&4 - mostly in 2nd stage, so they do not get as much restorative sleep.
They also spend less time in REM which has an impact on their short term memory which makes it harder for older adults to learn and remember new skills.
What fraction of our lives are spent sleeping?
1/3
If we do not get enough good sleep, what fraction of our life does lack of sleep affect?
2/3
How does sleep deprivation affect us neurologically?
It can lead to cognitive impairment and behavioral changes such as irritability and moodiness and lack of concentration and reaction time impairment.
How does sleep deprivation affect the endocrine system?
There is an increased risk of diabetes for chronic sleep deprivation due to it causing increased insulin resistance.
Decrease in growth hormone - decreases ability to heal. The body is not being repaired when it is experiencing sleep deprivation.
How does sleep deprivation affect the immune system?
the immune system will decline with insufficient sleep due to lack of functioning in the WBC’s.
How does sleep deprivation affect the cardiovascular system?
Sleep deprivation may lead to increased BP in people with hypertension do to the body becoming stressed with lack of sleep.
How does sleep deprivation affect the GI system?
Lack of sleep may lead to an increased risk of obesity. This is because there will be an increase of the hormone Ghrelin which controls hunger. Leptin which is the hormone that affect the feeling of being full is also suppressed with lack of sleep.
How does sleep deprivation affect pain?
Poor sleep may make pain worse because endorphins are not produced adequately.
What should eb the maximum duration of a nap to prevent disruption to nighttime sleep schedule.
15-20 min max. Longer than that will affect night time sleep.
Name some common sleep disorders.
Insomnia
Circadian Rhythm Disorder
Parasomnia
Obstructive Sleep Apnea
What is Insomnia?
A sleep disorder characterized by awakening in the night with difficulties or inability to return to sleep. Frequent awakening prevents the person from getting restorative sleep.
What are some ways that we as nurses can help a person suffering from insomnia?
Help with sleep hygiene.
Stimulus control : A form of CBT that identifies what help a person sleep and what disrupts the sleep which helps a person do more of what help and less of what disrupts.
Sleep restriction : Gradually restrict sleep by one hr. over 4 day and on the 4th day the person should fall asleep easily due to tiredness.
What is Circadian rhythm disorder?
Disrupt to the circadian rhythm. There are 2 types of sufferers: nigh-time workers or people who travel through time zones.
What is Parasomnia?
People who suffer from Parasomnia will sleep walk/talk. Have night terrors/nightmares.
This all happens in NREM due to muscle activity being depressed in REM.
Nightmares however happen in REM because you can often remember your nightmares.
What is obstructive sleep apnea?
Happens when the tongue is partially or fully blocking the airway when a person is sleeping causing an increase of Co2 and lack of O2 in the blood. the person will not have restorative sleep due to frequent awakening. Its main cause is obesity.
what is the treatment for sleep apnea?
Placement in fowlers position of side laying instead of supine position. Oral appliances can help with placement of the tongue or the patient can use CPAP or BPAP machines to keep airways open.
What is a CPAP machine and what does it do?
Used for treatment of sleep apnea. Provides a continuous positive airway pressure during inhalation. Used to treat simple cases of sleep apnea.
What is a BPAP machine and what does it do?
Used to treat more severe diagnoses of sleep apnea by providing a bilevel positive airway pressure for inhalation and exhalation.
Why should a person avoid caffeine, alcohol and nicotine if they’re not getting enough/good sleep?
These are all stimulants that shortens the REM cycle. Alcohol prevents deep sleep (stage 3&4 NREM) so the sleep is not restorative.
Why should be give patients with sleep disorders Nonbenzodiazepines and nonbarbiturates over Benzodiazepines and barbiturates.
These have less residual sleepiness and are less likely to lead to dependency and tolerance.
Where is a persons inner biological clock located?
In the hypothalamus
How many sleep cycles does a normal person go through each night?
4-5
How many hours of sleep does an average adult need?
8
How many hours of sleep does an infant need?
12-16 hrs
How many hours of sleep does an toddler need?
11-14 hrs
How many hours of sleep does a preschooler need?
10-13 hrs
How many hours of sleep does a school aged child need?
9-12 hrs
How many hours of sleep does a teenager need?
8-10 hrs
How many hours of sleep does an older adult need?
7-9 hrs
What group of people are more likely to experience insomnia?
Older adults, women, people under stress, and people with certain health and mental health problems, such as depression.
What are some common medication that may increase the risk of insomnia?
Those taken for hypertension and cardiovascular disease, cold and allergies, attention-deficit hyperactivity disorder (ADHA), and depression.
Is insomnia short term or chronic?
It can be both!
