Sleep

Question 1

Explain sleep hygiene

Answer 1

Do not go to bed unless you are sleepy

If you are not asleep after 20 mins, get out, nonstimulating activity until sleepy

Regular bedtime/wake pattern

Calming rituals for relaxation

Full night sleep on regular basis

Room quiet, dark, cool

No activities in bed besides sleep

Avoid caffeine, nicotine, alcohol 4-6 hrs before bedtime

No big meals before bed, but don’t be hungry

No strenous exercise within 6 hours

Avoid sleeping pills

Relaxation techniques for stress

Question 2

What kind of therapy is used for patients with chronic insomnia?

Answer 2

Cognitive Behavioral Therapy

Cognitive: stress management
Behavioral: sleep hygiene

Question 3

What kind of naps are advisable for someone with insomnia?

Answer 3

Avoid naps, limit to 10-15 mins once a day, within 7-9 hours of waking

Question 4

What are the risk factors for Obstructive Sleep Apnea?

Answer 4

Obesity
Age 65+
Neck circumference of 16+ inches

Male
Postmenopausal women

Question 5

Explain how an OSA diagnosis is confirmed?

Answer 5

Episodes at least 10 seconds long

Greater than 5 per hour

3-4% spO2 decrease

Question 6

Explain the difference between CPAP and BiPAP

Answer 6

CPAP: continuous pressure= uncomfortable, poor adherence

BiPAP: pressure decreases for easier exhaling, tolerated better, used in hospitals

Question 7

What kind of meds must patients with OSA avoid to prevent worse symptoms?

Answer 7

Sleep medications- cause the airway to relax too much

Question 8

Explain uvulopalatopharngyoplasty

Answer 8

Removal of obstructing tissue from tonsillar pillars, uvula, and posterior soft palate

For OSA patients

Question 9

Explain Genioglossal advancement & hyoid myotomy

Answer 9

Advancing the attachment of the muscular part of the tongue on the mandible

Question 10

What are some complications of OSA surgery? How long should patients stay in hospital after the surgery?

Answer 10

Hemorrhage, airway obstructions

Stay at least 1 night

Question 11

What should nurses monitor on a post-op OSA patient?

Answer 11

Decreased spO2, restlessness, increased swallowing, difficulty breathing

Question 12

What meds should OSA Surgery patients avoid after?

What kind of foods should they eat?

When should they notify the provider?

Answer 12

Aspirin/blood thinners

Soft food, cool liquids/popsicles

Elevate HOB at home

Elevated temperature or bleeding

Question 13

List 2 circadian rhythm disorders

Answer 13

Jet lag disorder
Shift work disorder