sleep Flashcards
what is NREM sleep
first three stages are grouped together as part of “non-rapid eye movement” (NREM)
- improves neural connections, facilitates cell restoration and repair
what is stage one of the sleep cycle
short transitional phase from wakefulness to sleep - easily disturbed by outside stimuli
- may not know they have fallen asleep
what is stage 2 in the sleep stages
deeper than stage I but still a light sleep
- heart rate slows and body temperature drops
- bursts of brain activity – sleep spindles and k-complexes
- stimuli from the environment can no longer reach higher level brain centres
what is stage 3 in the sleep stages
deepest sleep stage and most necessary for feeling well rested
* supports most restorative functions
* length of stage increases after physical activity or extended periods of no sleep
* difficult to wake up quickly – may be confused
* memory and learning can become active during stages II and III
what is REM sleep
inal stage of sleep
* named for the period in which the eyes move rapidly under the lids
* when most dreaming occurs
* some regions of the brain are more active
* blood pressure, respiration and heart rate rise – skeletal muscles are inhibited from contracting
what is a circadian rhythm
sleep wake pattern coordinated by the suprachiasmatic nucleus (SCN)
* every cell has a sleep wake pattern dictated by DNA – SCN coordinates them all
* night is the circadian rest phase
* x insufficient sleep disrupts the repair and regeneration tasks
what is circadian rhythm variations
genetics determines if you are an early riser or a night owl
* morning people do better in the day but tire earlier – more sensitive to sleep loss * evening people perform better in the evening and handle sleep loss better
what are circadian rhythm disruptions
et lag – internal clock is set to a new environment
* experience falling asleep and waking at appropriate times * can cause nausea and loss of appetite
* delayed sleep phase
* personstaysupuntil4amandsleepsuntilnoon–ifhavingtowakeupearlier–theswitch may be difficult – dysfunctional
what are natural sleep drives
Light
* direct connection to the suprachiasmatic nucleus (SCN) via the eye
* exposed to light in the morning at a certain time regularly, causes the SCN
to set the internal clock to wake up at the same time
* can also reinforce unhealthy behaviour
* light late at night the SCN will reset = delay sleep phase
* SCN can also cause the pineal gland to secrete melatonin at dusk –
preparation for sleep
* Xblind persons often have a difficult time wh sleep
due to the lack of light stimulation
* we are exposed to unnatural sources of light undermining the reliance on
the sun’s 24 hr cycle
* X blue light produced by electronics is most disruptive
& can affect sleep
what is the recommended amount of sleep for infants 0-3 months
14-17 hours
what is the recommended amount of sleep for infants 4-11
12-16
what is the recommended amount of sleep for toddlers (1-2)
11-14 hours
what is the recommended amount of sleep for children 14-17 years old
8-10 hours
what is the recommend amount of sleep for adults 18-64 years old
7-9 hours
how many hours of sleep is recommended for adults aged 65+
7-8 hours
what are circadian rhythm changes across the lifespan
children need to go to bed earlier than adults
* X insufficient sleep can interfere wh attention
* change in adolescence, stay awake at night and sleep late in the morning
* X sufficient sleep in this group aids in affecting grades& moods
positively
* high school and post-secondary students show a sleep deficit of 1 – 3 hours on school nights
* sleep longer on weekends
* almost 2/3 of this group are getting poor sleep
why do circadian rhythms change
school start times forcestudentstorise during their biological night - results in serious sleep deprivation
sleep is important for higherorderthinking, problem solving, reasoning and good judgement
school districts having implementedlater start times found a decrease in tardiness, absences, drop out rates, school nurse visits and car accidents
X studies have shown that there
m a y b e a substantial
economic gain by
circadian rhythms shiftawayfromthe ‘night owl’ tendency in the 20’s
what impact does age have on sleep
age reduces the time spent in restorative sleep and diminishes the number, amplitude and intensity of deep- sleep brain waves
may also be linked to neurodegeneration
what impact does sex have on sleep
women report more instances of insomnia and men report more snoring
more likely to be diagnosed with sleep apnea
women may be subject to sleep disruption due to hormonal changes during menstruation, menopause and pregnancy
what is chronic insomnia
insomnia is a condition where people have difficulty falling or staying asleep
what are symptoms of insomnia
insomnia symptoms
about 30% of North American adults have
some symptoms of issues insomnia
trouble sleeping not only at night but in the day
usually do not have
considered to have chronic insomnia is sleep disruption occurs at three nights per week over a three-month period
what are treatments for insomnia
treatment relies on addressing sleep disrupters or circadian rhythm factors
* discover the cause of poor sleep and remedy it
* coughing, urination, anxiety, reflux, congestion etc.
*sleeping pills are not recommended
what are sleep routines
horten the sleep period slightly – set a strict sleep window – go to bed at the same time
* increases homeostatic pressure to drive sleep onset
* sleep restriction o r consolidation a re very effective
approaches
* daytime haps need to be limited
* no biological benefits of oversleeping
what are environmental and other factors
horten the sleep period slightly – set a strict sleep window – go to bed at the same time
* increases homeostatic pressure to drive sleep onset
* sleep restriction o r consolidation a re very effective
approaches
* daytime haps need to be limited
* no biological benefits of oversleeping
what is restless leg syndrome
often a feeling of something crawling under the skin, ache or tingling sensation * happen more in the evening
* alleviated by walking around or moving the legs
* RLS can be associated with small kicking movements during the night
what is treatment for RLS
get more exercise during the day
* avoid all caffeine and ensure iron levels are in the middle range * OTC meds like Benedryl® may worsen sleep
what is sleep apnea
caused by a narrowed airway that gets more obstructed when sleeping
associated with hypertension, heart attacks and stroke
* negative impact on diabetes
* increase in work-related& motor vehicle accidents
* most common in overweight persons
* loud snoring and a family history – check for possibility of sleep apnea
what is treatment for sleep apnea
can have a major impact on quality of life
* lifestyle changes include weight loss, sleep on side, quit smoking using meds to keep nasal passages open at night
* dental devices or continuous positive airway pressure (CPCP) masks and machines
* surgical treatment may include removal of tonsils or adenoids
what is narcolepsy
feel sleepy during the daytime - urge to sleep at inappropriate times
* do not sleep well at night
* transition from sleep to wakening – the REM paralysis lingers
* cataplexy - sudden loss of muscle
what is the treatment for narcolepsy
few and ineffective
* modafinil helps afflicted people stay awake during the day
* antidepressants suppress REM sleep and the paralysis effects
* contraindicated in pregnant women
what is dementia
major disease as we age
* 20% of older adults develop memory problems
* sleep may prevent cognitive impairment and dementia
* changes in fluid that surrounds the brain during sleep
* flow of cerebral spinal fluid (CSF) increased by
90%
* allows for waste products of nerve metabolism to clear
* proteins such as amyloids have been associated with Alzheimer’s disease
* the glymphatic system clears the waste from the brain
* X sleep dementia
disruption at night increases the risk of or causes it to develop earlier
what affect does athletic performance have on sleep
sleep can have a profound effect on athletic performance
adhering to a more rigid sleep schedule student athletes performed better in their sports and in the classroom
circadian rhythms are also important
crossing time zones, longer flights increases jet lag in players
X
east coast teams playing west coast teams were most
adversely a ffe c te d ↓ why?
carcadium rhythms are use to
your hom e
growth hormones are also affected with sleep loss
growth hormone and testosterone are released during sleep – levels are reduced with sleep loss
testosteroneisnecessaryformuscle health therefore sleep is necessary for optimal performance
time
zone
what is musculoskeletal pain
poor sleep can lead to risk of developing body pain and reducing pain threshold
improving a patient’s sleep can improve pain symptoms
a challenge is that pain may interfere
wI the process sleep
creates &
feedback loop
what relationship does sleep have with obesity and weight management
we eat more and gain more weight when we do not sleep
Ghrelin and leptin are affected by sleep
Ghrelin rises when we have not eaten, increasing appetite
Leptin rises after we eat and makes us feel “full”
sleep deprivation causes leptin levels to fall by 20-30% - ghrelin increases by the same amount
what relationship does sleep have with csrdiovascular disease
strongest connection is sleep , particularly in people who snore
*also have hypertension – 2 to 3 times the risk
hypertension is related to other cardiac disorders
*cardiac arrest, strokes and coronary heart disease
*sleep apnea promote inflammatory pathways contributing to the plaque in the arteries *cardiac arrhythmias such as atrial fibrillation can be promoted by sleep apnea
in males , a sleep duration of less than 6 hours lead to a n increased risk
of
*If hypertensive the risk increases
it is recommended that sleep medications not be used as there is an association with a higher mortality risk
what relationships does sleep have with diabetes
sleep can affect the risk of developing diabetes
in males with short sleep duration, the risk of developing type 2 diabetes rose 2 fold
those with problems falling asleep had 50% chance of developing diabetes
untreated sleep apnea is associated with glucose regulation problems
