Sleep

Question 1

Circadian rhythms

Affected by.

Answer 1

light, temperature, social activities, and work routines

Question 2

Hospitals and extended care facilities usually do not

Answer 2

adapt care to an individual’s sleep-wake cycle preferences.

Question 3

The biological rhythm of sleep frequently becomes

Answer 3

synchronized with other body functions

Question 4

common symptoms of sleep cycle disturbances.

Answer 4

Anxiety, restlessness, irritability, and impaired judgment

Question 5

Physiology of Sleep: Sleep Regulation RAS and BSR:

Answer 5

Integrated by central nervous system (CNS) activity:

• Hypothalamus
• Reticular activating system (RAS)
• Bulbar synchronizing region (BSR)

Question 6

Purpose of sleep:

Answer 6

Remains unclear
Physiological and psychological restoration
NREM – body tissue restoration
REM – brain tissue & cognitive restoration
Loss of REM – confusion & suspicion

Question 7

Dreams:

Answer 7

Occur during NREM & REM
REM sleep – vivid & elaborate
Important for learning, memory, and adaptation to stress

Question 8

Physical illness can cause

Answer 8

pain, physical discomfort, anxiety, depression, and sleep disturbances

Question 9

Physical illness include:

Answer 9

Hypertension
Respiratory disorders
Nocturia 
Pain
Restless leg syndrome (RLS)

Question 10

Hypersomnolence =

Answer 10

Excessive sleepiness

Question 11

A polysomnogram involves

Answer 11

the use of electroencephalography (EEG), electromyography (EMG), and electro-oculography (EOG) to monitor stages of sleep and wakefulness during nighttime sleep.

Question 12

Sleep hygiene =

Answer 12

Practices that a patient associates with sleep

Question 13

Cataplexy is

Answer 13

sudden muscle weakness during intense emotions such as anger, sadness, or laughter; it can occur at any time during the day.

Question 14

Sleep paralysis is

Answer 14

the feeling of being unable to move or talk just before waking or falling asleep.

Question 15

Insomnia

Answer 15

Adjustment sleep disorder (acute insomnia), Inadequate sleep hygiene, Behavioral insomnia of childhood, Insomnia caused by medical condition

Question 16

Sleep apnea

Answer 16

Primary central sleep apnea, Central sleep apnea caused by medical condition, Obstructive sleep apnea syndromes, Excessive daytime sleepiness
-lack of airflow through the nose and mouth for periods of 10 seconds or longer during sleep

Question 17

Narcolepsy

Answer 17

Cataplexy, Sleep paralysis

Dysfunction of regulating sleep and wake states - excessive sleepiness is the most common complaint

Question 18

Sleep deprivation

Answer 18

Causes by Emotional stress, Medications, Environmental disturbances
Symptoms: fever, difficulty breathing, pain

Question 19

Parasomnias

Answer 19

More common in children

Somnambulism (sleepwalking), Night terrors, Nightmares, Nocturnal enuresis (bed-wetting), Body rocking, Bruxism

Question 20

Physical illness

Answer 20

Hypertension, respiratory, musculoskeletal, chronic illness, GI, nausea

Question 21

Drugs and substances

Answer 21

Hypnotics, diuretics, narcotics, antidepressants, alcohol, caffeine, beta-blockers, anticonvulsants

Question 22

Lifestyle

Answer 22

Work schedule, social activities, routines

Question 23

Usual sleep patterns

Answer 23

May be disrupted by social activity or work schedule

Question 24

Emotional stress

Answer 24

Worries, physical health, death, losses

Question 25

Environment

Answer 25

Noise, routines

Question 26

Exercise and fatigue

Answer 26

Moderate exercise and fatigue cause a restful sleep

Question 27

Food and calorie intake

Answer 27

Time of day, caffeine, nicotine, alcohol

Question 28

Sleep assessment

Answer 28

Sources for sleep assessment = Patient, family

Tools for sleep assessment = Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index

Question 29

Sleep history:

Answer 29

Description of sleeping problems 
usual sleep pattern 
current life events
physical and psychological illness
emotional and mental status
bedtime routines, bedtime environment 
behaviors of sleep deprivation

Question 30

Goal:

Answer 30

The patient will control environmental sources disrupting sleep within 1 month

Question 31

Outcomes:

Answer 31

Patient will identify factors in the immediate home environment that disrupt sleep in 2 weeks.
Patient will report having a discussion with family members about environmental barriers to sleep in 2 weeks.
Patient will report changes made in the bedroom to promote sleep within 4 weeks.
Patient will report having fewer than two awakenings per night within 4 weeks.

Question 32

Health promotion:

Answer 32

Environmental controls
Promoting bedtime routines
Promoting safety
Promoting comfort
Establishing periods of rest and sleep
Stress reduction
Bedtime snacks
Pharmacological approaches

Question 33

Acute care:

Answer 33

Environmental controls
Promoting comfort
Establishing periods of rest and sleep
Promoting safety
Stress reduction

Question 34

Restorative or continuing care

Answer 34

Promoting comfort
Controlling physiological disturbances
Pharmacological approaches

Question 35

Determine whether expected outcomes have been met.

Answer 35

Are you able to fall asleep within 20 minutes of getting into bed?
Describe how well you sleep when you exercise.
Does the use of quiet music at bedtime help you to relax?
Do you feel rested when you wake up?