Sleep and Rest Flashcards
sleep latency
amount of time it takes to fall asleep
3 things to consider for sleep health
- sleep latency
- how often wake up during the night
- is it easy to wake up in the morning
consequences of poor sleep
-increase BP, cortisol, levels of cytokines
NREM 1,2,3
LOOK UP TABLEq
70-80% of sleep is rem or nrem sleep
NREM
when does cognitive processing occur in sleep?
REM sleep
N3 sleep
deep sleep, restorative process
NREM sleep decrease from wakefulness
- brain activity
- heart rate
- BP
- mucsle tone (slightly)
- blood flow to brain
- RR
- sympathetic nerve activity
Swallowing response in sleep
suppressed from wakefulness in REM and NREM
Muscle tone in REM sleep
Absent
Body temp and rem/nrem sleep
rem: not regulated, no shivering/swearing
nrem: regulated at lower level form wakefulness
airway
airway resistance nrem and rem sleep
nrem: increase from wakefulness
rem: increase and varies from wakefulness
REM sleep increase from wakefulness
- brain activity
- heart rate
- BP
- sympathetic nerve activity
- blood flow to brain
- RR
expected duration of sleep for adult
7-9 hours
1/3 of adults sleep how much?
<6 hours
Average sleep latency for adult
10 minutes
What is sleep latency is less then 5 minutes
-sleep deprivation
What is sleep latency is more then 30 minutes?
-insomnia
average # of noctural awakenings in a night for adult
1-2
circadian rhythm
24 hours cycle in body
-balance between wake and sleep
What age does circadian rhythm develop?
2-3 months
Age when infants begin to sleep through night
6-9 months
average amount of sleep in day for newborn/infant
13 hours
average amount of sleep for toddler/preschooler
9 hours
___% of sleep is REM sleep in toddlers/ preschoolers
30
school age kids average hours of sleep
9
older adults sleep issues
increase sleep latency
increase time in bed
sleep related health problems
Light effect on melatonin
decrease melatonin
Temperature and sleep
avoid excessive heat or cold
Negative impacts sleep
- eating close to bed
- GERD
- caffeine within 6 hours of bed time
- nocturia
Benzodiazapines and sleep
make fall asleep quickly but not a normal fx on sleep
sleep latency
Alcohol and sleep (+chronic impact)
Chronic: impact sleep quality for a year once quit drinking
- sleep latency: fall asleep quick but not normal fx of sleep
- increase rebounding
- decrease rem
- nocturia due to inhibition of ADH
Insomnia
increase sleep latency that leads to decrease sleep time
sleep latency
amount of time it takes to fall asleep
3 things contributing to insomina
- stimulants
- medication side effects
- hospital environment
2 treatments for insomnia
cognitive behavioral therapy for insomnia
medications
sleep apnea
absence of breathing
hypopnea
shallow breathing
what happens to sleep in hypopnea and sleep apnea?
- frequent awakening
- decreased rem
consequences of hypopnea and sleep apnea
- hypertension
- increased risk of stroke
- impaired concentration
symptoms of hypopnea and apnea?
- excessive daytime sleepiness
- partner may report excessive snoring
nacrolepsy
- neurological autoimmune disorder with sleep attacked
- experience REM sleep within 20 minutes of falling asleep
- cataplexy and sleep paralysis
Cataplexy and narcolepsy
severe muscle weakness in 70% of people with narcolepsy
-usually occurs when falling asleep/waking up
Consequences of narcolepsy
- reduced quality of life
- poor work performance
- negative impact on personal relationships
Restless leg syndrome
unpleasant sensation leads to urge to move limbs
treatment for RLS
- intensified by inactivity- be active!
- maintain normal iron levels
Periodic Limb Movement Disorder (PLMD)
-repetitive dorsiflexion of foot and flexion of knee during sleep
treatment for PLMD
-dopamine agonist treatment
BEARS approach to sleep assessment
Bedtime Excessive Daytime sleepiness, fatigue Awakenings Regularity Snoring
Sleep habit education
- regular sleep/wake hours
- no caffeine within 6 hr bed
- no screen at bedtime
- dedicated space for sleep
- limit light in space
- use bathroom before sleep
- maintain sleep journal
