Sleep as an Occupation

Question 1

The physiological processes that take place in our bodies to maintain equilibrium; sleep is needed to maintain this state

Answer 1

Homeostatic rhythm

Question 2

24-hour cycle influenced by sunlight and involving two hormones: cortisol helps us wake in the morning, melatonin helps us sleep at night

Answer 2

Circadian rhythm

Question 3

90-minute cycles that occur throughout the day and night, regulated by dopamine

Answer 3

Ultradian rhythm

Question 4

The rapid-eye movement sleep that takes place after non-REM sleep and is when dreaming occurs; body movement is suppressed but not completely eliminated

Answer 4

REM-sleep

Question 5

A common sleep disorder in which the sleeper stops breathing

Answer 5

Sleep apnea

Question 6

A common sleep disorder: the most frequent health complaint after pain

Answer 6

Insomnia

Question 7

Insomnia that lasts less than 2 weeks; tx-medication

Answer 7

Transient

Question 8

Repetitive episodes of transient insomnia; tx-medication risk

Answer 8

Intermittent

Question 9

Continuing difficulty with sleep; high risk of addiction to meds

Answer 9

Chronic

Question 10

Non-invasive way (i.e., a FitBit) to measure cycles of movement that indicate sleep patterns and circadian rhythms

Answer 10

Actigraph

Question 11

A machine that keeps the airway open by delivering pressure (oxygen) through a face mask worn during sleep.

Answer 11

CPAP: continuous positive airway pressure

Question 12

How many stages of sleep are there in a healthy adults sleep cycle?

Answer 12

5 stages

Question 13

What stage of sleep does this describe? interim between consciousness and sleep

Answer 13

Stage 1 - (5-15 minutes)

Question 14

What stage of sleep does this describe? person moves into deeper sleep, HR slows, and the brain does less complicated tasks

Answer 14

Stage 2 (15 minutes)

Question 15

What stages of sleep does this describe? Non-REM phases of deepest sleep during which time the body heals itself.

Answer 15

Stage 3 and 4 (delta waves appear in stage 3 and predominate in Stage 4)

Question 16

What stage of sleep does this describe? REM Sleep

Answer 16

Stage 5

Question 17

T/F: In a healthy young adult, there is more non-REM sleep (esp. deep sleep) in the first half of the night, and more REM sleep in the second half.

Answer 17

True

Question 18

T/F: REM sleep occurs about 90 minutes after falling asleep and reoccurs about every 90 minutes, getting longer later in the night

Answer 18

True

Question 19

T/F: As we age, we spend more time in the deepest levels of sleep and less time in REM sleep.

Answer 19

False: As we age, we spend less time in the deepest levels of sleep and more time in REM sleep.

Question 20

T/F: Elderly adults sleep less overall, experience more nighttime wakings, tend to wake earlier in the morning and often nap during the day.

Answer 20

True

Question 21

Why is sleep important to health?

Answer 21

1. Sleep regulates homeostatic, circadian and ultradian rhythms.
2. Non-REM sleep supports physiological processes of growth and rejuvenation of major body systems: immune, nervous (incl. cognitive), muscular and skeletal.
3. We need to sleep so that we can eat and make babies when we’re awake. :)
4. Sleep is as important as nutrition and exercise for living healthy, productive, safe, satisfying lives. It supports healing on many levels: cardiopulmonary, neurological, psychiatric, substance abuse, etc.

Question 22

What happens physiologically during non-REM sleep?

Answer 22

• slowed heart rate
• lowered body temp
• lowered blood pressure
• slower brain waves (“less complicated” tasks)
• body makes repairs

Question 23

What happens physiologically during REM sleep?

Answer 23

increase in: eye movement, heart rate, breathing, blood pressure and body temp

Question 24

List at least 6 issues that may disrupt a person’s normal sleep cycle.

Answer 24

medical illness; psychiatric condition; medication; recreational drugs; surgery; age; stress; poor sleep hygiene; environmental conditions; sleep disorders

Question 25

How much sleep is considered “normal” at different stages of human development? Newborns, Infants, Toddlers, Preschoolers, School-aged kids, Teens, and Adults

Answer 25

``` Newborns: up to 18 hours/day Infants: up to 12 hours/day PLUS NAPS Toddlers: up to 14 hours/day (NO MORE NAPS) Preschoolers: 11-13 hours/day School-aged kids: 10-11 hours/day Teens: 9 hours/day Adults: 8 hours/day ```

Question 26

What tools are available to help you learn about a client’s sleep patterns?

Answer 26

1. ASK THEM ABOUT IT! You should always ask: Are you having any pain? Are you sleepy during the daytime? 2. Listen for complaints of insomnia or mention of other abnormal sleep-related behaviors. 3. Assessments (i.e. the Pittsburgh Sleep Quality Index (PSQI) 4. Formal eval at a sleep lab (pt. must be referred by medical doc)

Question 27

To reset your sleep clock, what is the one most important step you can take?

Answer 27

Wake up at the same time every morning.

Question 28

List some ways to manage your sleep environment for better sleep. (4 specific categories)

Answer 28

1. TOUCH: have a comfortable bed and pillows 2. LIGHT: make your room dark at night but if possible allow sunlight to shine in when morning arrives, to encourage circadian cycles that support sleep 3. SOUND: keep your sleeping area as far removed from environmental noise (traffic, kids, etc) as possible; soft music or white noise can also be useful tools. 4. TEMP: some people sleep better in a cool room; experiment to find out what supports your sleep

Question 29

List ways that a person who has trouble falling asleep at night may change behavior to sleep better.

Answer 29

Set a schedule; exercise; avoid caffeine, nicotine, and alcohol; relax before bed; sleep until sunrise; don’t lie in bed awake; manage environment; talk to your doctor if sleeping problems persist

Question 30

What is the primary symptom of sleep apnea?

Answer 30

Snoring

Question 31

What is this describing? During sleep, when throat and tongue muscles are more relaxed, soft/fatty tissue of the mouth and throat can block airway

Answer 31

Obstructive Sleep Apnea

Question 32

Why is sleep apnea dangerous?

Answer 32

- The decrease in oxygen levels throughout the night can cause increase in blood pressure and lead to cardiovascular disease - Impaired cognitive functioning (oxygen can’t get to brain) - Decreased daytime function when sleep is interrupted (increased risk for motor vehicle accidents)

Question 33

What is the usual solution for obstructive sleep apnea in children?

Answer 33

Get tonsils/adenoids removed

Question 34

What is the most effective solution for obstructive sleep apnea in adults?

Answer 34

CPAP machine (Continuous Positive Airway Pressure)

Question 35

How can OTs play a role in the management of obstructive sleep apnea?

Answer 35

1. Ask your clients about daytime sleepiness/fatigue 2. Listen for complaints of insomnia and abnormal sleep-related behaviors 3. Consider a formal evaluation and referral 4. Seek an MD order to treat using OT methodology

Question 36

List 5 situations when you would want to refer your client to sleep specialist

Answer 36

1. Has trouble initiating sleep or getting restful sleep for more than a month or two 2. Doesn’t feel rested despite getting the usual amount of sleep or more sleep than he/she is accustomed to getting in order to feel rested 3. Falls asleep at inappropriate times, even though he/she is getting 7.5-8 hrs sleep per night 4. Is told he or she snores loudly or gasps, and has periods of not breathing that disrupts a bed partner or roommate 5. Follows good sleep hygiene habits but still has difficulty sleeping