Sleep as an Occupation Flashcards
The physiological processes that take place in our bodies to maintain equilibrium; sleep is needed to maintain this state
Homeostatic rhythm
24-hour cycle influenced by sunlight and involving two hormones: cortisol helps us wake in the morning, melatonin helps us sleep at night
Circadian rhythm
90-minute cycles that occur throughout the day and night, regulated by dopamine
Ultradian rhythm
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
REM-sleep
A common sleep disorder in which the sleeper stops breathing
Sleep apnea
A common sleep disorder: the most frequent health complaint after pain
Insomnia
Insomnia that lasts less than 2 weeks; tx-medication
Transient
Repetitive episodes of transient insomnia; tx-medication risk
Intermittent
Continuing difficulty with sleep; high risk of addiction to meds
Chronic
Non-invasive way (i.e., a FitBit) to measure cycles of movement that indicate sleep patterns and circadian rhythms
Actigraph
A machine that keeps the airway open by delivering pressure (oxygen) through a face mask worn during sleep.
CPAP: continuous positive airway pressure
How many stages of sleep are there in a healthy adults sleep cycle?
5 stages
What stage of sleep does this describe? interim between consciousness and sleep
Stage 1 - (5-15 minutes)
What stage of sleep does this describe? person moves into deeper sleep, HR slows, and the brain does less complicated tasks
Stage 2 (15 minutes)
What stages of sleep does this describe? Non-REM phases of deepest sleep during which time the body heals itself.
Stage 3 and 4 (delta waves appear in stage 3 and predominate in Stage 4)
What stage of sleep does this describe? REM Sleep
Stage 5
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.
True
T/F: REM sleep occurs about 90 minutes after falling asleep and reoccurs about every 90 minutes, getting longer later in the night
True
T/F: As we age, we spend more time in the deepest levels of sleep and less time in REM sleep.
False: As we age, we spend less time in the deepest levels of sleep and more time in REM sleep.
T/F: Elderly adults sleep less overall, experience more nighttime wakings, tend to wake earlier in the morning and often nap during the day.
True
Why is sleep important to health?
- Sleep regulates homeostatic, circadian and ultradian rhythms.
- Non-REM sleep supports physiological processes of growth and rejuvenation of major body systems: immune, nervous (incl. cognitive), muscular and skeletal.
- We need to sleep so that we can eat and make babies when we’re awake. :)
- 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.
What happens physiologically during non-REM sleep?
- slowed heart rate
- lowered body temp
- lowered blood pressure
- slower brain waves (“less complicated” tasks)
- body makes repairs
What happens physiologically during REM sleep?
increase in: eye movement, heart rate, breathing, blood pressure and body temp
List at least 6 issues that may disrupt a person’s normal sleep cycle.
medical illness; psychiatric condition; medication; recreational drugs; surgery; age; stress; poor sleep hygiene; environmental conditions; sleep disorders
How much sleep is considered “normal” at different stages of human development?
Newborns, Infants, Toddlers, Preschoolers, School-aged kids, Teens, and Adults
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
What tools are available to help you learn about a client’s sleep patterns?
- ASK THEM ABOUT IT! You should always ask: Are you having any pain? Are you sleepy during the daytime?
- Listen for complaints of insomnia or mention of other abnormal sleep-related behaviors.
- Assessments (i.e. the Pittsburgh Sleep Quality Index (PSQI)
- Formal eval at a sleep lab (pt. must be referred by medical doc)
To reset your sleep clock, what is the one most important step you can take?
Wake up at the same time every morning.
List some ways to manage your sleep environment for better sleep. (4 specific categories)
- TOUCH: have a comfortable bed and pillows
- 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
- 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.
- TEMP: some people sleep better in a cool room; experiment to find out what supports your sleep
List ways that a person who has trouble falling asleep at night may change behavior to sleep better.
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
What is the primary symptom of sleep apnea?
Snoring
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
Obstructive Sleep Apnea
Why is sleep apnea dangerous?
- 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)
What is the usual solution for obstructive sleep apnea in children?
Get tonsils/adenoids removed
What is the most effective solution for obstructive sleep apnea in adults?
CPAP machine (Continuous Positive Airway Pressure)
How can OTs play a role in the management of obstructive sleep apnea?
- Ask your clients about daytime sleepiness/fatigue
- Listen for complaints of insomnia and abnormal sleep-related behaviors
- Consider a formal evaluation and referral
- Seek an MD order to treat using OT methodology
List 5 situations when you would want to refer your client to sleep specialist
- Has trouble initiating sleep or getting restful sleep for more than a month or two
- 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
- Falls asleep at inappropriate times, even though he/she is getting 7.5-8 hrs sleep per night
- Is told he or she snores loudly or gasps, and has periods of not breathing that disrupts a bed partner or roommate
- Follows good sleep hygiene habits but still has difficulty sleeping
