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exam4 > sleep evolve > Flashcards

sleep evolve Flashcards

1
Q

what happens to HB BP and respiration during sleep

A

heart rate slows down by 10 or 20 per minute and BP and resperations deacrease

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2
Q

Rapid eye movement (REM) sleep occurs during

A

deep sleep

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3
Q

REM is associated with

A

altered vital signs, muscle relaxation, increased cerebral blood flow, and steroid release

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4
Q

During non–rapid eye movement (NREM) sleep

A

physiologic activity is reduced; brain waves, breathing, and heart rate slow; and blood pressure drops

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5
Q

sleep is regulated by

A

reticular activating system (RAS) and neurotransmitter interactions

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6
Q

The most familiar rhythm is the

A

day-night, 24-hour circadian rhythm

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7
Q

diurnal means

A

active during the day

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8
Q

nocturnal means

A

most of their activity during the night

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9
Q

Humans are normally considered to be

A

diurnal

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10
Q

who controls the 24 hour circadian rythms

A

Nerve cells

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11
Q

what affect the sleep cycle

A

daily routines, work schedules, social commitments, alarm clocks, noise, light–dark cycle

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12
Q

Humans spend approximately ? of their lives asleep

A

one-third

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13
Q

Polysomnography is

A

the recording of brain waves and other physiologic variables, such as muscle activity and eye movements, during sleep

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14
Q

A normal polysomnograph shows a sleep sequence of ________ NREM stages and ____ REM stage

A

three, one

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15
Q

a normal sleep pattern consists of how many cycle of sleep

A

three to five

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16
Q

Quality of sleep is affected

A

frequent wakening, pain, and shortened REM stage of sleep

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17
Q

The usual sleep sequence for a person

A

rapid progression through NREM stages 1 through 3, back through NREM stage 2, and then into REM sleep

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18
Q

REM sleep lasts

A

up to 45 min

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19
Q

stage 1NREM characteristics

A
  • Lightest level of sleep, between sleep and wakefulness
  • Vital signs and metabolism begin to decrease/slow down
  • Easy arousal by external stimuli, such as noise
  • Feeling of drowsiness
  • Lasts a few minutes
  • May occur during the day as “resting my eyes”
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20
Q

NREM stage 2

A
  • Relaxation increases
  • Sleep becomes deeper
  • Snoring may occur
  • Relatively easy arousal
  • Physiologic functions continue to slow
  • Accompanied by occasional small muscle jerks
  • Lasts 10–20 min
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21
Q

NREM stage 3

A
  • Deepest stage of sleep, called slow-wave or delta-wave sleep for the type of brain waves seen during this type of sleep
  • More difficult arousal and rare movement
  • Muscles relaxed
  • Vital signs decrease, but regular rhythms/patterns maintained
  • Restorative processes (such as the release of growth hormone) occur
  • Sleep walking, somnambulism, and nocturnal enuresis may occur
  • Strong stimuli needed for arousal
  • Amount of time spent in slow-wave sleep depends on how long since a person slept
  • Lasts approximately 30–60 min
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22
Q

last stage REM

A
  • Occurrence of vivid, colorful dreaming (less vivid dreaming may occur in other stages)
  • Starts approximately 90 min after sleep is initiated
  • Autonomous response causes rapid eye movements, fluctuating heart rate and respirations, and increased blood pressure
  • Muscle tone decreased
  • Gastric secretions increased
  • Very difficult arousal
  • Duration of REM sleep increases with each sleep cycle and averages 20 min
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23
Q

what age group requires the most sleep

A

Newborns

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24
Q

what age group requires the least sleep

A

older adults

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25
Q

People deprived of REM sleep become

A

agitated and impulsive

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26
Q

deprivation of NREM sleep results in

A

withdrawal and vague physical complaints

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27
Q

Sleep disorders are classified into

A

dyssomnias

parasomnias

secondary sleep disorders

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28
Q

Dyssomnias are

A

disorders associated with getting to sleep, staying asleep, or being excessively sleepy

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29
Q

Decreases in the amount or changes in the timing of sleep result in

A

daytime sleepiness, poor concentration, and a feeling of not being rested

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30
Q

Causes of dyssomnias

A

too much napping, anxiety, depression, high levels of stimulation at bedtime, medication use, shift work, and hyperthyroidism

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31
Q

disruption of the normal circadian sleep pattern occurs when

A

person cannot sleep when sleep is wanted, needed, or expected

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32
Q

consequences of circadian rhythm disturbances include

A

sexual dysfunction, memory difficulties, high blood pressure, obesity, and an increased risk for accidents

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33
Q

organ system problems that hurt sleep cycle

A

breast, prostate, and colorectal cancer; depression; coronary artery disease; impaired glucose tolerance; and decreased fertility

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34
Q

Dyssomnias underlying cause

A
  • Insomnia
  • Obstructive sleep apnea (OSA)
  • Shift-work sleep disorder
  • Time zone change (jet lag)
  • Hypersomnia
  • Restless legs syndrome
  • Narcolepsy
  • Sleep deprivation
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35
Q

Parasomnias
Specific Disorder/Underlying Cause

A
  • Nocturnal enuresis
  • Somnambulism
  • Sleep terrors
  • Bruxism
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36
Q

Secondary sleep disorders
Specific Disorder/Underlying Cause

A
  • Physiologic effect of medical conditions: heart failure, chronic obstructive pulmonary disease, pain, or gastroesophageal reflux disease
  • Hospitalization with a serious illness
  • Mental health disorders:
  • Depression
  • Anxiety
  • Fear
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37
Q

Insomnia is the most common

A

dyssomnia

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38
Q

Insomnia is characterized by

A

difficulty in falling asleep or staying asleep, sleep that is too light, or early-morning awakenings

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39
Q

insomnia consern

A

not getting enough sleep

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40
Q

The occurrence of insomnia increases with

A

age

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41
Q

Short-term insomnia usually can be traced to

A

acute stress or lifestyle changes

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42
Q

insomnia is more common in

A

women

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43
Q

Insomnia can lead to symptoms of

A

sleep deprivation and daytime fatigue, which can cause impairment in work, social, and other areas of functioning

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44
Q

Narcolepsy is

A

chronic neurologic disorder caused by the brain’s inability to regulate the sleep-wake cycle normally, resulting in an uncontrollable onset of sleep or loss of awareness

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45
Q

people with narcolepsy experience

A

overwhelming sleepiness and fall asleep for periods of seconds to several minutes

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46
Q

three other major symptoms frequently characterize narcolepsy

A

cataplexy

vivid hallucinations

brief episodes of total paralysis

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47
Q

cataplexy is

A

sudden loss of voluntary muscle tone

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48
Q

Scientists now believe that narcolepsy results from

A

disease processes affecting brain mechanisms that regulate REM sleep

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49
Q

people with narcolepsy enter rem sleep within

A

few minute of falling asleep

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50
Q

The diagnosis of narcolepsy is confirmed by

A

sleep diagnostic tests, including the polysomnogram and the multiple sleep latency test.

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51
Q

newborns should sleep ___ to ___ hours a day

A

14- to 17

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52
Q

Infants sleep __ to __ hours a day

A

12 to 15

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53
Q

toddler sleep

A

11 to 14 hours a day

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54
Q

School-age children sleep

A

9 to 11 hours a day

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55
Q

adolescent sleep

A

8 to 10 hours a day

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56
Q

adults sleep

A

7 to 9 hours a day

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57
Q

older adults sleep

A

7 to 8 hours a day

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58
Q

Hypersomnia is

A

excessive daytime sleepiness lasting at least 1 month that causes impairment in the ability to function in occupational or other areas of the affected person’s life

59
Q

Hypersomnia can be caused by

A

kidney or liver disorders, diabetic acidosis, central nervous system damage, or hypothyroidism.

60
Q

Sleep apnea is

A

condition in which the person experiences the absence of breathing (apnea) or diminished breathing during sleep between snoring intervals

61
Q

Sleep apnea is characterized by

A

lack of airflow through the mouth and nose for at least 10 seconds, lasting up to 2 minutes, during sleep

62
Q

most common type of sleep apnea is

A

OSA obstructive sleep apnea

63
Q

OSA involves collapse of

A

the upper air way

64
Q

Prolonged sleep apnea can cause

A

daytime sleepiness and an increase in blood pressure, leading to cardiac arrest

65
Q

Risk factors for OSA include

A

being male,

overweight or obese

large neck circumference

smoking

alcohol use

middle-aged or older

family history of OSA

Structural abnormalities

66
Q

Sleep deprivation occurs from

A

prolonged lack of sleep of good quality and adequate quantity

67
Q

Disturbances of sleep leading to deprivation can be associated with

A

aging

hospitalization

drugs and substance abuse

stress

medications

environmental factors

disruptions of normal sleep pattern

68
Q

Sleep deprivation symptoms

A

fatigue

headache

nausea

increased sensitivity to pain

decreased neuromuscular coordination

irritability

difficulty concentrating

69
Q

Sleep deprivation could cause

A

hypertension

weight gain

inflammation

altered glucose metabolism and hormone regulation,

increased frequency of seizures in patients with seizure disorders

70
Q

what promotes sleep and rest

A

appropriate noise

hygiene

light

comfort

socialization

hope

nutrition

conservation of patient energy

71
Q

ICU could cause

A

sleep deprivation

72
Q

Restless legs syndrome is also called

A

Willis-Ekbom disease

73
Q

Restless legs syndrome is

A

familial sleep disorder

74
Q

Restless legs syndrome characterized by

A

uncontrollable urge to move the legs resulting from intense, abnormal, lower-extremity sensations of crawling or tingling

75
Q

Restless legs syndrome can occur at any age but is more common in

A

elderly

76
Q

Parasomnias are

A

disorders associated with abnormal sleep behaviors, rather than disorders of sleep itself

77
Q

Parasomnias behaviors comes from

A

activation of the autonomic nervous system, motor system, or cognitive processes during sleep or during the transitions between sleep and wakefulness

78
Q

parasomnia is more common in

A

children and adolescents

79
Q

attempting to wake a person up from parasomnia should be

ENCOURAGED

DISCOURAGED

A

DISCOURAGED

80
Q

Somnambulism is

A

sleep walking

81
Q

Nocturnal enuresis is

A

bedwetting at night

82
Q

Nocturnal enuresis is a

A

socially disruptive and stressful condition that is common, but underreported, in childhood

83
Q

what helps with nocturnal enuresis

A

Bed alarms

medications

behavioral therapy

84
Q

sleep terrors are considered

A

parasomnia

85
Q

sleep terrors are triggered by

A

fever, lack of sleep, use of alcohol, or periods of emotional stress or conflict

86
Q

Bruxism is

A

the clenching of teeth or the grinding of teeth from side to side

87
Q

bruxism is due to

A

stress

88
Q

Secondary sleep disorders can be

A

disabling symptoms of underlying medical or psychiatric disorders

89
Q

Lifestyle

A

work schedule that does not match the person’s biologic rhythms (such as night shift rotations or assignments) frequently interferes with sleep

90
Q

fast-paced life with multiple demands can prevent a person from

A

relaxing and falling asleep easily

91
Q

Diet and Exercise

A

type and amount of food and liquid consumed are recognized to affect sleep

92
Q

caffeinated substances can cause

A

sleep distubance

93
Q

nicotine can

A

affect sleep because it has a stimulating effect

94
Q

what food promote sleep

A

snacks that contain complex carbohydrates

95
Q

alchohol can

A

help fall asleep but increase wakefulness in last half of night

96
Q

Medications that decrease REM sleep include

A

barbiturates

amphetamines

antidepressants

97
Q

medications that affect sleep patterns include

A

diuretics

antiparkinson medications

antihypertensives

steroids

decongestants,

bronchodilator

98
Q

what medication causes nightmares and insomnia

A

Beta blockers

99
Q

Narcotics affect on sleep

A

suppress REM sleep

cause frequent awakening

may cause excessive daytime sleepiness

100
Q

what medications help sleep (short term)

A

zaleplon

zolpidem

101
Q

(long term) medications that improve sleep

A

Eszopiclone

102
Q

Sleeping in new environments may

A

alter both NREM and REM sleep stages

103
Q

hospitalization factors that affect sleep include

A

unfamiliar surroundings

sounds, and smells

proximity to other patients

lack of privacy

increased light levels

medical technology

underlying medical illnesses.

104
Q

Psychological stress decreases

A

REM sleep

105
Q

Anxiety—including stress associated with work, finances, illness, and family—can cause

A

intrusive thoughts

106
Q

muscular tension, and increased norepinephrine levels may interfere with

A

being able to go to sleep and stay asleep

107
Q

Relationships: new parents

A

New parents often report sleep disturbance as they adjust to the parenting role and associated frequent nightly awakenings

108
Q

Poor Sleep Hygiene

A

Lack of good sleep habits may prevent adequate sleep

109
Q

Focused Health Assessment Questions: sleep disorder

A
  • Why do you think you are having sleep problems?
  • Have you recently had any changes at home or at work?
  • Have you started any new medications?
  • Is there anyone else at home who does not sleep well?
110
Q

Focused Health Assessment Questions: Insomnia

A
  • How long does it take you to go to sleep?
  • How often do you have trouble falling asleep?
  • Do you have trouble staying asleep? Waking up early and not getting back to sleep?
  • What time do you wake up in the morning? Do you use an alarm clock?
  • What do you do to prepare for sleep?
  • What have you tried to improve your sleep?
111
Q

Focused Health Assessment Questions: Sleep Apnea

A
  • Has anyone told you that you snore loudly or stop breathing while you sleep?
  • Do you have headaches when you wake up?
  • Do you have trouble staying awake during the day?
  • Do you feel tired all the time?
112
Q

Focused Health Assessment Questions:

A
  • Do you fall asleep unexpectedly at random times? (Family or co-workers may report such episodes.)
  • Do you have episodes of weakness, causing you to fall to the floor?
  • Do you have vivid dreams when falling asleep?
113
Q

physical assessment for sleep

A

inadequate energy level for tasks

physical weakness

fatigue

lethargy

decreased affect

behavioral signs, such as yawning or slow speech

114
Q

Physical signs that may indicate potential sleep problems

A

obesity,

thick neck,

nasal polyps

deviated septum

shortness of breath.

115
Q

Other signs sleep problems

A

muscle contractions and jerks that arouse the patient from sleep

snoring

sleep apnea

or the irregular periods of silence followed by an abrupt snort indicative of OSA

116
Q

STOP-Bang tool assess for

A

OSA

117
Q

STOP-Bang tool questions

A

Snoring
Tiredness and sleepiness during the day
Observed cessation of breathing during sleep
Blood Pressure abnormalities

118
Q

STOP-Bang tool assessment data

A

Body mass index (BMI)
Age
Neck circumference
Gender

119
Q

Polysomnography records

A

eye movements

muscle movement and activity

heart and respiratory rates

oxygen levels

airflow

brain activity while the patient sleeps

120
Q

The results of polysomnography include

A

apnea-hypopnea index, or the number of apneic or hypopneic episodes per hour

121
Q

hypopneic is

A

shallow or slow breathing

122
Q

normal number of OSA (hypopneic)

A

fewer than 5 per hour

123
Q

mild number of OSA (hypopneic)

A

5 to 15

124
Q

moderate number of OSA (hypopneic)

A

15 to 30

125
Q

severe OSA is more than (hypopneic)

A

30

126
Q

sleep latency test monitor ? during several 20-minute naps during the day

A

brain waves

heartbeat

eye movement

127
Q

sleep latency test is used for patients suspected of

A

having narcolepsy

128
Q

sleep latency test shows weather the patient

A

enter REM sleep shortly after falling asleep

129
Q

strategies to improve sleep

A

Addressing the sleep environment

supporting sleep routines

providing light snacks if allowed

instituting relaxation measures

carefully using medications

130
Q

Treatment for insomnia should include

A

stimulus control

sleep restriction

sleep hygiene

cognitive therapy

131
Q

Treatment for hypersomnia is aimed at

A

correcting any underlying conditions contributing to the hypersomnia

132
Q

Treatment for narcolepsy

A

regular exercise routine

a regular sleep routine

daytime naps if possible

light meals high in protein to maintain alertness

vitamins

133
Q

narcolepsy patient should avoid

A

alcohol

heavy meals

long-distance driving

long periods of sitting

134
Q

Medications for narcolepsy

A

central nervous system stimulants

modafinil

tricyclic antidepressants

selective serotonin reuptake inhibitor antidepressants

sodium oxybate

135
Q

Lifestyle changes for good sleep practices recommended in the treatment of sleep apnea

A

weight loss and avoiding alcohol

136
Q

treatment of sleep apnea

A

surgical procedures to correct abnormalities of the soft tissue or bone structure that is obstructing the patient’s airway

use of an oral appliance while sleeping to keep the airway open

continuous positive airway pressure (CPAP)

137
Q

Treatment for restless legs syndrome

A

decreased caffeine

alcohol

tobacco use

routine exercise

maintaining a regular sleep pattern

138
Q

medications that help restless legs syndrome

A

dopaminergic agents

ropinirole

pramipexole

gabapentin enacarbil

rotigotine

Benzodiazepines and opioid medication (only if monitored by physician)

139
Q

Bedtime Routines That Promote Sleep

A

Take a warm bath.

Eat a light snack that contains carbohydrates.

Drink warm milk.

Avoid caffeine, tobacco, and excessive alcohol.

Get a back massage.

Relax using aromatherapy and music therapy.

Adjust the environment for temperature, noise, and light.

Elevate the head of the bed for patients diagnosed with gastroesophageal reflux disease (GERD).

Avoid large meals and certain medications in the evening.

140
Q

Antihistamines affect on sleep

A

sedative effects that can promote sleep

141
Q

Tricyclic antidepressants affect on sleep

A

alleviate depression for their beneficial effect on sleep patterns

142
Q

Sedative-hypnotics induce sleep but are associated with

A

disturbances in REM and NREM sleep patterns

143
Q

Information to be recorded daily in the sleep diary includes:

A
  • Activities and food within 2 hours of going to bed
  • Time of retiring
  • Time of awakening
  • Required time to fall asleep
  • Number of times aroused during the night
  • Length of time awake if aroused during the night
  • Degree of restfulness in the morning
  • Use or nonuse of an alarm
  • General comments regarding sleep

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