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H&I EXAM 1 > Sleep & Fatigue > Flashcards

Sleep & Fatigue Flashcards

1
Q

5 Stages of Sleep Cycle

A
  1. Awake
  2. NREM 1 ( falling asleep )
  3. NREM 2 ( light )
  4. NREM 3,4 ( deep sleep )
  5. REM ( rapid eye movement )
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2
Q

How many sleep cycles do we complete a night?

A

4-5

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3
Q

Most/ Least amount of time

A

50% of sleep in N2
25% in REM

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4
Q

Sleep Cycles throughout the night

A

Deep sleep is longer at the start of the sleep period

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5
Q

What happens during a sleep cycle?

A
  • Regulation of appetite hormones
  • Growth hormone secretion
  • Memory consolidation
  • Altered state
  • Tissue growth and repair
  • Brain growth
  • Muscle relaxing
  • Brain regrouping
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6
Q

N1

A
  • Heart and breathing slow down
  • Muscles relax
  • Mins
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7
Q

N2

A
  • No eye movements
  • Body temp drops
  • 25 mins
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8
Q

N3

A
  • Deepest sleep
  • Slowest HR
  • Fully relaxed
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9
Q

REM

A
  • Dreaming stage
  • Eye movements become rapid
  • Rem is where restoration of brain tissue and cognitive function
  • Waking in deep sleep will cause confusion
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10
Q

Circadian Rhythm

A

Regulates:
- When you go to sleep
- When you wake up
- BP
- Temp
- Hormone secretion

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11
Q

Cortisol is highest when?

A

In morning

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12
Q

Melatonin is lowest/ highest when?

A

Melatonin is lowest in morning and highest at night

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13
Q

Sleep Across Lifespan: Newborns

A
  • Sleep an average of 16 hours a day
  • Don’t have a circadian rhythm for first four weeks
  • Enter REM immediately after falling asleep
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14
Q

Sleep Across Lifespan: Infants

A
  • 15 hours a day of sleep
  • 1/3 is in REM
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15
Q

Sleep Across Lifespan: Toddlers

A
  • Sleep an average of 11-13 hours
  • Night-time fears
  • Need consistent bedtime routine
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16
Q

Sleep Across Lifespan: School age

A
  • Sleep for 10-11 hours
  • Sacrifices sleep for other things
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17
Q

Sleep Across Lifespan: Teens

A
  • 9-10 hours
  • Sleeping in, waking up later
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18
Q

Sleep Across Lifespan: Adults

A
  • 7-9 hours a night
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19
Q

Older Adults and Sleep

A
  • 7-9 hours a night
  • Awake earlier, go to bed earlier
  • Sleep latency ( can’t fall asleep )
  • Awakening in night ( polyuria )
  • Less deep sleep
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20
Q

Types of Sleep Disturbances

A
  • Insomnia
  • Hypersomnia ( randomly falling asleep )
  • Sleep apnea ( breathing starts/stops )
  • Restless leg syndrome
  • Parasomnias
  • Circadian rhythm disorders
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21
Q

Primary sleep disorders…

A

Are those that exist as an independent condition

22
Q

Secondary Sleep Disorders

A

Occur as the result of some other situation and correcting that situation with sleep
- Caused by medical conditions, mental health
- Conditions that impair sleep: Alzheimers, GERD
- Meds that impair sleep: Beta blockers, corticosteroids, diuretics

23
Q

Insufficient Sleep –>

A

Day-Time Sleepiness

24
Q

Who is at risk for sleep disturbances?

A
  • Adolescents
  • Poor Sleep
  • Pregnant people
  • Older adults
  • Shift workers
  • Chronic conditions
25
Q

Risk factor for lack of sleep ( Huge )

A

HOSPITLIZATION

26
Q

BEARS

A

Sleep assessment:
- B: Bedtime problems
- E: Excessive daytime sleepiness
- A: Awakenings during night
- R: Regularity/ Duration of sleep
- S: Sleep disorders breathinh

27
Q

Sleep Assessment

A
  • Self Report ( Sleep Diary )
  • Report from parent
  • Symtoms: Insomnia, irratability
28
Q

How to modify environment to promote sleep in a Hospital?

A
  • Turn off lights
  • Do Not Disturb sign
  • Close door
  • Comfy position
29
Q

Is napping all day healthy?

A

No, messes with circadian rhythm

30
Q

Promoting good sleep hygiene

A
  • Regular bedtime / wake up
  • Relaxing before bed
  • No electronics
  • Avoid naps
31
Q

Obstructive Sleep Apnea

A

Patient stops breathing while they sleep!
- Soft palate or tongue obstruction
- Risks: High BP, Stroke, Weight, Diabetes, Pulm Disease, Cardio Disease, smoking, edema in throat

32
Q

OSA Risk Factors

A
  • Obesity
  • Large Uvula
  • Smoking
  • Short neck
  • Large tonsils
  • Edema
33
Q

OSA Complications

A

Cardiovascular function: Increased risk for stroke
Metabolic: T2 Diabetes risk, weight gain
Neural functioning

34
Q

Sleep Fatigue

A

Higher in men, over 65+

35
Q

Assessment for Sleepiness ( Sleep Apnea )

A
  • Daytime sleepiness
  • Snoring
  • GERD
  • Height, weight, BMI
  • Assess oral cavity
  • High BP
36
Q

Diagnostic Assessment

A

STOP-Bang
Sleep study

37
Q

STOP Bang Questionnaire for Sleep Apnea

A

S: Snoring?
T: Tired
O: Observed
P: Pressure
B: BMI
A: Age
N: Neck size
G: Gender - Male
- Yes to 3+ questions= High risk
- Commonly treated with CPAP

38
Q

CPAP ( Continuous Positive Airway Pressure )

A

Nasal Pillow, Full face, Nasal

39
Q

Other interventions for improving sleep OSA:

A
  • Reduce obstruction
40
Q

Fatigue

A

Decrease in body’s reserves that affect basic body functions
- Examples: Overexertion of muscles –> weakens capacity

41
Q

Fatigue ( Affects )

A
  • Nutrition
  • Pain
  • Sleep
  • Perfusion
  • Mobility
  • Sickness
42
Q

Types of Fatigue

A

Physiologic
Secondary

43
Q

Physiologic Fatigue

A
  • Protein calorie malnutrition
  • Overexercising
  • Sleep deprivation
  • Pregnancy
  • Caffeine use
44
Q

Secondary Fatigue

A
  • Due to Acute Conditions
  • Acute renal failure
  • Influenza
  • Pneumonia
  • Traumatic injury
45
Q

Types of Fatigue

A

Secondary ( Due to Chronic Disease )
- Anemia
- Cancer
- COPD
- Diabetes
- Heart failure
- Depression

46
Q

Treatment related fatigue

A
  • Chemotherapy
  • Radiation therapy
  • Surgery
  • Medication side effects
47
Q

Medications that have the effect of Fatigue include

A
  • Beta blockers
  • Sedatives
  • Antihistamines
48
Q

Consequences of Fatigue

A
  • Neg impacts on quality of life
  • Limits functional ability
  • Change to routine
  • Depression
49
Q

Assessing Fatigue

A
  • Tiredness
  • Lack of motivation
  • Impaired function
  • Mental exhaustion
  • Lethargy
  • Muscle weakness
  • Loss of appetite
  • Palpitations / Dizziness
50
Q

EBP Interventions for Fatigue

A
  • Correct modifiable causes
  • Mild physical activity
  • Energy conservation
  • Balanced diet
  • Sleep hygiene
  • Therapies
  • Cognitive behavioral therapy

H&I EXAM 1 (10 decks)

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