Sleep Health Flashcards
describe the 2 main types of sleep
- Non-rapid eye movement (Non-REM)
- accounts for 75 to 80% of sleep
- has 4 different stages
- Rapid eye movement (REM)
- occurs about every 90 minutes
- lasts 5-30 minutes
- brain is highly active, but body is typically still
- dreams usually occur in the phase
T/F: some brain activity increases during sleep
TRUE
many parts of the brain are as active as awake periods
at least 2 hours of dream state per night
which hormones increase during sleep?
growth hormone
melatonin
how is sleep important?
- helps restore normal levels of activity and normal balance among parts of the nervous system
- necessary for protein synthesis which allows repair of cells and tissues
- allows time for our mind to solve problems
- allows time for memory processing
- non-REM sleep removes unnecessary info, moves memories to long-term storage
- REM sleep cements connections in our memory
describe sleep in newborns and infants
- 50% quiet or non-REM sleep and 50% active or REM sleep
- total sleep time = 16 to 17 hours/24 hour period with frequent awakenings for feeding and nurturing
describe sleep in children ages 1-5 years
- amount of sleep time decreases to ~11-13 hours per 24 hour period
- generally, sleep through the night
- nap during the day as needed
describe sleep in middle childhood ages 5-12 years
- total sleep time 10-12 hours
- may experience parasomnias (sleep problems) such as:
- enuresis (bedwetting)
- nightmares
- sleep walking
describe sleep in adolescents ages 12-18 years
- need ~9 hours of nightly sleep for optimal health, emotional well being, and cognitive functioning
- often experience delayed sleep phase syndrome
- frequently do not get sufficient sleep
what is delayed sleep phase syndrome?
can’t go to sleep until late at night and prefer to sleep later in the morning
describe sleep in adulthood
- generally need 7.5-8 hours of nightly sleep
- increasing frequency of problems sleeping including common sleep disorders such as:
- obstructive apnea
- insomnia
- restless leg syndrome
describe sleep in older adults ages 65+ years
- still need ~7-8 hours of total sleep time → may decrease to as little as 6 hours a night with naps common during the day
- increased number of nighttime awakenings
- frequently awaken very early in the morning
- sleep may be impacted by illness and medications
how common is it for people to get insufficient sleep?
- 7/10 adults have trouble sleeping
- ⅓ of Americans have symptoms of insomnia
- 57% of middle schoolers reported insufficient sleep
- 72% of high schoolers reported insufficient sleep
list contributors to sleep disorders
- aging
- overweight
- diabetes
- pain/illness
- genetics
- smoking
- medications, stimulants, alcohol
- stress
- environment
list 3 signs of sleep deprivation
- needing an alarm clock to wake up
- falling asleep within 5 minutes of hitting the pillow
- well-rested people take 10-15 minutes
- napping easily
list general symptoms of a sleep problem
- performance decrease: academic, physical, etc.
- behavioral difficulties
- irritable
- hyperactive
- frequent illness
- headaches, jaw pain, earaches
- depression, anxiety
- daytime sleepiness
list consequences of poor sleep health
- irritability
- exhaustion
- easily distracted
- making unsound decisions
- impaired cognition performance
- increase likelihood of:
- motor vehicle accidents
- industrial accidents
- medical errors
- loss of work productivity
- heart disease
- weight gain
- impaired immune system
- cancer
- stroke
- diabetes
- pain
- mental health
- memory
- reproduction
- early death
how does poor sleep contribute to weight gain?
inadequate sleep cases shifts in hormones which may:
- decrease sense of being full
- signal hunger
- increase appetite
- decrease impulse control
how does poor sleep contribute to heart disease?
shorter sleep is associated with 45% increase of developing heart disease and/or dying of heart disease
- increases BP and HR
- increases atherosclerosis
- increases cortisol (fight or flight hormone)
list common sleep issues
- Insomnia
- sleep apnea
- restless leg syndrome
list symptoms of insomnia
- difficulty falling asleep
- difficulty staying asleep
- waking after sleep and still not feeling rested and refreshed
- acute → less than 30 days
- chronic → 30 days or longer
T/F: there is a clear association between stress and insomina
TRUE
how is insomnia treated?
- behavioral and lifestyle changes
- relaxation techniques
- developing bedtime routine
- physical activity
- medications
- don’t rely on alcohol
list and describe the 2 types of sleep apnea
- obstructive sleep apnea → upper airway becomes blocked repeatedly during the night reducing or stopping airflow
- central sleep apnea → brain does not send signals needed to breathe during the night
how is sleep apnea diagnosed?
via sleep studies
list risk factors for sleep apnea
- age
- alcohol
- smoking
- obesity
- 10% increase in body weight increases risk up to 6x
- genetics
list common signs/symptoms of sleep apnea
- common signs:
- reduced or absent breathing
- frequent loud snoring
- gasping for air during sleep
- common symptoms:
- excessive daytime fatigue
- decrease in attention, concentration, motor skills
- dry mouth or headaches when waking
list complications of sleep apnea
- asthma
- atrial fibrillation
- cancers (pancreatic, renal, skin)
- chronic kidney disease
- cognitive and behavioral disorders
- vascular disease
- eye disorders
- metabolic disorders
- pregnancy complications
list treatments for sleep apnea
- physical activity
- obtain/maintain healthy weight
- develop healthy sleep habits
- quit smoking
- CPAP machine
- surgery
- mouthpieces
describe restless leg sydrome
- unpleasant or uncomfortable sensations in legs and an irresistible urge to move them
- symptoms occur in late afternoon or evening hours, and most severe at night
- moving legs or walking typically relieves the discomfort but symptoms return once movement stops
how common is restless leg syndrome?
estimated 7-10% of US population
what is the cause of restless leg syndrome?
unknown
restless leg syndrome is thought to be related to what things?
- genetics
- basal ganglia dysfunction
- end-stage renal disease
- iron deficiency
- neuropathy
- certain meds
- use of alcohol, nicotine, caffeine
how is restless leg syndrome treated?
- lifestyle changes
- decrease alcohol use
- decrease tobacco use
- maintain a sleep routine
- obtain moderate physical activity
- massaging the legs
- iron supplement if symptoms due to low iron blood levels
- anti-seizure meds
- dopaminergic agents
T/F: people with TBIs generally have more sleep disturbances than the general population
TRUE
this is due to physical and chemical changes to the brain as well as changes in the sleep-wake cycle and mood (depression and anxiety)
list common sleep problems in pts with TBIs
- insomnia
- hypersomnia - sleeping too much
- sleep apnea
- circadian rhythm disorders - disruption of sleep-wake cycle
why do we care about how pts with a TBI sleep?
- brain needs sleep to recover
- sleep disturbances are associated with many symptoms that can greatly affect day-to-day life
- poor sleep may have a negative effect on thinking abilities
- people living with TBI who experience sleep problems often have problems with:
- attention
- learning and memory
- aspects of executive functioning
- sleep interventions that change behaviors around sleep can improve mood and cognition
T/F: there is a link between pain and sleep
TRUE
evidence suggests the effects of sleep on pain is stronger than the effect of pain on sleep
sleep problems put people at higher risk of developing fibromyalgia and migraines
T/F: long term improvement in quality of sleep may improve chronic pain
TRUE
________ is a powerful cue for the circadian rhythm and cues wakefulness
daylight exposure
list common conditions contributing to sleep issues in older adults
- depression
- anxiety
- heart disease
- diabetes
- pain
list common sleep issues in older adults
- pain
- frequent urination
- insomnia
- daytime drowsiness
- sleep apnea
- restless leg syndrome
what standardized assessment should be used when assessing health status pertaining to sleep
Sleep Disorders Questionnaire
if not using standardized assessment use BEARS sleep assessment guide
what is the BEARS sleep assessment guide?
B - bedtime problems?
E - excessive sleepiness during the day?
A - awakening at night?
R - regularity of sleep (number of hours)?
S - sleep disorders (snoring, sleep apnea, etc.)
things to remember regarding stimulus control and healthy sleep habits
- don’t go to bed until you are sleepy
- use the bed/bedroom only for sleeping (don’t read watch TV, eat, use your cellphone, or worry)
- get out of bed when unable to sleep after 15 minutes; do something relaxing and avoid stimulating activity/thoughts
- arise from bed at the same time every day
- do not nap during the day
List healthy sleep habits
- sleep only as much as you need to feel refreshed during the following day
- exercise regularly
- make your bedroom comfortable and free from disturbing light and noise
- eat regular meals, do not go to bed hungry
- reduce caffeine intake
- avoid drinking alcohol - especially in evening
- avoid smoking at night when having trouble sleeping
- don’t try too hard to fall asleep
- put the clock under the bed or turn it so you can’t see it
- practice meditation and controlled breathing techniques
what is one of the most common sleep robbers?
- Technology
- FOMO
- screen addictions
- lights from technology
- vibrations from cell phones and WiFI routers
- Other sleep robbers
- sleep partner
- pets
- children
