Sleep & Rest Flashcards
Maslow lists sleep as-
A Physiological Requirement
Getting enough quality sleep according to our circadian rhythms can protect-
Mental/ physical health, safety, quality of life
What increases the risk of heart disease, kidney disease, high BP, diabetes, stroke, as well as weakens the immune system?
Chronic Sleep Deficiency
What are the 2 internal sleep mechanisms that help promote sleep?
Circadian Rhythm + Sleep-Wake Homeostasis
Your circadian rhythm directs a wide variety of body functions including -
Wakefulness, Core Temperature, Metabolism, and the Release of Hormones
Controls the timing of sleep, causes a person to feel sleepy at night and creates a tendency to wake up in the morning without an alarm =
Circadian Rhythm
Based roughly on a 24-hour clock + use environmental cues, such as light and temperature to determine the time of day =
Circadian Rhythm
Regulates sleep intensity, causing a person to sleep longer + more deeply after a period of sleep deprivation =
Sleep-Wake Homeostasis
What 3 hormones are a part of sleep-wake homeostasis?
Adenosine, Melatonin, & Cortisol
Increases through the day, peaking when it’s time to sleep. It’s broken down during sleep =
Adenosine
Released whenever it gets dark + signals the body that it is time to sleep =
Melatonin
Released in the morning to signal the body that it is time to awaken =
Cortisol
Name off the factors that influence a person’s sleep/ wakefulness
Medications, medical conditions, stress, sleep environment, foods + fluids consumed, exposure to light
The greatest influence to sleep and wakefulness is-
Exposure to light
Examples from a bright artificial light include light from-
A TV, Screen, Computer, or Smartphone
Bright artificial lights can-
Hurt sleep
Why might night-shift workers have the issue of falling asleep at work?
Their natural Circadian Rhythm + Sleep-Wake Cycle are disrupted
Jet lag disrupts-
Circadian Rhythms
When flying to a different time zone, a mismatch is created between-
A person’s internal clock and the actual time of day
Newborns may sleep more than how many hours a day?
16 hours
Preschool-aged children need to-
Take Naps
Young children tend to sleep more at what time of day?
Early Evening
Compared to young children, older adults tend to go to bed-
Earlier
Compared to young children, older adults tend to wake up-
Earlier
Compared to young children and older adults, teenagers tend to fall asleep-
Later at night
It’s natural for what kind’s of people to prefer later bedtimes at night and sleep later in the morning than adults?
Teenagers
Teenagers fall asleep later at night than younger children and adults because-
Melatonin is released and peaks later in the 24-hour cycle for teens.
The 2 Phases of Sleep =
Rapid Eye Movement (REM) + Non-REM (NREM) sleep.
A full sleep cycle takes how many minutes to complete?
80 - 100
Most people typically cycle through how many sleep cycles per night?
4 - 6
Is it common to wake up briefly between sleep cycles?
Yes
Restoration mostly takes place during-
Slow-Wave Sleep
During slow-wave sleep, what changes occur to the body?
Decreased brain oxygen consumption, HR, Body Temp.
Why is slow-wave sleep called slow-wave sleep?
Along with vitals, brain activity also decreases
What is it called to observe brain activity during sleep?
Sleep Studies
NREM has how many stages?
3
Transition between sleep and wakefulness is what stage of NREM sleep?
1st Stage
Initiation of the sleep phase is what stage of NREM sleep?
2nd Stage
Slow-Wave Sleep stage is also known as-
The deep sleep stage
Slow-wave sleep is what stage of NREM sleep?
The 3rd
What stage of sleep is based on a pattern that appears during measurements of brain activity?
Slow-Wave Sleep
People spend the most amount of sleep time in what stage of sleep during the early part of the night?
Slow-Wave Sleep
During REM sleep, what happens to a person’s vitals?
Increased HR + RR
In what stage of sleep do the eyes twitch as they rapidly move back and forth and the brain is active?
REM Sleep
Brain activity measured during REM sleep is similar to activity during-
Waking Hours
Dreaming occurs during what stage of sleep?
REM Sleep
In what stage of sleep do muscles normally become limp to prevent acting out one’s dreams?
REM Sleep
People typically experience more REM sleep when?
As the night progresses
What kinds of environments can affect a person’s REM sleep?
Hot + Cold Environments
How do hot or cold environments affect a person’s REM sleep?
The body doesn’t regulate temperature well during REM sleep
Lack of sleep affects-
Daytime performance + quality of life
During sleep, the body is working to promote-
Healthy brain function and maintain physical health
Sleep helps promote growth and development in-
Children + Teens
The way a person feels while awake depends on their-
Quality of sleep
A good night’s sleep helps improve-
Learning + improves problem-solving skills
What helps a person to pay attention, make decisions, and be creative?
Sleep
What can sleep deprivation lead to?
Depression, Suicide, Risky Behavior
Hormone that makes you feel hungrier =
Grehlin
Hormone that makes you feel like you can’t eat anymore =
Leptin
Does sleep control leptin and grehlin?
Yes
Is sleep involved in healing + repairing the heart and blood vessels?
Yeah
Can kidney disease, a high BP, diabetes and stroke be caused by sleep deficiency?
Yes
When a person doesn’t get enough sleep, the level of grehlin -
Increases
When a person doesn’t get enough sleep, the level of leptin -
Decreases
Why do you feel hungrier when sleep deprived?
Your grehlin levels are higher than your leptin levels
Adequate sleep helps promote-
Growth + Development
What stage of sleep triggers the body to release hormones that promote normal growth and development in kids + teens?
Deep Sleep (Slow-Wave Sleep)
Deep sleep triggers hormones that (along with helping growth and development) also help boost-
Muscle mass + Repair tissues & cells
What causes a slower reaction time?
Sleep Deficiency
How many hours of sleep do we have to lose for several nights before our functional ability declines?
1-2 Hours
What causes micro-sleep?
A lack of sleep
Short moments of sleep that occur when one is normally awake =
Micro-Sleep
Is it true that you can’t control micro-sleep and that you might not be aware of it?
Yes
Can micro-sleep affect how you function?
Yes
Is driving sleepy just as bad as being drunk, statistically speaking?
Yes
How many yearly car accidents are caused by sleepy driving?
100,000
How many yearly deaths are caused by sleepy driving?
1,500
What can lead to obesity?
Sleep Deficiency
What hormone controls your blood sugar level?
Insulin
How does sleep deficiency increase your risk for diabetes?
It affects your insulin level, which causes an elevated blood sugar level
Does sleep deficiency effect your immune system?
Yeah
Does sleep deficiency cause mood swings + impulsivity?
Yes
The total sleep lost =
Sleep Debt
Does sleep loss add up over time?
Yuh
If you lose 2 hours of sleep each night for a week, then what would your sleep debt be by the end of the week?
14 Hours
Can naps provide a short-term boost to alertness + performance?
Yes
Does napping provide restorative sleep?
No
Does napping affect the body’s sleep-wake rhythm?
Yes
Can sleep deficiency affect people even if they sleep the total number of hours recommended for their age group?
Yes
If your sleep is out of sync with your body clock or if you are routinely interrupted in your sleep. Are you at risk for suffering from sleep deficiency, even if you sleep the total number of hours recommended for your age group?
Yup
Sleep disorder that causes problems falling asleep, staying asleep, or getting good quality sleep =
Insomnia
Short-term insomnia lasts for-
A few days or weeks
Long-term insomnia lasts for -
Up to 3 months
Chronic insomnia raises the risk of-
High BP, coronary heart disease, diabetes, and cancer
Lying awake for a long time before going to sleep is a-
Insomnia symptom common in young adults
Sleeping only short periods and waking up often during the night is a-
Insomnia symptom
Waking up too early in the morning and not being able to go back to sleep is a-
Insomnia symptom
Having poor quality of sleep that causes one not to feel rested is a-
Insomnia symptom
Having poor quality of sleep that causes one not to feel rested (an insomnia symptom) causes -
Daytime sleepiness, difficulty focusing, irritability, anxiousness, depression
A health provider may ask for a 1-2 week sleep diary-records the time a person goes to sleep, wakes up and naps during the day. This is done to diagnose-
Insomnia
Timing of activities such as exercising and drinking caffeine should all be recorded when trying to diagnose -
Insomnia
What may be ordered for severe sleep problem?
A sleep study
Should you exercise 5-6 hours before bed?
Yeah
What is typically the first treatment for chronic insomnia?
CBT
Can prescription medication be used for chronic insomnia?
Yes
Certain medications for sleep are-
Habit-Forming
Benzodiazepines can be habit-forming and should only be taken for-
A few weeks
Ambien is a agonist for-
Benzo-Receptors
Ambien can increase-
Anxiety
Ramelteon (Rozerem) is a agonist for-
Melatonin
Rare side effects of Melatonin-receptor agonists may include-
Doing activities while asleep, such as walking, eating, or driving, or a severe allergic reaction
Can OTC melatonin worsen depression?
Yeah
Does OTC melatonin always help with sleep?
No
A common sleep condition that occurs when the upper airway becomes repeatedly blocked during sleep, reducing or completely stopping airflow =
Sleep Apnea
If the brain does not send the signals needed to breathe, then sleep apnea may be called-
Central Sleep Apnea
Sexual dysfunction is a symptom of-
Sleep Apnea
Waking up often to urinate is a symptom of-
Sleep Apnea
Decreased attention, concentration is a symptom of-
Sleep Apnea
Dry mouth or headaches when awake is a symptom of-
Sleep Apnea
Excessive daytime sleepiness + fatigue is a symptom of-
Sleep Apnea
Gasping for air during sleep is a symptom of-
Sleep Apnea
Frequently loud snoring is a symptom of-
Sleep Apnea
Reduced or absent breathing (apneic events) is a symptom of-
Sleep Apnea
Sleep apnea is diagnosed by a health care provider based on the person’s-
Medical history, a physical exam, and results from a sleep study
During sleep studies, the number of episodes of slowed or stopped breathing events (along with the oxygen levels in the blood during these events) are-
Recorded/ Documented
A CPAP machine is a-
Breathing device
The most commonly recommended treatment for patients with sleep apnea =
CPAP Machine
CPAP stands for-
Continuous Positive Airway Pressure
Uses mild air pressure to keep the airways open =
CPAP Machine
An uncommon sleep disorder that causes periods of extreme daytime sleepiness and sudden, brief episodes of deep sleep during the day =
Narcolepsy
Extreme daytime sleepiness is a symptom of-
Narcolepsy
Sleep attacks are a symptom of-
Narcolepsy
Falling asleep without warning is called a-
Sleep Attack
Difficulty focusing or staying awake is a symptom of-
Narcolepsy
Waking frequently at night is a symptom of-
Narcolepsy
Can narcolepsy cause hallucinations while falling asleep?
Yes
Can narcolepsy cause sleep paralysis?
Yeah
A feeling of not being awake but being unable to move=
Sleep Paralysis
Treatment for narcolepsy combines-
Medication + Behavior Changes
Stimulants, modafinil, sodium oxybate, and sedatives are all medications that are used to treat-
Narcolepsy
Modafinil, stimulants, and sodium oxybate are all used to treat what aspect of narcolepsy?
Daytime Sleepiness
Sedatives are used to treat what aspect of narcolepsy?
Nighttime Sleep
Do scheduled naps throughout the day help solve daytime sleepiness?
Yuh
How do you begin a focused assessment on a patient’s sleep patterns?
Ask an open-ended question such as, “Do you feel rested upon awakening?”
You are beginning a focused assessment on a patient’s sleep patterns. You’ve already done the first step (Ask the PT an open-ended question) so from here, what should be the next step?
Assess the 5 key sleep characteristics
What are the 5 key sleep characteristics?
Sleep Duration
Sleep Quality
Sleep Timing
Daytime Alertness
The presence of a sleep disorder
Is it helpful to determine the effects of caffeine intake and medications on a patient’s sleep pattern?
Yeah
If a patient provides information causing a concern for impaired sleep patterns or a sleep disorder, it is helpful to encourage them to-
Encourage them to make a sleep diary to share with a healthcare provider
Can nurses perform objective assessments of a patient’s sleep patterns during inpatient care?
Yes
The number of hours slept, wakefulness during the night, and episodes of loud snoring or apnea should be-
Documented
Physical (e.g., sleep apnea, pain, and urinary frequency) or Psychological (e.g., fear or anxiety) as well as sleepiness and napping during the day should all be-
Noted
If an older adult has Alzheimer’s disease, it often changes their-
Sleeping Habits
Some people with Alzheimer’s disease sleep too-
Much and others sleep too little
Some people with Alzheimer’s disease wake up many times during the night; others wander or yell at night.
True or false?
True
Are caregivers of those with Alzheimer’s at risk of not getting enough sleep?
Yes
What age group needs 12-16 hours of sleep a day (including naps)?
Infants aged 4-12 months
What age group needs 11-14 hours of sleep a day (including naps)?
Children aged 1-2 years
What age group needs 10-13 hours of sleep a day (including naps)?
Children aged 3-5 years
What age group needs 9-12 hours of sleep a day?
Children aged 6-12 years
What age group needs 8-10 hours of sleep a day?
Teens aged 13-18 years
What age group needs 7–8 hours of sleep a day?
Adults aged 18 years or older
A sleep study may be performed at a-
Sleep center or at home with a portable diagnostic device
Removable sensors are placed where on the person’s body during a sleep study?
Scalp, face, eyelids, chest, limbs, and a finger
Removable sensors are placed on the person’s body during a sleep study to record-
Brain waves, heart rate, breathing effort and rate, oxygen levels, and muscle movements before, during, and after sleep.
“Prolonged periods of time without sustained natural, periodic suspension of relative consciousness that provides rest” =
Sleep Deprivation
Healthcare staff should bundle care activities to minimize the number of awakenings by staff to allow for sleep cycles of at least-
90 Minutes
