sleep & Rest Flashcards
what is sleep
Cyclical states/altered consciousness
Decreased motor activity/perception
Selective response to external stimuli
what is rest
Mild to no activity
Relaxation; stress-free
Leads to feeling refreshed
What are the benefits of sleep
Increases mental performance Improves learning Helps the storage of long-term memory Restores energy Improves ability to cope Strengthens the immune system
how many hours do you need to get the benefits of sleep
at least 6 hours
Circadian rhythm
Internal clock
24-hour day-night sleep/wake pattern
Affects overall level of functioning
Reticular activating system
Its a part of the brain that helps control sleep, and wakefulness. caused by reaction in the hypothalamus to light.
when does Circadian rhythm start
Starts about 3rd week of life. and sets in about 6 months of life.
what are the stages of sleep
NREM
REM
NREM
non-rapid eye movement.
REM
rapid eye movement
how many stages of sleep are there
5
how long is a sleep cycle
approximately, 90-120 minutes and generally cycles 4-6 times a night
why is REM important
when you do most of your problem solving
stage I of sleep
NREM- light sleep, lasts a few minutes, person feels drowsy and relaxed, readily awakened.
Stage II of sleep
NREM- light sleep, body continues to slow, lasts 10-15 minutes, 44 to 55% of total sleep occurs, needs more stimulus to wake up
What happens in Stage II
body temperature begins to drop but the heart rate and breathing remain regular. The brain waves slow down.
Stage III & stage IV of sleep
NREM - deepest stages, difficult to arouse, muscles relax, snoring occurs.
what happens in body in Stage III of sleep
Deep sleep, brain slows, muscles and breathing slows, when bedwetting occurs in children
what happens in body in stage IV of sleep
deepest sleep, slowest brain waves, hard to awaken, tissue repair takes place, hormones are released for growth,
Loss of NREM
causes immune suppression, decreased pain tolerance, increased infection, profound fatigue
Rem sleep
every 90 minutes, lasts 5-30 minutes, when dreams occur
Brain highly active, increase in metabolism
If EEG is taken, REM resembles wakefulness
Eye movement occurs
voluntary muscles reduced
difficult to arouse
GI increased
irregular heart and respiratory rates
if you have a loss of REM
apathy, depression, confusion, disorientation
how long is the entire sleep cycle
90-110 minutes and they recommend 4-5 a night. between 6-9 hours.
how long does it take to get through the first 3 NREM stages
Pass through 1st 3 nrem stages in about 20-30 minutes
what is the longest stage
REM
what happens to the body in REM
rapid, irregular, shallow breathing
HR/BP increased
your legs/arms go flaccid ….this is what causes you not to act out your dreams.
can you skip stages
NO, you cannot skip stages….stages can vary in length , but you have to go through all of them
light sleep and slowing brain and body processes are associated with which stage of NREM sleep
II
Factors affecting sleep
Age, Lifestyle factors- Physical activity Food and alcohol Medications Caffiene Sleep habits An illness Environmental factors Temperature and humidity Noise and light Nonoxious odor Comfort of bedding
insomnia
inability to fall or remain asleep or go back to sleep
Circadian disorders
abnormality in sleep/wake times (e.g., jet lag, working night shift, rotating shifts)
dyssomnias
sleep disorders…you either can’t sleep, or can’t wake up- (insomnia or excessive sleep)
parasomnias
sleep walking-talking
Hypersomnia
excessive sleeping (especially during the day) can be related to depression
Restless leg syndrome
uncontrollable movement of legs during sleep/rest
sleep apnea
Periodic breathing cessation for at least 10 seconds during sleep
narcolepsy
Chronic disorder caused by the brain’s ineffectiveness in regulating sleep-wake cycles normally
Uncontrollable episodes of sleep during the day
symptoms of sleep apnea
loud snoring, sleepiness during the day, increased urination, insomnia , morning headache, intellectual deterioration, irritable and personality changes,
CPAP
continous positive airway pressure
bruxism
grinding of teeth. happens in stage II of non rem sleep
what are some disorders provoked by sleep
coronary artery disease, asthma, chronic obstructive pulmonary disease, diabetes, Gastric and intestinal ulcers.,
COPD
increased Co2 and decreased O2
sleep history
Description of sleeping problems Usual patterns Physical and psychological illness Current life events Emotional and mental status Bedtime routines Bedtime environment Behaviors of sleep deprivation
potential nursing diagnosis
Ineffective breathing pattern Compromised family coping Disturbed sensory perception Sleep deprivation Disturbed sleep pattern Anxiety Acute confusion Fatigue Ineffective coping
Nursing interventions to promote sleep
Cluster/schedule nursing care to avoid interrupting sleep
Create a comfortable/restful environment
Promote comfort/relaxation
Support bedtime rituals/routines
Offer foods that help promote sleep
Maintain safety of the client
Teach about sleep hygiene
Administer/complete client teaching aboutsleep-inducing medications
sleep medications
Non-Benzodiazepines
Benzodiazepines
Barbiturates
Tricyclic Antidepressants
non-benzodiazepines
short 1/2 life. eliminated quickly. it targets specific receptors, rather than depressing the whole central nervous system. can be habit forming. (ambien, sonata)
Benzodiazepines
long and short acting. There half life is longer. They linger longer. Daytime drowsiness, (valium, xanax, ativan….) more side effects. Not recommended
barbiturates
high risk for addiction, (seconal, nembutal) out for days
tricyclic antidepressants
elavil, tofranil,….very habit forming
melatonin
herbal sleep aid
