Sleep & Rest - Cycles And Disorders

Question 1

Sleep-wake patterns cause us to what? And when?

Answer 1

Sleepy : 10 pm - midnight
Wake rested (feeling fresh when waking up) : 6 am - 8 am

Question 2

What occurs with aging in terms of sleep phase/cycle?

Answer 2

Advanced sleep phase occurs - sleepy earlier in pm and wake earlier in am

Question 3

What does lack of sleep or inability to sleep cause?

Answer 3

Stress and anxiety

Question 4

How many sleep stages?

Answer 4

5

Question 5

How long is the sleep cycle intervals in length?

Answer 5

Approx 90 mins

Question 6

What are the two categories of sleep cycle?

Answer 6

Non rapid eye movement (NREM) and rapid eye movement (REM)

Question 7

What are the stages in NREM?

Answer 7

Stage 1 - lightest sleep
Stage 2 - onset of sleep
Stages 3-4 - deepest sleep

Question 8

What are the stages in REM?

Answer 8

Stage 5 - dream stage

Question 9

Age related changes in NREM sleep? (Each stage)

Answer 9

Stage 1 - increased time in light sleep
Stage 1 & 2 - increased shifts between these two stages
Stage 3 & 4 - decreased time in deep sleep

Question 10

Age related changes in REM sleep? (Each stage)

Answer 10

Stage 5 - shorter episodes, begins earlier in the night, less intense

Question 11

Age related changes in sleep schedule?

Answer 11

Advanced sleep phase

Question 12

Age related changes in sleep efficiency?

Answer 12

Reduced time sleeping vs time spent in bed

Question 13

Age related changes in sleep initiation? (Sleep latency)

Answer 13

Longer time to fall asleep

Question 14

Age related changes in sleep maintenance?

Answer 14

More frequent arousals (waking up more often in the night)

Question 15

What are risk factors that can affect sleep?

Answer 15

Psychosocial factors (anxiety, depression, excessive napping, boredom)

Environmental conditions (temp, noise, lack of privacy, lack of daylight)

Effects of meds (adverse effects, caffeine and nicotine, alcohol can suppress REM)

Question 16

What is insomnia?

Answer 16

• difficulty falling asleep
• difficulty staying asleep

Question 17

Comorbidities of insomnia? (One or more additional conditions that occur with primary condition)

Answer 17

• nocturia, dementia, GERD

Question 18

What is disordered breathing: obstructive sleep apnea?

Answer 18

Recurrent episodes of upper airway collapse and reduction or cessation of airflow despite persistent respiratory efforts

Question 19

How many times per hour does sleep apnea occur?

Answer 19

5-8x

Question 20

Involuntary airflow cessation is as long as?

Answer 20

More than 10 seconds

Question 21

Symptoms of sleep apnea?

Answer 21

• Gasping/choking
• irritability
• impaired cognition
• morning headaches
• daytime fatigue

Question 22

Risk factors for sleep apnea?

Answer 22

Obesity, large neck circumference, diabetes, stroke, Parkinson’s, alcohol and central nervous system depressant meds

Question 23

Management for sleep apnea?

Answer 23

Weight loss, exercise, continuous positive airway pressure, avoiding sedatives and alcohol

Question 24

What is periodic limb movement during sleep (PLMS)?

Answer 24

Leg jerks or movement (involuntary)

Occur every 20-40 seconds and last minutes to hours

Question 25

What is restless leg syndrome (RLS)?

Answer 25

Uncontrollable urge to move legs while awake (often when trying to fall asleep)