Stress & Sleep Flashcards

1
Q

General Adaptation Syndrome (GAS)

A

Three Stage reaction to stress

  1. Alarm Stage - Fight or flight response
  2. Resistance - body stabilizes and response opposite to alarm reaction —-> recovery
  3. Exhaustion - Body not able to resist the effects of the stressor —–> death
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2
Q

In response to stress, the hypothalamus sends a signal to the SNS. In response, the SNS stimulates the _______ to release epinephrine and norepinephrine (catecholamines) which prepare the body for the “flight and fight response”

A

Adrenal Medulla

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3
Q

In response to stress, the hypothalamus releases corticotropin releasing hormone (CRH) which stimulates the anterior pituitary gland to produce beta-endorphin (analgesic effect) and adrenocorticotropic hormone (ACTH). ACTH stimulates the release of corticosteroids (glucocorticoid - glucose and aldosterone - sodium)

A

Adrenal Cortex

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4
Q

Alarm Reaction in Other Bodily Systems

A

Heart - Increase heart rate & stroke volume; increase cardiac output —> increased BP, redistribution of blood to vital organs
Blood Vessels - peripheral vasoconstriction
Lungs - increased respirator rate; shallow breathing
Liver - glycogenolysis; increase blood glucose
GI system - decreased secretions and peristalsis; decrease digestion
Muscle - increase blood flow to muscle

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5
Q

Resistance Stage

GAS

A

Stabilization
Hormonal levels return to normal
Parasympathetic nervous system activity
Adaptation to stressors

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6
Q

Exhaustion State

GAS

A

Increase physiological response as noted in the alarm reaction
Decreased energy level
Decreased physiological adaption

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7
Q

Reticular Activating System (RAS)

A

Region in the brainstem that controls sleep cycle
Diffuse network of nerve pathways in the brainstem connecting the spinal cord, cerebrum, and cerebellum, and mediating the overall level of consciousness

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8
Q

Bulbar Synchronizing Region

A

Region in the brainstem that controls the sleep cycle
Area in the brainstem that releases serotonin from specialized cells in the raphe nuclei sleep system of the pons and medulla causing sleep

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9
Q

Other regions in the brain as well as hormones and neurotransmitters involved with sleep

A

Hypothalamus
Norepinephrine, serotonin, dopamine, Acetylcholine, histamine, GABA
Melatonin

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10
Q

NREM (non-REM) Sleep

Stages of Sleep

A

Accounts for 75%-80% of sleep
Subdivided into 4 stages
Stage I & II: light sleep states, easily arousable
Stage III & IV: deep sleep states, termed slow or delta waves
Decrease in vital signs and metabolic rate with continuous low level muscle movements

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11
Q

REM (rapid eye movement) Sleep

A
Accounts for 20%-25% of sleep
follows NREM sleep
Brain waves resemble wakefulness
Most vivid dreams occur
Increase in vital signs
Body loses muscle tone called REM atonia
Important in mental and emotional equilibrium and learning
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12
Q

Factors Affecting Sleep

A
Developmental Considerations
Motivation
Culture
Lifestyle & Habits
Environmental Factors
Psychological Stress
Illness
Medications
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13
Q

benefits of nap and sleep room for night-shifters

A

A 20 minute nap (restorative sleep) has potential to boost performance and accuracy, reduce fatigue, improve moods and better address patient’s needs

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14
Q

What are the differences in the NREM and REM Cycles during sleep for young and older adults? Similarities? Explain significance to nursing practice

A

Young adults: Sleep is affected by many factors - health, occupation, exercise. Lifestyle demands may interfere with sleep patterns. REM sleep averages about 20% of sleep; important to reinforce developing good sleeping habits
Older Adults: Sleep is less sound and stage IV sleep is absent or considerably decreased. Periods of REM sleep shorten; comprehensive nursing assessment and individualized interventions may be effective in long-term care of this age group. Use sedatives with extreme caution because of declining physiologic function and concerns about polypharmacy

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15
Q

Insomnia

A

Assessment: History taking, finding the cause of the disorder and note clinical manifestations (includes difficulty of falling asleep, long sleep latency, frequent awakenings, fragmented sleep; prolonged nighttime awakenings or awakening too early and not able to fall back to sleep; awakening feeling unrefreshed (nonrestorative sleep)
Interventions: Cognitive behavioral therapy; drug therapy

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16
Q

Obstructive Sleep Apnea

A

Sleep-disordered breathing characterized by partial or complete upper airway obstruction during sleep
Assessment: narrowing of air passages with relaxation of muscle tone during sleep or the tongue and soft palate fall backward and partially or completely obstruct the pharynx; loud snoring and brief cessation of breathing lasting from 10-90 seconds usually reported by bed partner; brief arousal described as startle response
Intervention: sleep on side (side lying/lateral) rather than supine, elevate head (fowlers); oral appliance; CPAP

17
Q

Central Disorders of Hypersomnolence

A

Narcolepsy and Hypersomnia are characterized by excessive daytime sleepiness. One significant difference is people with narcolepsy experience sudden onset of sleepiness while hypersomnia experience increasing sleepiness over time

18
Q

Circadian Rhythm Sleep-Wake Disorders

A

Shift workers and jet lag disorder

19
Q

Parasomnias

A

Somnambulism (Sleepwalking)
Sleep Terrors
Nightmares

20
Q

Sleep- Related movement disorders

A

Restless leg syndrome

21
Q

Effects of Sleep Deprivation

A

Neurologic: cognitive impairment, behavior changes
Endocrine: Increased risk for Type II Diabetes; increased insulin resistance; sleep duration and quality are predictors of HgA1C; decreased growth hormone
Immune: Impaired function
Cardiovascular: increased blood pressure in people with HTN
GI: increased risk for obesity
Pain: Poor sleep can intensify pain