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NURS 875: Pediatrics > Week 04: Sleep > Flashcards

Week 04: Sleep Flashcards

1
Q

What is SDB?

A

Sleep-disordered breathing

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2
Q

What is leptin?

A

satiety hormone

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3
Q

What does leptin have to do with sleep and obesity?

A

lack of sleep increases leptin resistance which leads to obesity

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4
Q

When does the sleep cycle/circadian rhythm start to establish in a child?

A

2-4 months of age

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5
Q

How long does a typical sleep cycle last?

A

90 minutes

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6
Q

How many non-REM stages are there?

A

3

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7
Q

What are the non-REM stages?

A

NREM 1: eye movements/eye rolling
NREM 2
NREM 3: difficult to arouse

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8
Q

What happens during REM sleep?

A

muscle paralysis

vivid dreams

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9
Q

How much of sleep is REM sleep for infants?

A

50%

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10
Q

How much of sleep is REM sleep at age 5?

A

25%

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11
Q

symptoms of lack of sleep

A

excitable
more anxiety
intense fatigue

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12
Q

At what age do babies no longer need nighttime feeds?

A

6 months onward

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13
Q

At what age do most babies start sleeping through the night?

A

3 months

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14
Q

How long do babies keep the 2nd nap?

A

age 1

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15
Q

When do children often give up the afternoon nap?

A

age 3

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16
Q

DEFINE: night wakening

A

a child awakens >= 1x between 12A-5A
4-7x per week
>4 consecutive weeks

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17
Q

What is the FERBER METHOD?

A

a sleep training method that teaches self-soothing

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18
Q

Define SIDS

A

death of an infant (< age 1) during sleep

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19
Q

Known associations with SIDS

A

not breastfeeding
smokers in the house
sleep on tummy

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20
Q

School-age sleep struggles: when to cut out screen time?

A

at least 1 hour before bed

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21
Q

Define PARASOMNIAS

A

sleep disorder that causes abnormal behavior while sleeping

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22
Q

Parasomnia: normal or abnormal

A

COMMON in childhood; decreases with age

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23
Q

What can lead to parasomnias?

A 
fever
sleep deprivation
overly busy day
some medications
alcohol in a teenager
emotional stress
stimulants
antihistamines
menstruation
24
Q

Should kids use Benadryl?

A

generally not due to respiratory depression effects; NOT recommended to aid with sleep; if child needs something like Benadryl, use Allegra or Claritin instead

25
Q

DEFINE: bruxism

A

grinding of teeth at night

26
Q

Name some parasomnias

A 
sleepwalking
sleeptalking
night terrors
RLS
enuresis
bruxism
27
Q

What parasomnias do boys tend to experience more?

A

sleep talking

28
Q

What parasomnia do girls tend to experience more?

A

RLS

29
Q

Parasomnias tend to decrease except for which 3, which are more common at age 13?

A

sleeptalking
RLS
bruxism

30
Q

Night terrors: more in boys or girls?

A

boys

31
Q

What kind of family history makes night terrors more common?

A

FHx enuresis/sleepwalking in 1st degree relatives

32
Q

When do sleep terrors tend to occur?

A

During 1st 3rd of sleep, stage 3-4

33
Q

What medications can be beneficial for sleep terrors? Who prescribes them?

A

benzodiazepines, typically prescribed by sleep clinic

34
Q

For whom are sleep terrors associated with a neurological or psychiatric disorder?

A

Child: generally not
Adult: can be manifestation of PTSD

**Can be manifestation of a seizure

35
Q

When do NIGHTMARES tend to occur?

A

LATE in the sleep cycle

3-6 years

36
Q

When do NIGHT TERRORS tend to occur?

A

EARLY in sleep cycle

ages 4-8

37
Q

Issues with sleep bruxism

A

can damage teeth –> refer to dentist IF CHILD doesn’t outgrow it

38
Q

For whom does sleepwalking more commonly occur?

A

FHx of sleepwalking

39
Q

Major concern with sleepwalking

A

safety

40
Q

Treatment for sleepwalking

A

benzodiazepines or sedating anti-depressants: these are prescribed by a sleep clinic and NOT primary care

41
Q

DEFINE: nocturnal enuresis

A

bedwetting

42
Q

Why does nocturnal enuresis occur?

A

child develops bladder pressure during deep sleep

43
Q

For whom does nocturnal enuresis more commonly occur?

A

FHx of nocturnal enuresis

kiddos with:
OSA
constipation

44
Q

What is PRIMARY ENURESIS vs. SECONDARY ENURESIS?

A

PRIMARY: never attain dryness
SECONDARY: previously potty trained and dry for 6 months and nighttime wetting is happening again

45
Q

Treatments for nocturnal enuresis

A
  • behavior modifications (until ages 6-8): adequately hydrate earlier in the day; limit at night
  • double void: pee when dressing for bed; do bedtime routine; void right before bed
  • nighttime voids: wake child prior to when child typically wets the bed
  • alarm systems (try for 2-3 months): to arouse child enough that they awaken before an accident
46
Q

If using an alarm system for nocturnal enuresis, how many nights in a row does a child need to be dry in order to stop using it?

A

14

47
Q

Drug used to treat nocturnal enuresis

A

DDAVP (desmopressin 0.2mg)

48
Q

ISSUEs with using DDAVP for nocturnal enuresis

A

reduces urine volume at night, but there is high relapse rate
nasal spray not recommended due to higher adverse effect of hyponatremia

49
Q

If prescribing desmopressin for nocturnal enuresis, how long should a child use it?

A

stop it every 3 months to see if child has stopped bedwetting

50
Q

Tips for SLEEP HYGIENE

A

cut off screen time 1 hour before bed
comfortable environment
all night lights > 6’ from bed; dark if possible
nothing high energy right before bed; do something relaxing

51
Q

When do nocturnal penile erections typically begin?

A

13 years, 2 months

but can happen in utero; occurs throughout life

52
Q

What is Delayed Sleep Phase Syndrome?

A

difficulty falling asleep until early morning hours, but no trouble sleeping once they fall asleep

53
Q

With what is Delayed Sleep Phase Syndrome associated?

A

melatonin off
vitamin D deficiency
vitamin B12 deficiency

54
Q

What is used to treat Delayed Sleep Phase Syndrome?

A

melatonin, 1mg - 10mg
40-60min before bed
short term is the best so you don’t throw off innate melatonin and circadian rhythm

55
Q

What is associated with OSA?

A

obesity

large adenoids

56
Q

Medical word for sleep study

A

polysomnography

57
Q

What are nocturnal seizures?

A

can mask as disturbed sleep
more common in children
more common in 1st 2 hours of sleep

NURS 875: Pediatrics (12 decks)

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