Week 7 Promoting Sleep Flashcards
What is sleep?
Altered state of consciousness where perception and reaction to environment is decreased
Reticular Activating System
- Consists of ascending nerve fibres and is involved in the sleep wake cycle
- During sleep RAS experiences few stimuli from cerebral cortex and periphery
RAS stimulation indicates
Awake
Neurotransmitter
Lessens response to sensory stimulation
Serotonin
Neurotransmitter
Inhibition of sensory excitation
GABA
Neurotransmitter
Influence cerebral cortical arousal and wakefulness
Acetylcholine, Dopamine and Noradrenaline
Decrease in RAS stimulation
Darkness and preparation for sleep
Circadian Rhythm
Sleep wake cycle
Two types of sleep that alternate in cycles during sleep
NREM
REM
Non-rapid eye movement (NREM)
Occurs when RAS inhibited
75-80% of sleep
Has 3 stages
Rapid eye movement (REM)
20 - 25% of sleep
Lasts 5-30 mins
Recurs approx every 90 mins
Transitional stage between wakefulness and sleep
Relaxed state but still aware of surroundings
Involuntary muscle jerks (may wake)
Only lasts minutes
5% of sleep
NREM Stage 1
HR and RR decrease slightly
Eyes still
Lasts 10-15 mins
44-55% of sleep
NREM Stage 2
Greatest depth of sleep
Snoring
Swallowing and saliva production decreased
HR and RR decrease more
BP decreases
NREM Stage 3
Which stage is the brain active but the body can’t do anything
REM
Sleep cycle
Wakefulness
NREM Stage 1
NREM Stage 2
NREM Stage 3
NREM Stage 2
REM
NREM Stage 1/2
Newborn (0-3 months)
Sleep 14-17 hours
50/50 REM NREM
Infant (4-11 months)
Sleep 12-15 hours
More naps
Toddler (1-2 yrs)
Sleep 11-14 hours
Preschool (3-5 yrs)
Sleep 10-13 hours
School aged (5-12 yrs)
Sleep 9-11 hours
Adolescents (14-17 yrs)
Sleep 8- 10 hours
Adults
Sleep 7-9 hours
REM 20% of sleep
Sleep affected by health, occupation, exercise
Older Adult
Tendency toward earlier bedtime
May show increase in disturbed sleep
Functions of sleep
- Restores normal levels of activity
- Restores normal balance among nervous system
- Necessary for protein synthesis
- Psychological wellbeing
Insomnia
Inability to gain sufficient amount of quality sleep
- Difficulty falling asleep
- Waking frequent
- Difficulty staying asleep
- Daytime sleepiness
- Difficulty concentrating
- Irritability
Hypersomnia
Sufficient sleep at night and cannot stay awake during the day
- Drugs/alcohol
- Trauma to CNS
- Medication
- Depression
- Obesity
- Medical conditions related to kidney, liver ect
Narcolepsy
An uncontrollable desire for sleep or attacks of sleep during the day.
- Typically have sleep attacks during the day
- Nighttime sleep starts with onset of REM within 5 mins
- Lack of hypocretin in CNS (regulates sleep)
Sleep Apnoea
Frequent short breathing pauses during the night
- More than 5 episodes > 10secs every hour is abnormal
- Snoring
- Difficulty falling asleep
- Morning headaches
- Memory problems
- Irritability
Insufficient Sleep
Sleep deprivation which may be acute or chronic
- Daytime fatigue
- Poor concentration
- Reduced motivation
- Malaise
- Diplopia
- Dry mouth
Lack of sleep for 19 hours is equivalent to
0.05 BAC
Lack of sleep for 24 hours is equivalent to
0.10 BAC
Parasomnias
Behaviours interfering with and occurring during sleep
- Arousal disorders
- Sleep/wake transition disorders
- REM disruption
- Bruxism
- Enuresis
Somnambulism
Sleep walking
Sleep/wake transition disorders
Sleep talking
Bruxism
Teeth clenching/grinding
Enuresis
Bed wetting
(After 3 yrs age)
Sleep pattern assessment
- Sleep history
- Health history
- Physical examination
- Sleep diary and diagnostic studies
Sleep history
- Sleep/wake time habits
- Bedtime rituals
- Snoring?
- Drugs/alcohol/caffeine
Health history
- Used to rule out medical or psychiatric causes of poor sleep
- General health
- Medication
- Other diseases which may impact sleep
Physical examination
Used to determine presence of physical abnormalities associated with sleep apnoea
- Tonsils
Sleep diary
- Time factors
- Activities 2-3 hours prior to sleep
- Medication
- Caffeine/alcohol/drugs
- Bedtime rituals
- Daytime sleepiness
Goal for person with sleep disturbance
- Maintain a sleeping pattern providing sufficient energy for daily activities
- Enhance feeling of wellbeing
- Improve quality and quantity of persons sleep
Sleep hygiene
- Education
- Restful environment
- Support bedtime rituals
- Promote comfort and relaxation
- Medication if appropriate
The collection of ideas, feelings, beliefs one has about self
Self-concept
Image of physical self - How a person perceives the size, appearance and functioning of their body and its parts.
Body image
The conscious sense of individuality and uniqueness that is continually evolving throughout life
Personal identity
What a person does in a particular role in relation to the behaviours expected of that role
Role-performance
The value one has for one self, self confidence
Self-esteem
Positive concept – in which person is individually and socially responsible, self-directive, displays self-awareness, possesses resilience and good functioning.
Mental health
Knowing ones emotions, managing emotions, motivating oneself, recognising emotions in others, and handling relationships.
Emotional intelligence
