WK 7 Sleep Flashcards
benefits of sleep
provides healing and restoration
preserves cardiac function
repairs and renews cells
conserves energy
improve memory
improve creativity
have a healthy weight
sharpen attention
stay healthy
reduce stress
reduces inflammation
boosts immune system
greater athletic performance
better productivity and concentration
prevents depression
chronic sleep loss can increase risk of:
obesity
depression
hypertension
heart attack
CVA
DM
factors influencing sleep
physical illness
medications and substances
lifestyle
usual sleep patterns
emotional stress and mental illness
environment
exercise and fatigue
food and caloric intake
two sleep phases
nonrapid eye movement (NREM)
rapid eye movement (REM)
NREM progress through 3 stages
recent changes - combine 3&4
typically 90 min
stages progress from lighter to deeper sleep
REM
phase at the end of each 90-min sleep cycle
increased brain activity
rapid eye movements
muscle atonia
stage 1 NREM
lightest level, lasts few minutes
decreased physiological activity
loss of awareness of surroundings
muscle relaxation
VS and metabolism begin to decrease
stage 2 NREM
deeper
progression of relaxation
VS and metabolism continue to slow
NREM stage 3
slow wave sleep or delta sleep
deepest stage
VS continue to decrease
T/F: NREM is 75% of night
true
T/F: REM is 35% of night
true
REM facts
vivid, full color dreaming occurs
happens about 90 minutes after falling asleep
rapidly moving eyes
fluctuating VS
cognitive restoration
loos of skeletal muscle tone
difficult to around
duration of REM sleep increases with each cycle with an average of 20 mins
REM suppressants
opioids/narcotics
stimulants
benzodiazepines
antidepressants
alcohol
smoking
biological rhythms
these rhythms are controlled within your body and synchronized with environmental factors
biological rhythms regulate
feelings of sleepiness and wakefulness over 24-hour period
most familiar biological rhythm is
circadian rhythm
circadian synchronization
when a person’s biological clock coincides with their sleep/wake cycle
sleep disorders
insomnia
sleep apnea
narcolepsy
sleep deprivation
parasomnias
shift work sleep disorder
restless leg syndrome
insomnia
most common sleep disorder
most common in individuals with depression and women
experience excessive daytime sleepiness and insufficient sleep quality and quantity
transient insomnia
associated with situational stresses
insomnia treatment: self care
improve sleep hygiene measures
stay active
review medications
avoid or limit naps
limit or avoid alcohol and nicotine
treat pain
avoid large meals or beverages before bed
at bedtime, follow good sleep hygiene
insomnia treatment: therapies
light therapy
yoga
acupuncture
cognitive behavioral therapy
insomnia treatment: medications
prescriptions: eszopiclone, remelteon, zaleplon, zolpidem
OTC: antihistamine, melatonin
antidepressants
benefits of light therapy
non-invasive and safe
increase effectiveness of other forms of treatment
light therapy can help alleviate symptoms of:
seasonal affective disorder
non seasonal mood disorders
psoriasis and other skin disorders
insomnia and sleep disorders
stress
chronic pain
acne and breakouts
signs of aging
sleep apnea
where breathing is repeatedly interrupted
frequent pauses 10 seconds to 2 mins
large amount are undiagnosed and untreated
types of sleep apnea
obstructive
central
mixed
sleep apnea risk factors
increased age
male
fam history
obesity
HTN
smoking
heart failure
alcohol
nasopharyngeal structural abnormalities
large neck circumference
menopause
sleep apnea symptoms
loud snoring
episodes of no breathing
gasping for air during sleep
excessive daytime sleepiness
fatigue
morning headaches
irritability
depression
difficulty concentrating
decrease sex drive
dry mouth when you wake
insomnia
sleep apnea complications
daytime fatigue
HTN
heart disease
heart failure
DM
metabolic syndrome
complications with medications and surgeries
liver problems
sleep-deprived partners
sleep apnea treatment
weight reduction and exercise
avoid alcohol and smoking
sleep on side
improve sleep hygiene
BiPAP
CPAP
surgery
oral repositioning devices
sleep apnea treatment: BiPAP and CPAP
BiPAP: bilevel positive airway pressure
CPAP: continuous positive airway pressure
sleep apnea treatment: surgery
tissue removal
tissue shrinkage
jaw repositioning
implant
tracheostomy
narcolepsy
chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep
difficult to stay awake for long periods of time
type 1 narcolepsy
with cataplexy
type 2 narcolepsy
without cataplexy
risk factors of narcolepsy
age and fam history
no cure
symptoms of narcolepsy
excessive daytime sleepiness
cataplexy
sleep paralysis
changes in REM sleep
hallucinations
narcolepsy complications
public misunderstanding of condition
interference with intimate relationships
physical harm
obesity
narcolepsy treatment: medications
stimulants or wakefulness promoting agents: modanifil, armodafinil
antidepressants to supress cataplexy
narcolepsy treatment: lifestyle changes
regular exercise program
strategic planning of day
eat meals high in protein
deep breathing
chewing gum
good sleep habits
avoid factors that increase drowsiness
narcolepsy treatment: coping and support
talk about it
be safe
support groups
sleep deprivation
decrease in quality or quantity of sleep and/or inconsistency in sleep
amount of sleep varies for individuals
most adults need 7-8 hours of sleep/day
1:5 adults fail to get enough sleep
causes of sleep deprivation
illness
emotional stress
medication
environmental disturbance
variability in timing of sleep as a result of shift work
sleep apnea and insomnia can lead to this
sleep deprivation psychological symptoms
confused and disoriented
increased sensitivity to pain
irritable, withdrawn, apathetic
agitated
hyperactive
decreased motivation
excessive sleepiness
sleep deprivation physiological symptoms
ptosis, blurred vision
fine motor clumsiness
decreased reflexes
slowed response time
decreased reasoning and judgment
decreased auditory and visual alertness
cardiac dysrhythmias
sleep deprivation treatment
there is no substitute for sufficient sleep
best and most effective treatment is correct the environmental problem
dangers of sleep deprivation
performance
magnifies alcohol effects
driver fatigue
parasomnias
more common in children
if adults have this, it could relate to a more serious problem
examples of parasomnias
nocturnal enuresis
body rocking
bruxism
confusional arousals
somnabulism
night terrors
nightmares
parasomnias treatment
they vary but aim towards maintaining safety and supporting pt
shift work sleep disorder (SWSD)
affects ppl who work different shifts or at night
common symptoms of SWSD
insomnia
excessive sleepiness
difficulty concentrating
headaches
lack of energy
consequences of SWSD
increased likelihood of accidents and work related errors
irritability and mood problems
difficulty coping
impaired social functioning
SWSD management and treatment
important to get at least 7-8 hours of sleep/night
attempt to minimize exposure to light on the way home
follow bedtime rituals and routines
create a quiet, dark, peaceful setting during sleeo
avoid string of night shifts in a row
avoid long commutes
plan a nap before your shift to increase alertness
restless leg syndrome
uncontrollable urge to move legs
moving eases the unpleasant feeling temporarily
can begin at any age but worsens as you age
symptoms of restless syndrome
unpleasant sensations in legs and feet (crawling, creeping, pulling, throbbing, aching)
relief after movement
worse in the evening
nighttime leg twitching
restless leg syndrome risk factors
peripheral neuropathy
iron deficiency
kidney failure
spinal cord injuries
restless leg syndrome treatment medications:
increase dopamine
affecting calcium channels
opioids
muscle relaxants
sleep medications
restless leg syndrome treatment: lifestyle changes
baths, massages
warm compress or cool
good sleep habits
exercise
foot wrap
sleep assessment
pt centered
obtaining sleep history
sources for sleep assessments
tools for sleep assessments
obtaining sleep history for sleep assessment
characteristics of sleep problems
usual sleep pattern
bedtime routines and environment
physical and psychological illness
current life events
sleep planning goals and outcomes
explore professional standards
make t pt centered
sleep planning setting priorities
if physical illness is causing symptoms - make this priority
ask the individual what is priority
sleep planning teamwork and collaboration
work with pt and sleep partner
are interventions planned realistic and achievable
in hospital: cluster care, use machines to monitor vs waking every hours, include all teams in this plan
may need referral to comprehensive center
sleep implementation health promotion bedtime environment
room temp
proper ventilation
reduce noise
bed: mattress, place in bed, angle of bed
light: varies, be sure to assess risk of falls
limit electronic devices: emit blue light that affects circadian rhythm
sleep implementation health promotion bedtime routines
important to go to sleep when tired or sleepy
avoid excessive mental stimulation
encourage relaxation activities (reading, music, deep breathing, guided imagery, praying)
bedroom not a place for work
sleep implementation health promotion bedtime snacks
diary products or something that contains L-typtophan
not recommended: caffeine, heavy meal, alcohol
sleep implementation health promotion promote comfort
loos fitting clothing
extra blanket
void before bed
sleep implementation health promotion promote safety
low position
night light
remove clutter and rugs
sleep implementation health promotion promote activity
stay physically active during the day
rigorous activity 2-3 hours before
sleep implementation health promotion promote stress reduction
do not force sleep
don’t lay in bed when unable to relax
sleep implementation pharmacological
melatonin
melatonin receptor agonist
herbal supplements
prescription drugs
promoting sleep in acute care: environment controls
curtains, shut door
lessen noise
ear plugs/ eye masks
promoting sleep in acute care: promoting comfort
provide personal hygiene before bed
void before
position off wounds or pressure points
back rub or massage
adjust dressings or change as needed
adjust lines, tubes, drains
promoting sleep in care: establishing periods of rest and sleep
avoid waking for nonessential tasks
cluster care
include pt
promoting sleep in acute care: promoting safety
monitor respiratory status
risk for falls: fall prevention intervention
promoting sleep in acute care: stress reduction
knowledge is power
sleep evaluation
through the pt eyes
pt outcomes
