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nurs 402: lecture > Rest and Sleep > Flashcards

Rest and Sleep Flashcards

Exam 3

1
Q

Rest

A

Rest refers to a condition in which the body is in a decreased state of activity, with the consequent feeling of being refreshed

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2
Q

Sleep

A

Sleep is a state of rest accompanied by altered consciousness and relative inactivity

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3
Q

What is sleep a part of?

A

Sleep is part of what is called the sleep–wake cycle

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4
Q

What is sleep a period of?

A

Sleep is a period of inactivity and restoration of mental and physical function

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5
Q

Wakefulness

A

Wakefulness is a time of mental activity and energy expenditure

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6
Q

Reticular activating system (RAS) facilitates what?

A

Facilitates reflex and voluntary movements

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7
Q

Reticular activating system (RAS) controls what?

A

Controls cortical activities related to state of alertness

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8
Q

What is the control center for sleeping and waking?

A

Hypothalamus

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9
Q

Non-rapid eye movement (NREM)
How many stages?

A

Consists of four stages

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10
Q

Stages I and II of NREM:

A

Stages I and II: 5% to 50% of sleep, light sleep

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11
Q

Stages III and IV of NREM:

A

Stages III and IV—10% of sleep, deep-sleep states (delta sleep)

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12
Q

Delta sleep

A

Deep sleep states

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13
Q

Rapid eye movement (REM)- how long is it?

A

20% to 25% of a person’s nightly sleep time

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14
Q

What happens physiologically during REM

A

Pulse, respiratory rate, blood pressure, metabolic rate, and body temperature increase;

skeletal muscle tone and deep tendon reflexes are depressed

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15
Q

How does someone pass through the stages of sleep in NREM

A

The person passes consecutively through four stages of NREM sleep

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16
Q

After someone does through the four stages of NREM consecutively, what happens?

A

The pattern is then reversed

Return from stage IV to III to II

Enter REM sleep instead of re-entering stage I

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17
Q

What occurs during NREM when four stages are occurring in order? (I–>IV)

A

The person re-enters NREM sleep at stage II and moves on to III and IV.

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18
Q

Effects of Insufficient Sleep in children?

A

May affect normal growth and development in children

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19
Q

Effects of Insufficient Sleep in children and adults?

A

May increase obesity risk in both children and adults

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20
Q

Effects of Insufficient Sleep in adults?

A

Lowers leptin levels and elevates ghrelin levels

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21
Q

Leptin

A

hormone that tells the brain to stop eating

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22
Q

Ghrelin:

A

promotes continued eating

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23
Q

Factors Affecting Rest and Sleep

A

Developmental considerations
Motivation
Culture
Lifestyle and habits
Environmental factors
Psychological stress
Illness
Medications

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24
Q

How does exercise affect sleep?

A

Activity and exercise increase fatigue and can promote relaxation followed by sleep; increases both REM and NREM sleep; contributes to a more restful sleep

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25
Q

Dietary habits:
affect of sleep

A

Amino acid L-tryptophan promotes sleep

Small protein snack combined with a healthy complex carbohydrate before bed improves sleep

Large quantities of alcohol limit REM and delta sleep

Caffeine blocks the ability of adenosine to cause drowsiness

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26
Q

What is associated with poorer sleep?

A

Smoking and nicotine are associated with poorer sleep

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27
Q

Psychological Stress: What causes it?

A

Can be caused by illness or life situations

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28
Q

Psychological Stress: How does it affect sleep?

A

Disturbs sleep

Difficult to obtain the amount of sleep needed

REM sleep decreases, leading to anxiety and stress

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29
Q

What happens to REM sleep during psychological stress?

A

Difficult to obtain the amount of sleep needed

REM sleep decreases, leading to anxiety and stress

30
Q

ICSD Classification of Sleep Disorders

A

Insomnia

Sleep-related breathing disorders

Central disorders of hypersomnolence

Circadian rhythm sleep–wake disorders

Parasomnias

Sleep-related movement disorders

Other sleep disorders

31
Q

Insomnia

A

Characterized by difficulty falling asleep, intermittent sleep or difficulty maintaining sleep, despite adequate opportunity and circumstances to sleep

32
Q

What percent of Americans complain of Insomnia?

A

As many as 30% to 35% of adults in the United States complain of insomnia

33
Q

Who is most likely to experience insomnia?

A

People with a history of depression are more likely to experience insomnia

34
Q

Many cases of insomnia are related to what?

A

Many cases of insomnia are related to disruptions in circadian rhythms

35
Q

How long is insomnia?

A

Insomnia may be short term or chronic in nature

36
Q

Sleep-Related Breathing Disorder: Obstructive Sleep Apnea (OSA)

A

Characterized by five or more predominantly obstructive respiratory events

37
Q

Five or more predominantly obstructive respiratory events called OSA are:

A

(apnea)

(hypopnea)

Respiratory effort-related arousals during sleep, accompanied by sleepiness, fatigue, insomnia, snoring

Subjective nocturnal respiratory disturbance

Observed apnea and associated health disorders

Gasping for air during sleep

38
Q

Apnea

A

The absence of breathing

39
Q

Hypoapnea

A

Diminished breathing efforts (hypopnea)

40
Q

Central Disorders of Hypersomnolence

A
  1. Idiopathic hypersomnia
  2. Narcolepsy
41
Q

Idiopathic hypersomnia

A

Characterized by excessive sleep, particularly during the day

42
Q

Narcolepsy is characterized by what?

A

Characterized by excessive daytime sleepiness and frequent overwhelming urges to sleep or inadvertent daytime lapses into sleep

43
Q

____% of people with narcolepsy also experience________

A

Up to 70% of people with narcolepsy also experience cataplexy,

44
Q

Cataplexy

A

the sudden, involuntary loss of skeletal muscle tone lasting from seconds to one or two minutes

45
Q

Characteristics of Circadian Rhythm Sleep–Wake Disorders

A

Chronic or recurrent pattern of sleep-wake rhythm disruption

46
Q

Primary causes of chronic or recurrent pattern of sleep- wake disruption include an alteration of:

A

An alteration in the internal circadian timing system or misalignment between the internal circadian rhythm and the sleep-wake schedule desired or required

47
Q

Other Primary causes of chronic or recurrent pattern of sleep- wake disruption include an alteration of:

A
  1. A sleep wake disturbance (ex; insomnia or excessive sleepiness)
  2. Associated distress or impairment, lasting for a period of at least 3 months (except for jet lag disorder)
48
Q

Parasomnias

A

Somnambulism

REM sleep behavior disorder (RBD)

Sleep terrors

Nightmare disorder

Sleep enuresis

Sleep-related eating disorder

49
Q

Sleep-Related Movement Disorders/Restless Legs Syndrome (RLS)

A

Restless legs syndrome (RLS), also known as Willis–Ekbom disease (WED),

50
Q

Restless legs syndrome (RLS), also known as Willis–Ekbom disease (WED) affects who?

A

is a common sleep-related movement disorder that affects up to 15% of the population, most often middle-aged and older adults

51
Q

What happens to people with RLS?

A

People with RLS cannot lie still and report unpleasant creeping, crawling, or tingling sensations in the legs

52
Q

What is the treatment for RLS?

A

Nonpharmacologic treatments

53
Q

Obtaining a Sleep History

A

Nature of problem

Cause of problem

Related signs and symptoms

When the problem began and how often it occurs

How the problem affects everyday living

Severity of the problem and how it can be treated

How the patient is coping with the problem and success of treatments attempted

54
Q

Screening Tools to Assess Sleep Disturbances

A

Sleep Diary

The Epworth Sleepiness Scale

The Pittsburgh Sleep Quality Index (PSQI)

STOP-Bang Questionnaire (OSA)

Stanford Sleepiness Scale

55
Q

Information Recorded in a Sleep Diary #1

A

Time patient retires

Time patient tries to fall asleep

Approximate time patient falls asleep

Time of any awakening during the night and resumption of sleep

Time of awakening in morning

Presence of any stressors affecting sleep

56
Q

Information Recorded in a Sleep Diary #2

A

Record of food, drink, or medication affecting sleep

Record of physical and mental activities

Record of activities performed 2 to 3 hours before bedtime

Presence of worries or anxieties affecting sleep

57
Q

Sleep Characteristics to Assess

A

Restlessness

Sleep activities

Sleep postures

Snoring

Leg jerking

58
Q

Key Findings of Physical Assessment

A

Energy level

Facial characteristics

Behavioral characteristics

Physical data suggestive of sleep problems

59
Q

Nursing Interventions to Promote Sleep

A

Prepare a restful environment

Promote bedtime rituals

Offer appropriate bedtime snacks and beverages

Promote relaxation and comfort

Respect normal sleep–wake patterns

Schedule nursing care to avoid disturbances

Use medications to produce sleep

Teach about rest and sleep

60
Q

Treatment for Dyssomnias

A

Pharmacologic therapy

Nonpharmacologic therapy

61
Q

Pharmacologic therapy
for Treatment for Dyssomnias

A

Sedatives
Hypnotics

62
Q

NonPharmacologic therapy
for Treatment for Dyssomnias

A

Cognitive behavioral therapy (CBT)

63
Q

NonPharmacologic therapy
for Treatment for Dyssomnias: Cognitive behavioral therapy (CBT)

A

Progressive muscle relaxation measures
Stimulus control
Sleep restriction; sleep hygiene measures
Biofeedback and relaxation therapy

64
Q
A
65
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66
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67
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68
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69
Q
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70
Q
A

nurs 402: lecture (17 decks)

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