class #3 sleep

Question 1

what is sleep?

Answer 1

the natural periodic suspension of consciousness during which the powers of the body are restored.

for general purposes, the most important idea is that sleep is natural, necessary, involves a shift in physiological and neurological activity and is intended to be restorative.

Question 2

what are the two internal biological mechanisms regulate wakefulness and sleep?

Answer 2

sleep-wake homeostasis/ homeostatic drive
circadian rhythms

Question 3

true or false: the longer one stays awake the pressure gets stronger and reaches low after good quality sleep

Answer 3

true

Question 4

what is sleep debt?

Answer 4

this is essentially when your not getting enough sleep

Question 5

what is a circadian rhythm?

Answer 5

physical, mental, and behavioural changes that follow a 24 hr cycle

control a wide variety of body functions (temp, hormones)

Directed by a master clock, group of neurons called suprachiasmatic nucleus located in the hypothalamus

Question 6

what is the strongest cue for circadian rhythms?

Answer 6

light/dark cycle of the sun

Question 7

where is the suprachiasmatic nucleus, the director of circadian rhythms located in the brain?

Answer 7

hypothalamus

Question 8

what is the master circadian pacemaker or circadian clock?

Answer 8

the brains hypothalamus

Question 9

true or false: Numerous peripheral circadian oscillators (clocks) throughout the human body do not drive circadian rhythms.

Answer 9

false; it does

Question 10

what are some neurotransmitters associated with wakefulness

Answer 10

orexin/hypocretin
serotonin
acetylcholine
histamine
noradrenaline
dopamine

Question 11

what are some neurotransmitters associated with sleep

Answer 11

Adenoise
GABA
Melatonin
Galanin

Question 12

Whats the reticular activating system?

Answer 12

• (RAS) is a complex bundle of brain nerves responsible for regulating wakefulness and sleep-wake transitions, calm mind and body

Question 13

what are the two phases of sleep?

Answer 13

REM and NREM - 3 stages

Question 14

how long does a full sleep cycle take?

Answer 14

90-110 minutes, most people cycle through four to six cycles per night

Question 15

what kind of waves are found in REM N1, N2, N3

Answer 15

REM - low voltage, high frequency, looks like this when having a dream and your tryna get away

N1- theta
N2- sleep spindle K complex
N3 - delta wave

Question 16

what kind of movement is found in REM N1 N2 N3

Answer 16

REM - feel paralyzed (to keep you safe)
N1 - hypnotic jerks
N2 - eye movement stops
N3 - N/A

Question 17

what does physiology look like in REM N1 N2 N3

Answer 17

REM - HR increase, BP increase, brain activity
N1 - transition from awake to sleep
N2 - decrease temp, rr and hr, muscles
N3-

Question 18

what does cognition look like in REM N1 N2 N3

Answer 18

REM - vivid dreams
N1 - halogenic hallucinations - might hear a voice (as your falling asleep)
N2 - N2 is light sleep
N3 - HR and breathing slow and muscles relax completely - deep sleep

Question 19

what kind of waves are found when awake and drowsy?

Answer 19

awake - beta waves
drowsy - alpha waves

Question 20

true or false - sleep increases metabolism

Answer 20

true

Question 21

what are some important factors on sleep?

Answer 21

healthy brain function and emotional well being
physical health
daytime performance
immune system

Question 22

what are the sleep duration considerations for infants - adults 18 and older?

Answer 22

infants aged 4-12 months - 12-16 hours a day (including naps)

Children aged 1-2 years - 11-14 hours a day (including naps)

Children aged 3-5 years- 10-13 hours a day (including naps)

Children aged 6-12 years - 9-12 hours a day

Teens aged 13-18 years - 8-10 hours a day

Adults aged 18 years or older 7-8 hours a day

Question 23

how does sleep vary?

Answer 23

age - more sleep required during rapid growth
health - stress and illness
genetics
sleep debt
circadian rhythm

Question 24

true or false: Children tend to sleep more soundly, deeply

Answer 24

true

Question 25

true or false: Sleep of older adults more fragmented,and lighter

Answer 25

true

Question 26

what does insufficient sleep cause?

Answer 26

obesity vehicle crashes worker error chronic diseases such as heart disease, diabetes and cancer premature death

Question 27

what does healthy sleep cause?

Answer 27

safety good mental health and body weight feelings of wellness preventing infections and development of many chronic illnesses

Question 28

what are some primary sleep disorders?

Answer 28

Insomnia Obstructive sleep apnea Restless leg syndrome Circadian rhythm sleep disorders hypersomnia(Narcolepsy) and Parasomnias include various behaviours such as sleepwalking, sleep terror and REM behaviour disorders.

Question 29

what are some secondary sleep disorders?

Answer 29

These disorders occur due to other situations and correcting that situation should resolve the problem

Question 30

what connects to circadian rhythm sleep disorders?

Answer 30

- jet lag/shift work sleep disruptions , melatonin: body can decrease production of it naturally - advanced sleep phase disorder (body circadian rhythm is altered) - delayed sleep phase disorder(night owls)

Question 31

what can shift work (long work hours) disrupt?

Answer 31

circadian rhythms, sleep and family/social life (cause problems and reduce productivity)

Question 32

what are some sleep disordered breathing?

Answer 32

Obstructive sleep apnea (soft palate collapsing, enlarged tonsils, tongue falling back) Obesity hypoventilation syndrome (intervention: sleep a little up right) Central sleep apnea (neurological)

Question 33

what is insomnia?

Answer 33

inability to fall asleep or stay asleep, common disorder with several risk factors these include: advancing age, family history, gender (females), lifestyle/sleep habits, stress, medical and psychiatric disorders

Question 34

what are some factors that affect insomnia?

Answer 34

spiritual factors social factors: responsibilities, work, family, loneliness, boredom psychological factors: anxiety, depression, dementia, grief, loss physiological factors: pain/discomfort, respiratory distress, immobility, meds

Question 35

what is narcolepsy?

Answer 35

- an uncommon sleep disorder that causes periods of extreme daytime sleepiness and sudden brief episodes of deep sleep during the day (can be dangerous)

Question 36

what is the physiology of narcolepsy?

Answer 36

A chronic neurological disorder caused by a deficiency of neuropeptide (hypocretin) that results in the brain’s inability to regulate properly sleep– wake cycles.

Question 37

what are some parasomnias?

Answer 37

somnambulism: (sleep walking) - most frequent in children (school aged), also occur in adults sleep terrors - mostly not remembered, deep sleep cant be woken up (mostly kids that dont get good sleep) Enuresis: bed wetting, usually grow out of it

Question 38

what screening tool can you use to see how sleepy you are?

Answer 38

Epworth Sleepiness scale

Question 39

true or false: sleep assessment can be very subjective

Answer 39

true

Question 40

what are some sleep related movement disorders?

Answer 40

restless leg syndrome and periodic limb movement during sleep cause: low iron, genetic secondary to other health conditions Symptoms: crawling feeling, women esp. pregnant, worse in evening and night, disturbs sleep, PLMS common treatment: moderate exercise, iron, calcium(some studies say this), water if dehydrated dopaminergic agents, anticonvulsants, benzodiazepines, opioids (severe

Question 41

what does a sleep assessment consist of ?

Answer 41

◦ History ◦ Examination Findings: Physical examination ◦ Micrognathia, retrognathia, enlarged tonsils ◦ Body mass index (BMI). ◦ Physical examination of respiratory and cardiac function ◦ Medical history and Medication review ◦ Diagnostic Tests ◦ Polysomnogram ◦ Focused interviews

Question 42

what are some ways to manage sleep issues

Answer 42

primary prevention: how to make sleep better secondary prevention: screening collaborative interventions: sleep hygiene Pharmacologic agents

Question 43

what are some pharmacologic agents used for sleep?

Answer 43

Anticonvulsants Antidepressants Antihistamines Benzodiazepines Benzodiazepines receptor like agents Melatonin receptor agonists Herbals OTC (short term)

Question 44

what are some "do's" when thinking of sleep health strategies

Answer 44

Make sleep a priority * Gear down * Organize your home and work life to promote good- quality sleep ◦ A good sleep environment that is very dark, quiet, cool, and comfortable can improve sleep ◦ Avoid watching TV, reading, or working in the bedroom. Keep bedroom temperature cool ◦ Eat a small snack before bedtime

Question 45

what are some "do not's" when thinking of sleep health strategies

Answer 45

Avoid the following before bedtime: * Heavy, spicy meals 2 to 3 hours before, Liquids (to avoid having to get up during sleep), and alcohol, which promotes sleep onset but causes early awakening and sleep disturbances. If you plan to drink alcohol, have it several hours before bedtime. Exercise: if you have trouble falling asleep, try finishing the exercise at least 3 hours before bedtime. ◦ Consistent Sleep Times Improve Sleep. ◦ If you have any of the following symptoms of common sleep disorders, see your healthcare provide

Question 46

true or false: non pharmacological treatments are always the best #1 line treat for insomnia; combined with short term meds

Answer 46

true

Question 47

non pharmacological treatments

Answer 47

thought stopping relaxation Massage Pacing Meditation Mindfulness Yoga

Question 48

what term does this describe: natural, necessary, involves a shift in physiologic and neurologic activity, and is intended to be restorative.

Answer 48

sleep!

Question 49

true or false: Sleep occurs in a cyclic pattern following intermitent periods of wakefulness for the majority of humans.

Answer 49

true

Question 50

true or false: some people may not feel restored and refreshed after a period of sleep.

Answer 50

true

Question 51

true or false: the scope of sleep ranges from restorative sleep that results in an individual feeling rested to impaired sleep leaving the individual not feeling rested or refreshed.

Answer 51

truuuuu

Question 52

select all that are true regarding sleep: Movement must be through all four stages before reaching REM. Each stage lasts generally from 5 to 15 minutes (N1-N4) , and the entire cycle through all four stages plus REM typically takes 90 to 110 minutes. Periods of REM become progressively longer as the individual completes successive sleep cycles, and the final period of REM may last as long as 1 hour.

Answer 52

all true

Question 53

true or false: these are common conditions that affect sleep: Anxiety * Arthritis * Asthma * Cancer * Chronic obstructive pulmonary disease * Chronic kidney disease * Depression * Diabetes * Epilepsy * Febrile conditions * Fibromyalgia * Gastroesophageal reflux disease Heart failure * Hyperthyroidism * Menopause * Pain * Parkinson disease * Stroke

Answer 53

all true