Sleep And Rest

Question 1

What is rest?

Answer 1

A condition in which the body is inactive or engaging in mild activity, resulting in a feeling of refreshment.

People rest by doing things they find calming and relaxing.

Question 2

What is sleep?

Answer 2

A cyclically occurring state of decreased motor activity and perception, characterized by altered consciousness and slowed body functions.

A sleeping person is unaware of their environment and responds selectively to stimuli.

Question 3

What are the benefits of rest?

Answer 3

• Reduces stress
• Improves mood
• Enhances mental alertness and clarity

Rest allows the body to relax while still awake, benefiting overall health.

Question 4

Why do we need sleep?

Answer 4

Necessary for developing and maintaining pathways for learning and memorization, and removing brain toxins.

Adequate sleep promotes health and enhances physiological functions.

Question 5

What are the risks of chronic sleep loss?

Answer 5

• Obesity
• Depression
• Hypertension
• Diabetes mellitus
• Heart attack
• Stroke

Too little sleep leads to poor concentration and increased irritability.

Question 6

How much sleep do infants and toddlers need?

Answer 6

9-15 hours a day.

Question 7

How much sleep do adolescents need?

Answer 7

9-10 hours a day.

Question 8

How much sleep do adults need?

Answer 8

7-9 hours a day.

Question 9

What influences circadian rhythms?

Answer 9

Environmental factors such as light and darkness.

Circadian rhythms help synchronize bodily functions with the day-night cycle.

Question 10

What is melatonin?

Answer 10

A hormone produced by the body that promotes sleep and is inhibited by light.

Question 11

What is the Reticular Activating System (RAS)?

Answer 11

A collection of brain areas that regulate the sleep-wake cycle and process sensory input.

Question 12

What is sleep apnea?

Answer 12

A disorder characterized by more than five breathing cessations lasting longer than 10 seconds per hour during sleep.

Question 13

What is insomnia?

Answer 13

The inability to get an adequate amount of sleep and feel rested, which can be acute, chronic, or intermittent.

Question 14

What are the stages of NREM sleep?

Answer 14

• Stage 1: Very light sleep
• Stage 2: Deeper sleep
• Stage 3: Slow wave or delta sleep

Each stage has different characteristics and physiological responses.

Question 15

What is REM sleep?

Answer 15

A sleep stage characterized by vivid dreaming, occurring approximately 90 minutes after falling asleep.

Question 16

What is the impact of caffeine on sleep?

Answer 16

Caffeine blocks adenosine, which promotes sleepiness.

Question 17

What is restless legs syndrome (RLS)?

Answer 17

A disorder characterized by a strong urge to move the legs while resting or before sleep onset.

Question 18

What are dyssomnias?

Answer 18

Sleep disorders characterized by insomnia or excessive sleepiness, including conditions like insomnia, sleep apnea, and hypersomnia.

Question 19

What are parasomnias?

Answer 19

Patterns of waking behavior that occur during sleep, such as sleepwalking and night terrors.

Question 20

What is the role of temperature in sleep quality?

Answer 20

A comfortable sleep environment is generally around 65 degrees Fahrenheit.

Question 21

What is nocturnal dipping?

Answer 21

A phenomenon related to hormone levels, including insulin, cortisol, and ghrelin, that can affect sleep quality.

Question 22

What factors affect sleep quality?

Answer 22

• Total amount of sleep
• Sleep quality
• NREM and REM sleep amounts

Medications, anxiety, noise, light, and temperature can all influence sleep.

Question 23

What is hypersomnolence disorder?

Answer 23

A condition characterized by excessive daytime sleepiness lasting at least 3 months.

Question 24

What are common treatments for sleep disorders in blind individuals?

Answer 24

• Melatonin
• Daytime activities
• Following a strict schedule

Sleep disorders are prevalent among blind individuals due to disrupted circadian rhythms.

Question 25

What is narcolepsy?

Answer 25

A disorder characterized by sudden, uncontrollable attacks of sleep, often accompanied by cataplexy.

Question 26

What are nonbenzodiazepine hypnotics commonly prescribed for?

Answer 26

They are commonly prescribed sleep medications.

Question 27

Name three examples of nonbenzodiazepine hypnotics.

Answer 27

* Zolpidem * Zaleplon * Eszopiclone

Question 28

What are some adverse effects of nonbenzodiazepine hypnotics?

Answer 28

* Gastric discomfort * Hallucinations * Memory loss

Question 29

True or False: Nonbenzodiazepine hypnotics have a potential for abuse.

Answer 29

True

Question 30

What are benzodiazepines primarily used for?

Answer 30

They are used to treat anxiety.

Question 31

List three examples of benzodiazepines.

Answer 31

* Alprazolam * Clonazepam * Lorazepam

Question 32

What is a major risk associated with long-term use of benzodiazepines?

Answer 32

Clients can develop physical dependence.

Question 33

What should be conducted for any client requiring medications to promote sleep?

Answer 33

A sleep study should be conducted.

Question 34

What is a common ingredient in nonprescription sleep medications?

Answer 34

An antihistamine

Question 35

Fill in the blank: Diphenhydramine may induce drowsiness, but can cause _______ due to its long half-life.

Answer 35

grogginess

Question 36

What are some side effects of diphenhydramine?

Answer 36

* Dry mouth * Constipation * Urinary retention * Visual disturbance * Impaired memory

Question 37

What is melatonin's role in the body?

Answer 37

It regulates the sleep-wake cycle and acts as an antioxidant.

Question 38

True or False: Melatonin is FDA regulated.

Answer 38

False

Question 39

What type of information is collected during a sleep assessment?

Answer 39

Questions about sleep patterns, history, and recent changes in sleep habits.

Question 40

What is a sleep log used for?

Answer 40

To provide specific information on a patient's patterns of sleep.

Question 41

What is an actigraph?

Answer 41

An application that estimates a person's sleep and wake patterns.

Question 42

What does polysomnography record during sleep?

Answer 42

* Brain wave activity * Eye movement * Oxygen and carbon dioxide levels * Vital signs * Body movements

Question 43

What is the recommended nursing diagnosis for patients with impaired functioning due to sleep disruption?

Answer 43

Insomnia

Question 44

What is the nursing diagnosis used when the quality of sleep is decreased over prolonged periods?

Answer 44

Sleep Deprivation

Question 45

List some goals for a patient with sleep issues.

Answer 45

* Verbalize quality sleep * Show no signs of restlessness * No signs of abnormal sleeping patterns * Maintain oxygen saturation above 93%

Question 46

What should be limited 2-4 hours before bedtime?

Answer 46

Fluids

Question 47

What type of activities are recommended to promote relaxation?

Answer 47

* Massage * Meditation

Question 48

What should be done if a patient takes more than 20 minutes to fall asleep?

Answer 48

Change the environment.

Question 49

What is an important consideration for the patient's room temperature?

Answer 49

Ensure it is comfortable.

Question 50

What should you do to help patients establish a bedtime routine?

Answer 50

Limit waking patients during resting periods.

Question 51

What is nocturnal dipping?

Answer 51

BP drop in sleep, increases HTN

Question 52

Sleep hormones

Answer 52

Cortisol levels typically rise in the early morning, helping to wake us up, and gradually decrease throughout the day, allowing us to feel tired. Sleep deprivation reduces leptin (tells brain that you are full) levels and increases ghrelin (hunger) levels, leading to increased appetite and cravings, often for high-calorie foods. This imbalance can contribute to weight gain and health conditions. Can increase insulin resistance. Growth hormone (used for muscle development, immunity, metabolism, and protein production) affects how your body metabolizes glucose, which can create problems if your body isn’t producing enough of it.

Question 53

Biorhythms are “biological clocks” that are controlled within the body and synchronized with environmental factors (e.g., gravity, electromagnetic forces, light, and darkness

Question 54

Circadian rhythm is a biorhythm based on the day-night pattern in a 24-hour cycle

Question 55

Factors affecting sleep

Answer 55

age physical activity diet nicotine alcohol caffeine medications disease process anxiety depression noise light and temp

Question 56

RAS system

Answer 56

Reticular Activating System (RAS) – collection of brain areas that cue up neuromodulators (serotonin, norepinephrine, etc). Sensory input feeds RAS, where the information is deemed important and processed, or unnecessary and discarded. This system helps regulate the sleep-wake cycle.

Question 57

Dyssomnias

Answer 57

Sleep disorders characterized by insomnia or excessive sleepiness. They include insomnia (acute, chronic, or intermittent), sleep-wake schedule (circadian) disorders, sleep apnea, restless leg syndrome, hypersomnia, and narcolepsy.

Question 58

parasomina

Answer 58

Patterns of waking behavior that appear during sleep, including: sleepwalking (occurs in stage 3), sleeptalking (NREM just before REM), bruxism (stage 2), night terrors (stage 3 sleep), REM sleep behavior disorders (violently acts out dreams in REM), and nocturnal enuresis (mostly NREM).

Question 59

Common sleep disorders

Answer 59

insomina sleep apnea obstructive osa Obstructive (OSA) is the upper airway is occluded by mouth and throat relaxation

Question 60

Common sleep disorders

Answer 60

Narcolespy nigght terros RLS hypersomnoience disorder

Question 61

Medications affecting sleep

Answer 61

Amphetamines, tranquilizers, and antidepressants reduce the amount of REM sleep; barbiturates also interfere with NREM sleep. Opioids, such as morphine, suppress REM sleep and cause frequent awakening.  Beta blockers are reported to cause sleep disorders and nightmares.

Question 62

Medications promoting sleep

Answer 62

Nonbenzodiazepines – Nonbenzodiazepine hypnotics, such as zolpidem, zaleplon, and eszopiclone (also known as the z-drugs), are the most commonly prescribed sleep medications. These medications can cause adverse effects such as gastric discomfort, hallucinations, and memory loss. Nonbenzodiazepine hypnotics have the potential to be abused since higher doses can induce stimulation and euphoria. Benzodiazepines -GABA agonists or benzodiazepines, such as alprazolam, clonazepam, and lorazepam, can cause drowsiness, relax muscles, lessen anxiety, and cause retrograde amnesia. They should be used cautiously in older adult clients with decreased liver and kidney function. Clients can develop physical dependence on benzodiazepines, so these agents are not recommended for long-term use. . Many were originally formulated to treat anxiety. *Any client requiring medications to promote sleep should have a sleep study conducted.

Question 63

non Prescription meds for sleep

Answer 63

antihistamine melatonin Advise clients that OTC sleep medications can interact with other medicines they may be taking, so they should consult their prescriber or pharmacist before using them.

Question 64

Sleep Assessment

Answer 64

Ask sleep patterns, history, and recent changes in sleep habits Identify the usual sleep patterns and sleep aids Use a scale for sleep rating Check for common interruptions and details regarding the problem - when, how often, related factors, and seriousness All of the factors that affect sleep

Question 65

Light therapy

Answer 65

Designed to treat certain health conditions through exposure to artificial light. During a light therapy session, the person sits in front of a specialized device, known as a light therapy box, that emits bright light similar to natural sunlight. Also known as light exposure therapy, circadian light therapy, bright light therapy, or phototherapy. Light therapy can be helpful for people with the following: Insomnia Circadian rhythm sleep disorder Seasonal affective disorder (SAD) Depression Jet lag Working an overnight schedule Alzheimer’s disease or dementia

Question 66

Nursing diagnoses for sleep

Answer 66

sleep deprivation and disturbed sleep pattern

Question 67

Goals of sleep

Answer 67

Rate on a scale of 0-10

Question 68

interventions of sleep

Answer 68

Limit waking patient during resting periods. Help patients establish and follow a bedtime routine. Consult RT to obtain CPAP if home device unavailable. Consult provider for sleep-promoting medications. Adjust routines to conform to patient home schedule. Promote exercise more than 2 hours prior to anticipated bedtime. Limit fluids 2-4 hours before bedtime. Engage in relaxation activities: massage, meditation. Promote a regular sleep-wake schedule. Encourage client to keep a sleep journal. Cluster care. Administer medication at appropriate times. Change environment if falling asleep is taking longer that 20 minutes. Education: alcohol, caffeine, nicotine use 4 hours prior to bedtime (and cessation) and medications. Ensure CPAP is clean and available when needed. Promote a quiet environment (this includes hallway noise).