Sleep Problems Flashcards
(31 cards)
When it comes to sleep issues in the elderly, what is the biggest complaint?
Not being able to fall asleep, 40%
What are four risk factors that account for insomnia?
- chronic illness
- mood disturbance
- Less physical activity
- Physical disability
What are 3 screening questions used to assess for insomnia?
- is the person satisfied with his or her sleep?
- Does sleep or fatigue interfere with daytime activities?
- Does the bed partner or others complain of unusual behavior during sleep, such as snoring, interrupted breathing, or leg movements?
Apnea episodes characterized by cessation of breathing without associated respiratory effort
Central sleep apnea
central sleep apnea can be a primary disorder but what else can it be associated with?
opioid use, stroke, heart failure, or other conditions
characterized by complete or partial upper airway obstruction during sleep, with evidence of respiratory effort curing the events
Obstructive sleep apnea
What is a major symptom of obstructive sleep apnea?
Daytime sleepiness
Morning headache, personality changes, poor memory, confusion, and irritability are all symptoms of?
Obstructive sleep apnea
What are two risk factors for obstructive sleep apnea?
High BMI and large neck circumference
What is the main treatment for obstructive sleep apnea?
positive airway pressure (PAP)
Is CPAP or biPAP better for obstructive sleep apnea?
CPAP
Repetitive, stereotypic leg movements that occur during non-REM sleep
Periodic Limb Movement Disorder
Characterized by an urge to move legs, usually with an unpleasant sensation in the legs that occurs with inactivity generally at night, and improves with movement
Restless Legs Syndrome
What is the initial agent of choice for patients with PLMD and restless legs syndrome
a dopaminergic agent
What does a delayed sleep phase mean?
Fall asleep late, awaken late
What does an advanced sleep phase mean
Fall asleep early, awaken early
If you have a patient who is suffering from insomnia and is taking a cholinesterase inhibitor, what time of the day should they take it?
Morning as they can exacerbate insomnia and cause vivid dreams
What are four factors that contribute to insomnia in the hospital?
Illness, medications, change form usual routines, and sleep-disruptive environment
What class of medications is commonly used to help sleep disturbances in the hospital?
Benzodiazepines
should we use sedating antihistamines to help people sleep in the hospital?
Definitely not.
If you are unable to fall asleep in the first 30 minutes of going to bed, what should you do?
Get up and perform a soothing activity (avoid bright light)
What is the goal of a stimulus control intervention?
To recondition maladaptive sleep-related behaviors
What is the goal of a sleep restriction intervention?
To improve sleep efficiency (time asleep divided by time in bed) by causing sleep deprivation
The goal of this type of intervention is to change misunderstandings and false beliefs regarding sleep
Cognitive interventions
