Sleep sherpath

alcohol

-Alcohol in small amounts may help a person fall asleep but will increase wakefulness later in the night. -Large quantities of alcohol will limit REM sleep. -Alcohol combined with sleeping pills should always be avoided, as it can result in dangerous side effects.

NREM 3

-Deepest stage of sleep, called slow-wave or delta wave sleep for the type of brain waves seen during this type of sleep -More difficult arousal and rare movement -Muscles relaxed -Vital signs decrease but regular rhythms/patterns maintained -Strong stimuli needed for arousal -Amount of time spent in slow-wave sleep depends on how long since a person slept -Lasts approximately 30-60 minutes

NREM 1

-Lightest level of sleep, between sleep and wakefulness -Vital signs and metabolism begin to decrease/slow down -Easy arousal by external stimuli, such as noise -Feeling of drowsiness -Lasts a few minutes -May occur during the day as "resting my eyes"

REM

-Occurrence of vivid, colorful dreaming (less vivid dreaming may occur in other stages) -Starts approximately 90 minutes after sleep is initiated -Autonomous response causes rapid eye movements, fluctuating heart rate and respirations, and increased blood pressure -Muscle tone decreased -Gastric secretions increased -Very difficult arousal -Duration increases with each sleep cycle and averages 20 minutes

older adult

-Optimal sleep is 7-8 hours at night. -The first REM cycle is typically longer than the subsequent cycles. -Use of sleep medications should be kept to a minimum. -Nighttime urination (nocturia) is most common for the this group and makes it difficult for the person to return to sleep after a visit to the toilet.

adult

-Optimal sleep is 7-9 hours at night. -Sleep patterns established when younger are often carried into this stage -Long-term use of sleep medications should be discouraged.

adolescent

-Optimal sleep is 8-10 hours at night. -Nocturnal emissions ("wet dreams") are common for adolescent males during puberty. -Technology may impair sleep quality and increase daytime sleepiness.

school-age child

-Optimal sleep is 9-11 hours at night. -this age group rarely naps

toddler and preschooler

-Optimal sleep pattern is 11-14 hours a day with a nap to restore energy. -Amount of sleep will vary with growth spurts. -Bedtime routines become incredibly important at this stage. -Night terrors

infant

-Optimal sleep pattern is 12-15 hours at night with naps during the day. -Bedding, pillows, and stuffed animals should be kept out of the crib to decrease risk for suffocation.

newborn

-Optimal sleep pattern is in 2-to-4-hour blocks after a feeding. -14-17 total hours a day is optimal. -should be positioned on their back to decrease the risk for suffocation and sudden infant death syndrome (SIDS).

NREM 2

-Relaxation increases -Sleep becomes deeper -Snoring may occur -Relatively easy arousal -Physiologic functions continue to slow -Accompanied by occasional small muscle jerks -Lasts 10-20 minutes

sleep terrors

A consistent sleep schedule, along with proper sleep hygiene, is crucial for managing ________ _______ -Relaxation therapy and cognitive behavioral therapy can also be helpful -Hypnosis may be used in severe cases

secondary sleep disorder

A patient may experience an alteration in sleep quality or quantity as a result of a medical or psychiatric disorder -a sleep disorder resulting from a primary disease process examples: heart failure, hypertension, chronic obstructive pulmonary disease (COPD), pain, and gastric reflux

bedtime routine

Almost everyone has a _____ ______that helps facilitate relaxation and mental preparedness for sleep.

impaired

Concentration, memory, healing, and decision-making are a few functions that become ________ when a person does not get enough sleep

sleep

Lack of _______ has been linked to the development of diseases like diabetes, cardiovascular disease, obesity, and depression

Restless Legs Syndrome (RLS)

Lifestyle changes like decreasing caffeine and alcohol consumption are helpful for patients with _________ -Walking, leg massages, and deep knee bends may also relieve symptoms

menopause

Low estrogen levels, common in women who are experiencing ____________, causes daytime sleepiness, hot flashes, and night sweats

90

NREM and REM sleep typically alternate in _____ minute intervals

Hypersomnia

Nonpharmacologic intervention for a patient with ____________ will be focused on correcting the underlying medical condition that is contributing to the hypersomnia

exercise

Nonrapid eye movement (NREM) and rapid eye movement (REM) sleep are increased when a person is fatigued and relaxed from having performed ___________ -High-intensity, vigorous exercise should be performed in the morning or late afternoon, at least 2 hours before bedtime. -Relaxing exercise like yoga and stretching can be done within the hours prior to bed. This will help initiate a healthy night's sleep

Insomnia

Patients with ______________ may be placed on sleep restrictions, such as staying in bed only when asleep. -Cognitive therapy for helping the patient to relax and change thought patterns is also beneficial for patients

REM, NREM

Research indicates that ______ sleep is not vital for human survival, but _____ sleep is essential.

disturbances

Sleep cycle ___________ can manifest as decreased appetite, anxiety, irritability, and impaired judgment, and can negatively influence overall health and the ability to heal

NREM, REM

There are two main cycles of sleep: _______ and _____

evening care (hour of sleep care)

This helps establish and maintain the bedtime routine for the patient -includes: -Oral care -Partial bathing -Skin care -Backrub -Linen maintenance -Toileting -Snacks or fluids

Narcolepsy

Treatment for patients with ____________ should be focused on regular exercise, regular sleep routines, and light meals high in protein and vitamins -The patient should avoid alcohol, heavy meals, long-distance driving, and long periods of sitting

Irritability, difficulty making decisions, decreased concentration

Which characteristics may a sleep-deprived person experience? -Hyperactivity -Violent behavior -Decreased concentration -Difficulty making decisions -Irritability

-Sleep -Digestion -Body temperature -Endocrine function

Which functions of the human body are impacted by the circadian rhythm? -Sleep -Blood production -Digestion -Body temperature -Endocrine function

heart rate decreases, body temperature drops, blood pressure decreases

Which physiologic changes occur during sleep? -Heart rate decreases -Respiratory rate increases -Body temperature drops -Blood pressure decreases -Muscle tone increases

smoking

____ affects sleep by: -Nicotine is a stimulant, which will make falling asleep difficult. It also makes a person more easily aroused once asleep. -Individuals who are long-term smokers may have lung damage, which results in hypoxia and a need for increased amounts of sleep. -Smoking cessation will result in increased quality and quantity of sleep after the initial withdrawal period.

lifestyle

_____ affects sleep by: -If a person's work schedule does not align with his or her biologic rhythm, sleep will be affected. -Younger adults may be able to adjust more easily to a change in work schedule than an older adult. -Individuals with multiple schedule commitments and a fast-paced lifestyle may have difficulty relaxing and falling asleep.

age

_____ influences both quality and quantity of sleep

stimulants and other medications

______ and ______ affect sleep by: -Barbiturates, amphetamines, and some antidepressants cause a decrease in REM sleep. -Diuretics, antiparkinsonian medications, antihypertensives, steroids, decongestants, and asthma drugs also affect sleep. -Nightmares and insomnia are reported side effects of beta blockers. -Medications to improve sleep may be indicated for some patients and should be heavily regulated by the health care team.

environmental factors

_______ ______ affect sleep by: -Travel is a change in environment and will affect the quality and quantity of sleep obtained. Linens, pillows, or different mattresses are factors affecting sleep, as is a change in time zone. -Light, noise, and temperature are other environmental variables that can affect sleep. -The use of electronic devices while in bed can delay the circadian rhythm, lower melatonin, and make falling asleep more difficult. Keeping devices with sound notifications near the bed will cause sleep interruption.

diet and exercise

_______ and _____ affect sleep. by: -Quality and quantity of food intake will affect sleep. -Going to bed with an empty or overly full stomach will make falling asleep more difficult. -Caffeine is a stimulant that may disrupt a person's ability to fall asleep. -Eating snacks containing complex carbohydrates before bedtime can promote relaxation. -Spicy foods may cause heartburn and interfere with a person's ability to fall asleep. -Individuals who exercise late in the day may have trouble getting to sleep and staying asleep.

hospitalization

________ is likely to cause disturbances in sleep -Not only may patients be experiencing pain, discomfort, shortness of breath, etc., but they will also be exposed to a variety of environmental factors that will affect their sleep

external

__________ factors like work, alarms, and noise can affect the circadian rhythm and affect the sleep-wake cycle

relationships

___________ affect sleep by: -Becoming a parent or caregiver is a change in lifestyle that will affect sleep. Sleep deprivation is common for new parents and those who assume a caregiver role. -Change in marital status or other partnerships where a bed is shared can have an effect on sleep. The sleep patterns of the other person can contribute to sleep cycle disturbances.

circadian rhythm

a 24-hour, day and night rhythm that is controlled by the hypothalamus -affects body temperature, endocrine function, blood pressure, eating habits and digestion, sleep, and other factors

neurotransmitter

a chemical that modifies or results in the transmission of nerve impulses between synapses

hormone

a complex chemical substance produced in one part or organ of the body that initiates or regulates the activity of an organ or a group of cells in another part

adenosine

caffeine blocks the action of _______

Antihistamines

can be effective for a night or two of restful sleep, but should not be used long-term

dreams

function to process memories, adapt to stress, and sort out immediate concerns

low, high

having ______ levels of thyroid hormone causes reduced NREM and having _______ levels of thyroid hormone causes difficulty falling asleep

factors affecting sleep

include: -diet and exercise -smoking -alcohol -stimulants and other medications -environmental factors -relationships -lifestyle

sleep hygiene

includes a regular sleep schedule, exercise considerations, dietary choices, sleep environments, and bedtime routines

more

individuals who are ill, especially those with chronic illness, need _______ rest and sleep than someone who is healthy

sleep schedule

involves: -Going to bed at the same time each night and getting up at the same time every morning, including weekends. -Avoiding naps during the day, if possible. Naps disturb a normal sleep pattern. The exception would be for patients with a medically diagnosed sleeping disorder. -Adequate exposure to natural light during the day. Light helps regulate the circadian rhythm and maintain a healthy sleep-wake cycle.

3

restorative process, sleepwalking, and nocturnal enuresis occur in NREM ___

3-5

the normal sleep pattern is ___-____ cycles

routine

the nurse can create a ________ for patients in the hospital by cluster care activities together to allow for 90 to 120 minutes of uninterrupted sleep for the patient. This allows the patient time to complete a full sleep cycle.

noise

the nurse can reduce ______ for the patient by: -Drawing curtains and closing doors -Negotiating times to mute televisions and radios -Limiting overhead pages -Lowering the volume of phone ringtones -Limiting staff conversations in the hallway -Conducting shift reports outside of the patient room, unless the facility requires bedside reports -Moving equipment quietly, paying attention to avoid other objects -Monitoring equipment frequently to prevent alarms

Obstructive Sleep Apnea (OSA)

treatments for _____________ include improving sleep hygiene and weight-loss efforts -A continuous positive airway pressure (CPAP) device may be prescribed by a polysomnographic specialist