Comfort, Rest, and Sleep

1. Why is sleep important?

It supports physical repair, mental health, memory, and concentration.

2. What body structures are repaired during sleep?

Muscles, tissues, and bones.

3. How does sleep support the immune system?

It helps the body maintain defenses against illness.

4. How does quality sleep help the brain?

It improves learning, memory, mood, and attention.

5. How does sleep affect physical performance?

It supports reaction time, coordination, strength, and power.

6. What does ghrelin do?

It signals hunger.

7. What does leptin do?

It signals fullness and reduces hunger.

8. How can sleep deprivation affect hunger hormones?

Ghrelin may increase and leptin may decrease, increasing hunger.

9. How can poor sleep affect blood sugar?

It can make insulin work less effectively and worsen blood sugar control.

10. What is cortisol?

A stress hormone that can raise blood sugar.

11. What is sleep deprivation?

Not getting the sleep the body needs.

12. What is total sleep deprivation?

Going without sleep for an extended period, such as an entire night.

13. What is partial sleep deprivation?

Sleeping fewer hours than the body needs.

14. What is chronic sleep deprivation?

Repeatedly getting insufficient sleep over time.

15. What is selective sleep deprivation?

Being deprived of a particular sleep stage.

16. What circumstances can cause sleep deprivation?

Stress, illness, medications, a newborn, aging, sleep disorders, or heavy workloads.

17. How can hospitalization interfere with sleep?

Noise, lights, pain, procedures, and frequent care can interrupt sleep.

18. How does sleep deprivation affect judgment?

It makes decision-making less accurate.

19. How does sleep deprivation affect reaction time?

It slows reactions and increases the time needed to respond.

20. How can sleep deprivation affect emotions?

It can cause irritability, mood swings, anxiety, and increased depression risk.

21. How can sleep loss affect people prone to migraines or seizures?

It can trigger migraines or seizures.

22. Why is drowsy driving dangerous?

Sleepiness reduces attention and slows reactions, increasing crash risk.

23. Can losing a small amount of sleep repeatedly cause problems?

Yes. Repeated sleep loss can build up and impair thinking.

24. What determines treatment for sleep deprivation?

The cause, severity, and effects on the person.

25. What is sleep hygiene?

Habits and environmental changes that support healthy sleep.

26. What bedtime schedule promotes sleep?

Going to bed and waking at consistent times.

27. What is the circadian rhythm?

The body’s roughly 24-hour sleep–wake clock.

28. What bedroom environment promotes sleep?

Dark, quiet, and comfortably cool.

29. What bedtime routines can promote relaxation?

A warm bath, quiet reading, or another calming activity.

30. What should a person do if unable to sleep and feeling restless?

Leave bed for a quiet activity in dim light and return when sleepy.

31. What activities should the bedroom mainly be associated with?

Sleep and sexual activity.

32. Why should work materials be removed from the bedroom?

They can increase stress and keep the mind alert.

33. How can phones interfere with sleep?

Light, stimulating content, and continued use can delay sleep.

34. How does caffeine affect sleep?

It increases alertness and can make falling asleep harder.

35. How does nicotine affect sleep?

It acts as a stimulant and can disrupt sleep.

36. Is alcohol a good sleep aid?

No. It may cause initial drowsiness but disrupts sleep and can worsen apnea.

37. How long before bedtime do your notes recommend avoiding caffeine, nicotine, and alcohol?

At least 4–6 hours; caffeine may affect some people longer.

38. How should naps be managed to support nighttime sleep?

Keep them short and avoid taking them late in the day.

39. How can exercise support sleep?

Regular exercise can improve sleep quality.

40. What should someone do if vigorous exercise near bedtime keeps them awake?

Move the exercise to an earlier time.

41. What is sensory overload?

More sensory stimulation than a person can comfortably manage.

42. What hospital conditions can contribute to sensory overload?

Alarms, conversations, bright lights, visitors, pain, and frequent procedures.

43. What does clustering care mean?

Combining compatible care activities to reduce unnecessary interruptions.

44. When should the nurse cluster care?

When the patient’s condition and required monitoring allow it.

45. What environmental nursing actions can promote sleep?

Reduce noise, dim lights, and close the door when safe.

46. When might earplugs or an eye mask help?

When appropriate and safe for a patient disturbed by noise or light.

47. What comfort needs should the nurse address before sleep?

Pain, positioning, toileting, bedding, and room temperature.

48. Why do night-shift workers often have sleep problems?

Their work schedule conflicts with the body’s circadian rhythm.

49. How can menopause interfere with sleep?

Hot flashes, night sweats, and other changes can interrupt sleep.

50. What is the difference between sleepiness and fatigue?

Sleepiness is a tendency to fall asleep; fatigue is a lack of energy.

51. What is insomnia?

Difficulty sleeping despite having the opportunity to sleep.

52. How can insomnia appear?

Trouble falling asleep, staying asleep, or returning to sleep after waking early.

53. What daytime problems can insomnia cause?

Low energy, poor concentration, memory problems, irritability, and low motivation.

54. What is CBT-I?

Cognitive behavioral therapy for insomnia.

55. What is generally the first treatment for chronic insomnia in adults?

CBT-I.

56. How does CBT-I help?

It changes thoughts and behaviors that keep sleep problems going.

57. What is sleep apnea?

Repeated episodes of stopped or greatly reduced breathing during sleep.

58. How long does an adult apnea event last in sleep testing?

At least 10 seconds.

59. What is hypopnea?

Reduced airflow during sleep, usually with an oxygen drop or a brief awakening-related brain response.

60. What is obstructive sleep apnea, or OSA?

Repeated collapse or blockage of the upper airway during sleep.

61. Does breathing effort usually continue during obstructive apnea?

Yes. The person tries to breathe against a blocked airway.

62. What findings suggest OSA?

Loud snoring, witnessed breathing pauses, gasping, and daytime sleepiness.

63. What factors can contribute to or worsen OSA?

Obesity, enlarged tonsils, back-sleeping, alcohol, and smoking.

64. Can a person with OSA feel tired after enough hours in bed?

Yes. Repeated breathing interruptions can prevent restful sleep.

65. What is polysomnography?

A sleep study that records sleep and breathing information.

66. What does polysomnography monitor?

Brain activity, breathing, oxygen levels, heart rhythm, and body movements.

67. What does CPAP stand for?

Continuous positive airway pressure.

68. How does CPAP treat OSA?

Air pressure through a mask helps keep the airway open during sleep.

69. Does CPAP always provide extra oxygen?

No. It provides pressurized air; oxygen is added only when prescribed.

70. What lifestyle changes may help OSA?

Weight management when appropriate, avoiding alcohol, stopping smoking, and changing sleep position when advised.

71. What is central sleep apnea, or CSA?

Breathing pauses caused by disrupted brain signals to the breathing muscles.

72. What conditions or substances can be associated with CSA?

Heart failure and opioid use, among other causes.

73. What is the main difference between OSA and CSA?

OSA involves airway blockage; CSA involves reduced or absent breathing signals and effort.

74. What is narcolepsy?

A chronic disorder causing excessive daytime sleepiness and possible sleep attacks.

75. What other symptoms can occur with narcolepsy?

Sleep paralysis, vivid dreamlike experiences, and sometimes cataplexy.

76. What is cataplexy?

Sudden muscle weakness triggered by emotion, usually with awareness preserved.

77. What is an example of cataplexy?

A person’s knees buckle while laughing, but the person stays conscious.

78. What is the difference between narcolepsy type 1 and type 2?

Type 1 is usually associated with cataplexy and low hypocretin; type 2 has no cataplexy.

79. What is hypocretin, also called orexin?

A brain chemical that helps maintain wakefulness.

80. What treatments can help narcolepsy?

Prescribed medication, planned short naps, support, and safety planning.

81. What is hypersomnolence?

Excessive sleepiness that requires assessment for its cause.

82. What is restless legs syndrome, or RLS?

An urge to move the legs, often with uncomfortable sensations.

83. What symptom pattern is typical of RLS?

Worse at rest and in the evening, with temporary relief from movement.

84. What factors can be associated with RLS?

Low iron, family history, and certain medical conditions.

85. What is a parasomnia?

An unusual behavior or experience associated with sleep.

86. When do night terrors usually occur?

During deep non-REM sleep, usually early in the night.

87. How do nightmares differ from night terrors?

Nightmares usually occur during REM sleep and are remembered; night terrors usually are not remembered.

88. What should a caregiver do during a night terror?

Stay calm, prevent injury, and avoid forcing the person awake.

89. What are examples of benzodiazepines listed in your notes?

Alprazolam, clonazepam, and lorazepam.

90. What are important benzodiazepine risks?

Sedation, falls, memory problems, dependence, and withdrawal if stopped abruptly after regular use.

91. What type of memory problem can benzodiazepines cause?

Anterograde amnesia—difficulty forming new memories after taking the drug.

92. What are examples of nonbenzodiazepine hypnotics, or Z-drugs?

Zolpidem, zaleplon, and eszopiclone.

93. What serious behaviors can occur with Z-drugs?

Sleepwalking, sleep-driving, or other activities while not fully awake.

94. What should a patient do if complex sleep behaviors occur after a Z-drug?

Stop taking it and contact the prescriber immediately.

95. Is melatonin the first treatment for every sleep problem or age group?

No. Its usefulness depends on the problem; CBT-I is preferred for chronic adult insomnia.

96. What OTC antihistamines are used as sleep aids, and what adverse effects can they cause?

Diphenhydramine and doxylamine can cause daytime drowsiness, dry mouth, blurred vision, constipation, and urinary retention.

97. What nonmedication methods may promote relaxation and sleep?

Guided imagery, slow breathing, mindfulness, meditation, music, and suitable yoga or gentle massage.

98. What massage precautions should the nurse consider?

Avoid or modify massage around wounds, injured skin, fragile bones, or suspected blood clots.

99. How can a sleep diary support the PN nursing process?

It provides data for planning and implementing personalized care, then evaluating whether sleep improves.

100. What does promoting comfort involve?

Relieving physical and emotional distress through listening, honest explanations, respect, symptom relief, and support.