Sleep nursing WEEK 8

What is the difference between sleep and rest?

Sleep is a temporary state of reduced awareness; rest is relaxation while remaining awake.

What are the major physiological benefits of adequate sleep?

Tissue repair, energy restoration, hormone regulation, and normal glucose metabolism.

What are the major psychological benefits of adequate sleep?

Memory consolidation, emotional stability, improved concentration, and psychological well-being.

What are common consequences of sleep deprivation?

Impaired memory, poor concentration, irritability, decreased performance, and elevated blood pressure.

How does sleep deprivation affect metabolism and hormones?

Disrupts glucose and appetite regulation and alters cortisol, growth hormone, and inflammatory cytokines.

What is the reticular activating system (RAS)?

A brainstem network that regulates wakefulness and the sleep-wake cycle.

What neurotransmitter inhibits RAS activity to promote sleep?

GABA.

What role does serotonin play during sleep?

Decreases responsiveness to sensory stimulation.

What hormone promotes sleep in response to darkness?

Melatonin, secreted by the pineal gland.

What is circadian rhythm?

An approximately 24-hour biological clock regulating the sleep-wake cycle.

What environmental factor primarily synchronizes circadian rhythm?

Light and darkness.

How does body temperature change during the sleep-wake cycle?

Body temperature is generally higher during wakefulness and lower during sleep.

What percentage of sleep occurs during NREM sleep?

Approximately 75–80%.

What percentage of sleep occurs during REM sleep?

Approximately 20–25%.

What occurs during NREM stages 1 and 2?

Light sleep; the person can be awakened easily.

What occurs during NREM stage 3?

Deep sleep, physical restoration, tissue repair, and growth hormone release.

How do vital signs change during NREM sleep?

Heart rate, respirations, and blood pressure generally slow and stabilize.

What are the primary functions of REM sleep?

Brain restoration, memory consolidation, and emotional processing.

What are the characteristic features of REM sleep?

Vivid dreaming, skeletal muscle atonia, and irregular vital signs.

What is skeletal muscle atonia during REM sleep?

Temporary loss of voluntary skeletal muscle activity.

How many complete sleep cycles typically occur each night?

Approximately 4–5 cycles.

How does REM sleep change throughout the night?

REM periods become progressively longer.

How much sleep do healthy adults generally need?

7–9 hours nightly.

How long does it typically take a healthy adult to fall asleep?

20–30 minutes.

How much sleep do newborns (0–3 months) need?

14–17 hours daily.

How much sleep do infants (4–11 months) need?

12–16 hours daily.

How much sleep do toddlers (1–2 years) need?

11–14 hours daily.

How much sleep do preschool children (3–5 years) need?

10–13 hours daily.

How much sleep do school-age children (6–12 years) need?

9–12 hours daily.

How much sleep do adolescents (13–18 years) need?

8–10 hours daily.

How do sleep patterns change during adolescence?

Circadian rhythms shift toward later sleep and wake times.

How do normal sleep patterns change in older adults?

Earlier bedtimes, earlier waking, and more nighttime awakenings; sleep needs do not necessarily decrease.

What factors can negatively affect sleep quality?

Pain, illness, medications, stress, noise, lighting, temperature, elimination needs, and shift work.

What subjective questions should nurses ask during a sleep assessment?

Usual bedtime, wake time, sleep duration, awakenings, sleep quality, daytime sleepiness, and factors disturbing sleep.

What objective findings indicate sleep deprivation in adults?

Dark circles, yawning, nodding, slow responses, irritability, and impaired concentration.

How may sleep deprivation present differently in children?

Hyperactivity rather than obvious sleepiness.

How can nurses evaluate whether a patient received adequate rest after activity?

Assess whether heart rate and other physiological parameters return to baseline.

What is polysomnography?

A sleep study measuring brain waves, oxygen levels, heart rate, breathing, and eye and leg movements.

What sleep disorder is commonly diagnosed using polysomnography?

Obstructive sleep apnea.

What is insomnia?

Difficulty falling asleep, staying asleep, or waking too early.

What is the recommended first-line treatment for chronic insomnia?

Cognitive Behavioral Therapy for Insomnia (CBT-I).

What interventions are included in CBT-I?

Sleep hygiene, stimulus control, sleep restriction, and cognitive restructuring.

What is stimulus control in CBT-I?

Using the bed only for sleep to strengthen the association between bed and sleeping.

What is obstructive sleep apnea (OSA)?

Repeated upper-airway obstruction during sleep that interrupts airflow.

What is the minimum duration of an apnea episode?

At least 10 seconds without airflow.

What is the most common symptom of obstructive sleep apnea?

Excessive daytime sleepiness.

What are the major risk factors for obstructive sleep apnea?

Obesity, increased neck circumference, enlarged tonsils, alcohol, and sedative use.

What complications can result from untreated obstructive sleep apnea?

Hypertension, cardiac dysrhythmias, and increased motor vehicle accident risk.

What is the standard treatment for obstructive sleep apnea?

Continuous Positive Airway Pressure (CPAP).

How does CPAP treat obstructive sleep apnea?

Delivers positive airway pressure to keep the upper airway open during sleep.

What lifestyle interventions help manage obstructive sleep apnea?

Weight loss when appropriate, side-lying sleep, and avoiding alcohol and sedatives.

What is narcolepsy?

A sleep-wake regulation disorder causing sudden, uncontrollable daytime sleep episodes.

What is cataplexy?

Sudden loss of muscle tone triggered by strong emotions, often associated with narcolepsy.

What is restless legs syndrome (RLS)?

An uncomfortable urge to move the legs that worsens at rest or during the evening and improves temporarily with movement.

What conditions are associated with restless legs syndrome?

Iron deficiency, pregnancy, and chronic kidney disease.

What is periodic limb movement disorder (PLMD)?

Repetitive involuntary limb movements during sleep.

What are parasomnias?

Abnormal behaviors or experiences during sleep, such as sleepwalking, night terrors, and nightmares.

What nursing interventions improve sleep in hospitalized patients?

Cluster care, reduce nighttime noise, dim lights, manage pain, and minimize unnecessary interruptions.

Why is preventing sleep deprivation important in ICU patients?

Sleep deprivation is a modifiable risk factor for ICU delirium.

What is sleep hygiene?

Healthy behaviors and environmental practices that promote consistent, restorative sleep.

What sleep schedule should nurses recommend?

Go to bed and wake up at consistent times every day, including weekends.

What bedroom environment promotes healthy sleep?

Quiet, dark, cool, and comfortable.

Which substances should patients avoid before bedtime?

Caffeine, nicotine, and alcohol.

How does alcohol affect sleep quality?

May initially induce sleep but disrupts REM sleep and increases nighttime awakenings.

What exercise recommendations promote healthy sleep?

Exercise regularly during the day, but avoid vigorous activity immediately before bedtime.

What is the purpose of a consistent bedtime ritual?

Promotes relaxation and prepares the body for sleep.

What is the priority nursing concern for patients receiving sedative-hypnotics?

Fall prevention due to sedation, dizziness, and impaired coordination.

Why should benzodiazepines never be stopped abruptly?

Withdrawal can cause nausea, tremors, and potentially life-threatening seizures.

Why should older adults generally avoid diphenhydramine and other sedating antihistamines?

Anticholinergic effects increase confusion, urinary retention, and fall risk.

What safety precautions should nurses implement after administering sedative-hypnotics?

Keep the bed low, place the call light within reach, and assist with ambulation.