ch 38: rest and sleep

control center for sleeping/waking

hypothalamus

risk of acute sleep loss

impaired concentration and judgment, moodiness/irritability, increased accidents

risk of chronic sleep loss

obesity, depression, hypertension, diabetes, heart attack, stroke

non-rapid eye movement (NREM) sleep

body restoration

what are the stages of NREM

1: light sleep, 2: deeper sleep, 3: deepest, slow-wave sleep

rapid eye movement (REM) sleep (aka stage 4)

brain restoration, vivid dreaming, increase in vitals, skeletal muscles tone and deep tendon reflexes are depressed

insomnia

difficulty falling asleep, intermittent sleep despite opportunity and circumstances to sleep

sleep apnea

repeated breathing pauses during sleep

obstructive sleep apnea (OSA)

airway physically blocked

central sleep apnea

brain fails to signal breathing muscles

CPAP airflow

continuous positive airway pressure, single set pressure, doesn’t accommodate changes in breathing

BiPAP airflow

bilevel positive airway pressure, 2 pressure settings for inhale/exhale, treats complex sleep/breathing disorders

somnambulism

parasomnia (walking) during deep NREM sleep, common in children

hypersomnolence disorder

excessive daytime sleepiness despite main sleep period of 7 hrs, lead to functional impairment

idiopathic hypersomnia

neurological disorder causing excessive daytime sleepiness for unknown reason

narcolepsy

chronic neurological disorder of dysregulated sleep-wake cycle, causing daytime sleepiness and abnormal REM sleep; exhibit sleep attacks, cataplexy, hypnagogic hallucinations, sleep paralysis

restless legs syndrome (RLS)

can’t lie still, report unpleasant, creeping, crawling, tingling sensation in legs

nursing actions for sleep issues

establish consistent bedtime routine, minimize nighttime disturbances, promote quiet comfortable environment, melatonin/meds (last resort)

when should you stop eating before sleeping

4 hrs before bed

when should you stop exercising before sleeping

3 hrs before bed

sleep

transfer short to long term memory

cataplexy

sudden loss of muscle tone triggered by strong emotion, remain conscious

hypnagogic hallucination

vivid dreams while falling asleep

nocturia

waking up in middle of night to urinate; manage by reducing nighttime urine production, schedule restroom breaks, limit fluids

polysomnography

test that records what happens when you sleep, helps diagnose sleep disorders

transcutaneous electrical nerve stimulation (TENS)

therapy that uses low-voltage electrical currents to help relieve pain

massage is not given if

blood clots, inflammation, fragile skin, fracture