Chapter 35: Rest and Sleep

Comprehensive vocabulary flashcards covering the concepts, physiology, sleep cycle stages, developmental factors, disorders, screening tools, and interventions from Chapter 35: Rest and Sleep.

Rest

A condition in which the body is in a decreased state of activity, resulting in a consequent feeling of being refreshed.

Sleep

A state of rest accompanied by altered consciousness and relative inactivity that is part of the sleep-wake cycle, serving as a period of restoration of mental and physical function.

Wakefulness

A state and period characterized by mental activity and energy expenditure.

Reticular Activating System (RAS)

A brain network that facilitates reflex and voluntary movements and controls cortical activities related to the state of alertness.

Bulbar Synchronizing Region

A brainstem structure that works in conjunction with the reticular activating system to control the physiology of sleep.

Hypothalamus

The brain structure that acts as the primary control center for sleeping and waking.

Non-Rapid Eye Movement (NREM) Sleep

A major sleep division consisting of four stages, progressing from light sleep to deep delta sleep.

NREM Stage I

A transitional stage of light sleep between wakefulness and sleep.

NREM Stage II

A stage of light sleep that, combined with Stage I, comprises $5\%$ to $50\%$ of sleep, wherein the person falls into sleep but can be aroused with relative ease.

Delta Sleep (NREM Stages III and IV)

Deep-sleep states constituting approximately $10\%$ of sleep, during which the depth of sleep increases and arousal becomes increasingly difficult.

Rapid Eye Movement (REM) Sleep

A sleep state comprising $20\%$ to $25\%$ of nightly sleep time, characterized by increases in pulse, respiratory rate, blood pressure, metabolic rate, and body temperature, while skeletal muscle tone and deep tendon reflexes are depressed.

Normal Sleep Cycle

The recurring cyclic pattern in which a person progresses consecutively through NREM stages I to IV, reverses from IV to III to II, enters REM sleep instead of stage I, and then re-enters NREM sleep at stage II.

Leptin

A hormone that signals the brain to stop eating, which decreases as an effect of insufficient sleep.

Ghrelin

A hormone that promotes continued eating, which elevates as an effect of insufficient sleep.

L-tryptophan

An amino acid found in dietary protein that promotes sleep.

Adenosine

A substance that causes drowsiness, whose sleep-inducing ability is blocked by caffeine.

Alcohol Effect on Sleep

The impact of consuming large quantities of alcohol, which limits both REM sleep and deep delta sleep.

Nicotine and Smoking

A lifestyle habit and chemical stimulant associated with poorer sleep quality.

Complex Carbohydrate Bedtime Snacks

Food choices (such as toast or crackers) that promote sleep, particularly when combined with a small protein snack before bed.

Psychological Stress Effect on Sleep

A condition caused by illness or life situations that reduces REM sleep, leading to heightened anxiety and difficulty obtaining adequate rest.

REM-Decreasing Medications

Pharmacologic agents including barbiturates, amphetamines, and antidepressants that decrease REM sleep.

Insomnia

A sleep disorder characterized by difficulty falling asleep, intermittent sleep, or difficulty maintaining sleep despite adequate opportunity and circumstances, affecting $30\%$ to $35\%$ of adults in the United States.

Obstructive Sleep Apnea (OSA)

A sleep-related breathing disorder characterized by $5$ or more predominantly obstructive respiratory events per hour, marked by absence of breathing between snores and upper airway occlusion involving the tongue, soft palate, and uvula.

Apnea

The cessation or absence of breathing during sleep.

Hypopnea

Significantly diminished breathing efforts occurring during sleep.

Idiopathic Hypersomnia

A central disorder of hypersomnolence characterized by excessive sleep, particularly during daytime hours.

Narcolepsy

A central disorder of hypersomnolence characterized by excessive daytime sleepiness and uncontrollable urges to sleep, during which a person can fall asleep while performing activities of daily living (ADLs).

Cataplexy

A sudden, involuntary loss of skeletal muscle tone lasting from seconds to $1$ or $2\text{ minutes}$, experienced by up to $70\%$ of people with narcolepsy.

Circadian Rhythm Sleep–Wake Disorders

Disorders marked by a chronic or recurrent disruption between the internal timing system and required schedule, causing impairment lasting at least $3\text{ months}$ (except jet lag disorder).

Parasomnias

A classification of sleep disorders characterized by abnormal behavioral or physical phenomena during sleep, such as somnambulism, sleep terrors, and enuresis.

Somnambulism

A parasomnia in which an individual walks while asleep.

REM Sleep Behavior Disorder (RBD)

A parasomnia occurring during REM sleep characterized by abnormal physical behaviors or actions.

Sleep Terrors

A parasomnia involving abrupt awakenings accompanied by signs of extreme panic and terror.

Nightmare Disorder

A parasomnia characterized by repeated occurrences of frightening dreams that result in awakenings.

Sleep Enuresis

A parasomnia characterized by involuntary bedwetting during sleep.

Sleep-Related Eating Disorder

A parasomnia in which an individual involuntarily and compulsively eats or drinks while sleeping or during sleep awakenings.

Restless Legs Syndrome (RLS)

A sleep-related movement disorder, also known as Willis–Ekbom disease (WED), affecting up to $15\%$ of the population, characterized by creeping, crawling, or tingling sensations that prevent the patient from lying still.

Sleep Diary

A diagnostic assessment tool used to record bedtime, sleep latency, nighttime awakenings, morning wake time, stressors, food/drink intake, and pre-bedtime activities.

STOP-Bang Questionnaire

A clinical screening questionnaire used specifically to assess risk factors and signs for obstructive sleep apnea (OSA).

Cognitive Behavioral Therapy (CBT) for Dyssomnias

A nonpharmacologic treatment program that includes progressive muscle relaxation, stimulus control, sleep restriction, sleep hygiene measures, and biofeedback.