NSG 117 Rest, Sleep, and Wakefulness

Sleep is

natural, necessary and involves a shift in physiological and neurological activity

Sleep is intended to be

Restorative, it’s not a period of inactivity

The scope of sleep ranges from

Restorative sleep to impaired sleep

What is the result of restorative sleep

An individual feeling rested

What is the result of impaired sleep

The individual doesn’t feel rested or refreshed

Impaired sleep can be

Intermittent or chronic with chronic sleep being associated with physical,cognitive, and social challenges

What are the normal physiological processes of sleep

Non-rapid eye movement (NREM) ; Sleep 4 stages

Rapid eye movement (REM) sleep

Restorative processes of sleep

The amount of sleep typically needed by infants

14-16 hours each day

The amount of sleep typically needed by toddlers

9-10 hrs at night

2-3 hrs of daytime naps

The amount of sleep typically needed by school aged children

9-11 hours

The amount of sleep typically needed by teenagers

9 hours

The amount of sleep needed for adults

7-9 hours

What are the two categories of sleep disorders

Primary

Secondary

Primary sleep disorders are

Those that exist as an independent condition

Secondary sleep disorders are often caused by

Medical conditions

Mental health conditions

Side effects of medical treatments

Commonly occurring physiological consequences of poor sleep include

Hypertension

Stroke

Heart disease and heart failure

Obesity

Increased mortality

Reproductive disorders due to disruption in hormonal regulation

Development disorders such as alterations in growth hormone

How does the lack of sleep impact Immune function

Circadian rhythm being interrupted declines the bodies ability to restore balance (WBC/RBC)

How does lack of sleep impact effective weight management

How does sleep apnea effect effectiveness of weight management

What are the two causes of sleep apnea

Obstructive airway from collapse ( common in those obese or with large neck circumference)

Cerebral ( brain doesn’t signal sometimes while in that sleep state)

Every human being is at risk for

Sleep problems

What populations are at risk for sleep problems

Middle-aged and older adults

Women

Pregnant

Perimenopausal women

Obesity

Men

Men have the highest risk for

obstructive sleep apnea (OSA)

When a sleep problem presents

Question about how

What is fragmented sleep

What is the number one reason for sleep deprivation/ disruptions

Urinary frequency at night

What are the primary sleep disorders

Insomnia

Sleep apnea

Restless leg syndrome

Bed wetting

Night terrors

What are some reasons you might have secondary sleep disorders

ADD/ADHD ( Stimulants)

Caffeine

Alcohol

Drugs

Pain

Cognitive disorders

Mental health

Premature babies light sensitivity

What is sleep hygiene

Primary prevention of sleep disorders focuses on

Good sleep hygiene

Good sleep environment

Reviewing personal behaviors

Regular exercise

Good dietary habits

Reviewing personal behaviors

Consistent bedtime and awakening time

What are the secondary Prevention (screening tools: that prevent sleep disorders

What is insomnia

What is narcolepsy

Narcolepsy is

Uncontrolled

What is bruxism

Teeth/ jaw grinding and clenching

What is the medical term for sleepwalking

What are sleep terrors

Rest refers to

Sleep is a state of

Sleep is a part of

What is mom rem

During non-rapid eye movement ( NREM) stage of sleep you have decreased

heart rate

temperature

Blood pressure

Respirations

Brain waves

During the REM stage of sleep you have

Increased brain activity waves

There are how many stages of sleep

4

What are the 4 stages of the sleep cycle

Describe a single normal sleep cycle pattern

Ghrelin

Promotes continued eating

Leptin is a hormone that

Tells the brain to stop eating

How does culture and motivation play into sleep patterns

What are some examples of medication interactions in sleep

Furosemide (loop diuretic)

Opioids ( prevent true REM cycle)

Antidepressant

Steroids

Asthma medication

Decongestants

Anti hypertensives

Benzodiazepines

Amphetamines

Antiparkinsonian drugs

What is restless leg syndrome

ISCD classification of sleep disorders

What are some sleep related breathing disorders

Insomnia is characterized by

Insomnia may be

Short term or chronic

Obstructive sleep apnea. (OSA) is characterized by

What is secondary effects of OSA

Heart arrhythmia due to poor perfusion and oxygenation

Central disorders of hypersommolomence

What are the primary causes of chronic/recurrent sleep- wake rhythm disruptions

Parasomnias

What is a parasomnias

What is sleep enuresis

Sleep related eating disorders are common in those with

Dementia and they don’t achieve REM

Activity and exercise increase

Illnesses associated with sleep disturbances

Medications that affect sleep

What intervention can we do for those with Gastroesophagel reflux

Restless leg syndrome (RLS) is also known as Most often middle age

Willis Ebkom Disease

It effects up to 15% of the population

What do we focus on when obtaining a patients sleep history

What are some screening tools to assess sleep disturbances

Sleep diary

Stanford sleepiness scale

What information is recorded in a sleep diary

Naps taken in the day

Time the patient retires

Time the pt tries to fall asleep

Approximately time they fall asleep

Time of any awakening during the night and resumption of sleep

Time awakening in the morning

Any stressors effecting sleep

What else do we record in a sleep diary

What sleep characteristics do we assess

What are the key findings of a physical assessment for someone with sleep disorders

Nursing interventions that promote sleep

How can nurses help the patients to promote sleep while delivering their care in the hospital

Cluster the care , meaning:

Non-pharmacologic therapy for dyssomnias

Pharmacologic therapy for dyssomnias