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Sleep and Rest

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Question
Answer
Sleep is under control of   reticular formation  
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Researchers believe the __ located in the upper brain stem to contain special cells that maintain alertness and wakefulness.   ascending reticular activating system (RAS)  
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The RAS receives   visual, auditory, pain, and tactile sensory stimuli  
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Activity from the __ (e.g., emotions or thought processes) also stimulates the RAS.   cerebral cortex  
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Arousal, wakefulness, and maintenance of consciousness results from neurons in the   RAS that release catecholamines such as norepinephrine.  
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Bulbar synchronizing region (BSR)   Researchers hypothesize that the release of serotonin from specialized cells in the raphe nuclei sleep system of the pons and medulla produces sleep.  
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Whether a person remains awake or falls asleep depends on a balance of   impulses received from higher centers (e.g., thoughts), peripheral sensory receptors (e.g., sound or light stimuli), and the limbic system (emotions).  
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At some point the __ takes over, causing sleep.   BSR  
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Inhibitory signals appear to result from release of the neurotransmitter __ by reticular formation cells.   serotonin  
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The major sleep center in the body is the   hypothalamus  
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The hypothalamus secretes hypocreatins (orexins) that promote   wakefulness and rapid eye movement sleep  
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___ inhibits the RAS from firing   serotonin and dopamine, and GABA  
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Serotonin does what regarding sleep?   Inhibits RAS from firing, temporarily ending consciousness - levels in the brain gradually fall off allowing the individual to wake up.  
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Sleep and wakefulness follow a cyclic pattern unless the pattern is blocked, changed, or interrupted.   Circadian Rhythm  
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Factors such as light, temperature, social activities, and work routines affect   circadian rhythms and daily sleep-wake cycles  
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NREM sleep contributes to   body tissue restoration  
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During __ sleep, biological functions slow.   NREM  
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During deep slow-wave (NREM stage 4) sleep, the body releases   human growth hormone for the repair and renewal of epithelial and specialized cells such as brain cells.  
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Stage I: NREM   lightest level of sleep; stages last a few minutes; gradual fall in vital signs and metabolism; easily aroused.  
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Stage II: NREM   period of sound sleep; relaxation progresses; arousal remains relatively easy; lasts 10 to 20 minutes; body functions continue to slow.  
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Normal sleep involves two phases   nonrapid eye movement (NREM) sleep and rapid eye movement (REM) sleep  
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During NREM a sleeper progresses through four stages during   a typical 90-minute sleep cycle  
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Lighter sleep is characteristic of stages __, and a person is more easily arousable   1 and 2  
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Stages __ involve a deeper sleep, called slow-wave sleep.   3 and 4  
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Rapid eye movement sleep is the phase at the end of each   sleep cycle  
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Stage III: NREM   involves initial stages of deep sleep; sleeper is difficult to arouse; rarely moves; muscles completely relaxed; VS decline but remain regular; stage lasts 15 to 30 min. – May start snoring at this stage.  
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Stage IV: NREM   deepest stage (delta); very difficult to arouse; if sleep loss occurred, sleeper will spend large portion of night in this stage; VS significantly lower; lasts approximately 15 to 30 min; sleepwalking and enuresis may occur  
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Dreams occur during   both NREM and REM sleep, the dreams of REM sleep are more vivid and elaborate and some believe they are functionally important to learning, memory processing, and adaptation to stress.  
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REM sleep is necessary for   brain tissue restoration and appears to be important for cognitive restoration.  
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REM sleep is associated with changes in   cerebral blood flow, increased cortical activity, increased oxygen consumption, and epinephrine release  
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With each successive cycle   stages 3 and 4 shorten, and the period of REM lengthens. REM sleep lasts up to __ during the last sleep cycle.  
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__ disorders are linked to increased incidence of nocturnal angina (chest pain), increased heart rate, electrocardiogram changes, high blood pressure, and risk of heart diseases and stroke.   Sleep-related breathing  
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Chronic difficulty falling asleep – or intermittent sleeping   Insomnia  
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Lack of airflow through nose & mouth from 10 seconds or longer during sleep   sleep apnea  
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Central sleep apnea   dysfunction in brain’s respiratory control center – so impulse to breathe is temporarily inhibited. Can occur in patient with close head brain injury, stroke-common with brain stem injuries and muscular dystrophy.  
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CPAP   (continuous positive airway pressure) – equipment/mask connected to tubing and air pressure machine. It continuously blows air in their airway to keep it open.  
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What changes in sleep occur in the elderly?   REM tends to shorten, Progressive decrease in stages 3 & 4 NREM, Some have no stage 4 or deep sleep, and Tendency to nap.  
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sleep journal to be kept how long?   1 – 4 weeks  
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Why is sleep-wake log important?   Because it shows the day-to-day variations in the pattern.  
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Stage 4 sleep begins to fall when?   In middle adulthood and will continue throughout the rest of life.  
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Sleep problems often result from   depression, anxiety, stress, some physical conditions, and, in women, the onset of menopause.  
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tracheobranchial obstruction can cause?   sleep apnea  
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