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3802 Sleep

Biological Rhythms are necessary for what? Adaptation
What are the 3 types of rhythms? Circadian; Infradian; Ultradian
What is the circadian rhythm? Cycle occurring every 24 hrs (sleep-wake cycle)
What is the infradian rhythm? Longer, slower cycle than circadian (menstrual cycle)
What is the ultradian rhythm? Shorter, faster cycle than circadian (cardiac cycle, 90 min. sleep cycle)
What are other physiological cycles synchronized with the Sleep-Wake Cycle (S-WC)? 1) body temperature 2) hormone levels 3) cell division
What are the two phases of sleep? NREM and REM
What are the stages of NREM and the corresponding total sleep time (percent)? Stage 1 (5%); Stage 2 (50-55%); Stage 3 (10%); Stage 4 (10%)
What is the total sleep time (percent) of REM? 20-25%
What are the characteristics of NREM? Slow rolling eye movement/none, muscle relaxation, decreased pulse, blood pressure and respirations
What is the function of NREM? Physical restoration
What are the characteristics of REM? Rapid, darting eye movement, small facial twitches, loss of muscle tone, increased pulse, blood pressure and respirations, and irregular pulse and respirations
What is the function of REM? Psychological and mental restoration
How many cycles does an adult go thru every night? 4-6
How long is a cycle? 60-120 minutes
What is the total sleep time (TST) for adults? 6-8 hours
What is the total sleep time (TST) for 6 y/o? 10-12 hours
What is the total sleep time (TST) for adolescents? 8-9 hours
What is the total sleep time (TST) for a 12 month old? 14 hours
What is the total sleep time (TST) for a neonate? 16 hours
What are symtoms of sleep deprivation? Decreased reflexes, reasoning & judgment, auditory & visual alertness, motivation, fine motor clumsiness, slowed response time, reduced word memory, excessive sleepiness, cardiac arrhythmias, irritable, withdrawn, apathetic, agitated, confused/disoriented
What is insomnia? difficulty falling asleep (longer than 30 min); difficulty staying asleep/frequent awakening; difficulty going back to sleep after awakening; awakening too early or any comination of above
What is the most prevalent sleep disorder? Insomnia
Insomnia is most commonly associated with what? Poor sleep habits
What are therapies for insomnia? 1) Stimulus-Control Therapy 2) Relaxation Training 3) Sleep Restriction Therapy
What is stimulus-control therapy? Assumes that sleep is a conditioned response to bed and bedtime
When would relaxation training be appropriate? Assumes that people w/sleep problems often When person displays high levels of arousal at night and during the day
For whom would sleep restriction therapy be used? Poor sleepers - increase time in bed to provide more opportunity for sleep, BUT results are fragmented/poor quality sleep
What is sleep apnea? cessation of breathing for a time during sleep
What are the types of sleep apnea? 1) Obstructive 2) Central 3) Mixed
What are the symptoms of sleep apnea? Loud snoring with periods of apnea; frequent awakening at night; excessive daytime sleepiness; morning headaches; fatigue and irritability
What are treatments for sleep apnea? Behavioral therapy, physical or mechanical therapy, surgery
What does behavior therapy consist of in relation to sleep apnea? Weight loss (if obese); Avoidance of alcohol & smoking; Positional therapy
What does physical or mechanical therapy consist of for sleep apnea? Dental appliance or Positive Airway Pressure Device (CPAP or BiPAP)
What type of surgery is performed for sleep apnea? 1) Nasal septum repair 2) Palatal surgery
What measures are used to promote sleep? 1) Adequate assessment 2) Plan activities to maximize time for rest and sleep 3) Provide comfort measures 4) Establish sleep environment 5) Patient education
What is involved in order to establish sleep environment? Presleep/bedtime routine; decrease light & noise; avoid excessive physical & mental stimulation; consistent time for sleep; void before going to bed; avoid alcohol & smoking
What would be included in your sleep assessment? Time goes to bed/gets up; # of sleep hrs; naps-when & how long; feels rested
What additional data would you get if sleep problem is indicated? Symtoms; Medications; Physical health; Emotional status; Major Life Changes; Sleep environment; Use of alcohol/caffeine, things tried to alleviate problem