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Theory Test IV

Unit XII Sleep

QuestionAnswer
Amount of life spent sleeping one third
Advantages of adequate sleep Helps cope with stress, prevent fatigue, conserves energy, restores the mind and body.
Characteristics of sleep minimal physical activity, variable levels of consciousness, changes in the body's physiological process, and decreased responsiveness to external stimuli.
Reticular Activating System (RAS) A network of ascending nerve fibers that are involved in the sleep/wake cycle.
Definition of sleep An alternate state of consciousness in which the individual's perception of and reactions to the environment are decreased.
Biological rhythms in humans Controlled by environmental factors such as light and darkness.
Circadian rhythm Most familiar biological rhythm. Latin for "circa dies" meaning "about a day". A 24-hour internal biologic clock. Sleep, wake, BP, temp, etc...
Circadian synchronization When a persons biological clock coincides with the sleep/wake cycles. (eg. person is awake when body temp is the highest, and asleep when it is lowest.
Serotonin Neurotransmitter that is thought to lessen the response to sensory stimulation.
Gamma-aminobutyric acid (GABA) Neurotransmitter that is thought to shut off the activity in the neurons of the RAS.
This hormone is secreted during sleep Growth hormone (GH) is secreted and cortisol is inhibited
This hormone makes a person feel less alert Melatonin is secreted from the pineal gland when a person is preparing for sleep.
Cortisol Stimulating hormone
Non-rapid-eye-movement (NREM) Occurs when activity in the RAS is inhibited. About 75% - 80% of sleep during the night. 3 stages.
Stage 1 of NREM Very light sleep and lasts only a few minutes. Eyes roll from side to side. Drowsy and relaxed. Heart and respiratory drop slightly. Readily awakened.
Stage 2 of NREM Body continues to slow down. Eyes are still. Heart and respiratory decrease slightly. Temperature falls. Requires more intense stimuli to awaken.
Stage 3 of NREM Deepest stage of sleep. Essential for restoring energy and releasing GH. Heart and respiratory drop 20% - 30% lower than waking hours. Difficult to arouse. Reflexes are diminished. Not disturbed by sensory stimuli. Snoring may occur.
How often does Rapid-eye-movement (REM) occur? Recurs about every 90 minutes and last 5 - 30 minutes
When do dreams take place? During REM sleep. They will not be remembered unless the person arouses briefly at the end of the REM period.
Characteristics of REM sleep Brain is highly active. Brain metabolism increases up to 20%. Highest levels of acetylcholine and dopamine released. Distinctive eye movements. Heart and respirations irregular.
Acetylcholine and dopamine Neurotransmitters that are associated with cortical activation. Levels are high during REM; dream sleep.
Number of sleep cycles an adult experiences per night and how long each one lasts. 4 - 6 cycles during 7 - 8 hours of sleep. Each cycle lasts roughly 90 - 110 minutes.
Physiological changes during NREM sleep Arterial blood pressure and pulse rate decreases. Peripheral blood vessels dilate. Cardiac output and intracranial pressure decreases. Skeletal muscles relax. Basal metabolic rate decreases 10-30%. Growth Hormone levels peak.
Another name for deep sleep Delta sleep. Occurs in stage 3 of NREM
Paradoxical Sleep Also called REM sleep because electroencephalogram (EEG) activity resembles that of wakefulness.
Characteristics of sleep deprivation Emotional irritability, poor concentration, difficulty making decisions.
Sleep is necessary for this. Protein synthesis, which allows repair processes to occur.
What changes in sleep-rest patterns in 65-75 years old? Go to bed approximately 1 hour earlier and awaken 1.3 hours earlier than younger adults. During sleep, they have a flattened-circadian rhythm.
How does daytime napping effect older adults Contributes to reduced nocturnal sleep. After awakening at night it is difficult to fall back asleep, which results in a diminished amount of REM.
Sundown Syndrome Affects clients with dementia. Not a sleep disorder directly, but it refers to a pattern of symptoms that occur in the late afternoon and can last through the night. (agitation, aggression, anxiety, delusions)
How respiratory conditions disturb sleep. People with shortness of breath, nasal congestion, or sinus drainage may have trouble breathing.
How gastric and duodenal ulcers disturb sleep. Increased gastric secretions occur during REM sleep.
Why estrogen levels disturb sleep for women. Low levels result in fatigue and hot flashes or night sweats that cause discomfort.
How the environment can affect sleep. Can promote or hinder sleep. Any change such as: hospitalization, temperature, light levels, comfort and size of bed, and a person's partner who has different sleep habits can hinder sleep.
Lifestyle choices that disturb sleep Following irregular morning and nighttime schedules. Exercise late in the day. Night shift workers.
Lifestyle choices that promote sleep Following regular morning and nighttime schedules. Moderate exercise in the morning or early afternoon. Wearing dark, wrap-around sunglasses after working a night shift.
Emotional Stress Considered by most sleep experts to be one of the greatest causes of difficulties falling asleep or staying asleep.
Result of constant exposure to stress Increases the activation of the hypothalmic-pituitary-adrenal (HPA) axis leading to sleep disorders.
How anxiety affects sleep Increases norepinephrine blood levels through stimulation of the SNS, results in less deep and REM sleep and more stage changes and awakenings.
How caffeine disturbs sleep. Act as a stimulant of the CNS.
How alcohol disturbs sleep. Disrupts REM sleep, although it may hasten the onset of sleep. People often experience nightmares while trying to make up for lost REM.
How weight affects sleep. Weight gain = reduced total sleep time, broken sleep, earlier waking. Weight loss = increase total sleep time and less broken sleep.
L-tryptophan Found, for example, in cheese and milk. May induce sleep, a fact that might explain why warm milk helps some people get to sleep.
How Nicotine affects sleep. Has a stimulating effect on the body. People often have more difficulty falling asleep and describe themselves as "light sleepers".
How medications affect sleep. Hypnotics, narcotics, and antidepressants suppress REM sleep. Beta-blockers can cause insomnia and nightmares. Tranquilizers interfere with REM sleep.
Insomnia Inability to fall asleep and remain asleep. Individuals do not awaken feeling rested. Most common sleep complaint in America.
Acute insomnia Lasts one to several nights, often caused by a personal stressor or worry.
Chronic insomnia Persists for longer than a month.
Chronic intermittent insomnia Difficulty sleeping for a few nights, followed by a few nights of adequate sleep before the problem returns.
Hypersomnia Conditions where the affected individual obtains sufficient sleep at night but still cannot stay awake during the day.
Narcolepsy Disorder of excessive daytime sleepiness caused by the lack of the chemical hypocretin in the area of the CNS that regulates sleep.
Sleep apnea Characterized by frequent short breathing pauses during sleep.
Three common types of sleep apnea Obstructive, Central, and Mixed
Obstructive apnea Occurs when structures of the pharynx or oral cavity block the flow of air. (enlarged tonsils, deviated nasal septum, nasal polyps)
Central apnea Involves a defect in the respiratory center of the brain.
Mixed apnea A combination of central and obstructive apnea.
Parasomnia Behavior that may interfere with sleep and may even occur during sleep. Displayed as emotions, perceptions, or dreams.
Three classes of parasomnia's Non-rapid eye movement, rapid eye movement, and miscellaneous with no specific stage of sleep.
Parasomnia's with NREM are associated with... Confusion upon arousal, sleep tremors, and sleep walking.
Parasomnia's with REM are associated with... Arousal disorders such as sleep paralysis. May be a nightmare disorder with exaggerated features of REM.
Miscellaneous parasomnia's may cause these problems... Nocturnal enuresis or hallucinations. Often related to medication, substance abuse, or a medical disorder.
Bruxism Clenching and grinding of the teeth during stage 2 NREM sleep.
Enuresis Bed wetting during sleep can occur in children over 3 years old. Often occurs 1-2 hours after falling asleep, when rousing from stage 3 NREM sleep.
Periodic limb movement disorder (PLMD) Nocturnal Myoclonus. Legs jerk twice or three times per minute during sleep. Not the same as RLS.
Sleeptalking Talking during sleep occurs during NREM sleep before REM sleep.
Sleepwalking Somnambulism. Occurs during stage 3 of NREM sleep. Episodic. Occurs 1-2 hours after falling asleep.
Restless Leg Syndrome Occurs whenever the person is at rest, not just at night when sleeping.
Polysomnography How sleep is measured objectively for sleep disorders. Includes an electroencephalogram (EEG), electromyogram (EMG), and electro-oculogram (EOG) that are corded simultaneously.
Electroencephalogram (EEG) Electrodes are placed on the scalp to record brain waves.
Electro-oculogram (EOG) Electrodes are placed on the outer canthus of each eye to record eye movement.
Electromyogram (EMG) Electrodes are placed on the chin muscles to record the muscle structure.
Sleep hygiene Interventions used to promote sleep.
Created by: Jnford15