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Sleep P&P
Potter and Perry 7th Edition Chapter 42
| Question | Answer |
|---|---|
| Proper rest and sleep are as important to good health as? | Good nutrition and adequate exercise. |
| Sleep define. | Cyclical physiological process that alternates with longer periods of wakefulness. |
| Circadian rhythm is? | Most familiar 24-hr day/night cycle. |
| Why are hospitals and acute care facilities detrimental to sleep? | They do not adjust to individual sleep cycles. |
| How do body temps correlate to sleep cycles? | Temp peaks in afternoon, gradually decreases, then drops sharply after falling asleep. |
| What happens to the body if sleep cycle is disrupted? | Decrease appetite, Increase in anxiety, restlessness, irritability, and impaired judgment. |
| What equipment is used to monitor sleep cycles? | EEG (cerebral cortex activity), EMG (muscle tone), EOG (Eye movements) |
| What is the major sleep center in the body? | Hypothalamus. |
| What are hypocreatins (orexins) and where are they secreted? | Hormones that promote wakefulness and REM sleep; Hypothalamus. |
| What hormones control sleep? | Prostaglandin D2, L-tryptophan, and growth factors. |
| What is believed to control alertness and wakefulness? | Cells located in the ascending reticular activating system (RAS) located in the upper brain stem. |
| What does the RAS receive that promotes wakefulness/alertness? | Visual, auditory, pain, tactile sensory stimuli. |
| What chemicals are responsible for maintaining arousal? | Catecholamines such as norepinephrine. |
| What hormone is responsible for sleep? | Serotonin. |
| Where is serotonin secreted? | Cells in the raphe nuclei sleep system in the pons and medulla. |
| Normal sleep involves how many phases? | 2; Nonrapid eye movement (NREM) and REM. |
| How long is a regular sleep cycle? | 90 mins. |
| How many stages of sleep occur during a 90 mins sleep cycle? | 4. |
| What are the 4 stages of sleep cycle? | Stage 1 and 2 (light sleep), Stage 3 and 4 (deep sleep), REM. REM is not a "stage" of sleep, it is classified as the period at the end of each cycle. |
| How many sleep cycles are completed each night during sleep? | 4-5. |
| What is the flow of the stages of sleep? | 1, 2, 3, 4, 3, 2, REM, 2, 3, 4... |
| What percentage of sleep is spent in the NREM stages? | 75-80% |
| With each cycle completed, stages 3 and 4 and REM get longer or shorter? | Longer |
| Newborns and children spend more time in which stages? | 3 and 4 (deep sleep) |
| Which stages of sleep contribute to tissue restoration? | NREM (1,2,3,4) |
| During NREM, do body functions increase or decrease? | Decrease. |
| What biological functions decrease while sleeping? | Heart rate, Resp, BP, Muscle tone. |
| Stages 3 and 4 are called deep sleep and what else? | Slow-wave. |
| What is released during Stage 4 to repair and renew epithelial and specialized cells? | Human growth hormone. |
| Protein synthesis also occurs during sleep, what is this used for? | Repair and renewal of tissues: skin, bone marrow, gastric mucosa, brain. |
| The muscular system rests and BMR decrease resulting in what during sleep? | Conservation of energy stores. |
| When is brain tissue and cognitive restoration? | REM sleep. |
| What changes in the brain are related to REM sleep? | Change in cerebral blood flow, increase cortical activity, increased O2 consumption, epinephrine release. |
| A loss in REM sleep results in? | Confusion and suspicion. |
| When do dreams occur and when are they most vivid? | Occur in NREM and REM; most vivid in REM. |
| Sleep-related breathing disorders are linked to increased? | Nocturnal angina, increase heart rate, ECG changes high BP, and increase risk of heart disease and stroke. |
| Hypertension causes what? | Early morning awakening and fatigue. |
| Hypothyroidism causes what? | Decreased stage 4 sleep. |
| Hyperthyroidism causes what? | Takes more time to fall asleep. |
| Primary Restless legs syndrome is classified as? | Nervous system disorder. |
| Secondary RLS is associated with? | Lower lvls of iron, pregnancy, and uremia. |
| Gastric acid secretion and stages of sleep are complimentary or conflicting? | Conflicting. |
| What are the 3 sleep problems? | Insomnia, Abnormal movements/sensations during sleep, Excessive daytime sleepiness. |
| How many categories of sleep disorders are there? | 8 |
| Hypersomnia is? | Group of disorders that is not caused by disturbed circadian rhythms or nocturnal sleep. |
| Parasomnias are what? | Undesirable behaviors that occur usually during sleep. |
| Polysomnogram involves which tests? | EEG, EMG, and EOG to monitor sleep. |
| What is characteristic of insomnia? | Difficulty falling asleep, frequent awakenings, or short sleep (non-restorative) |
| Insomnia occurs more in? | Women, most common sleep disorder of women. |
| What causes transient insomnia? | Situational stresses such as family, work, school, jet lag, illness, death in family. |
| What is sleep hygiene? | Practices associated with sleep. |
| What is characteristic of sleep apnea? | Lack of airflow through the nose and mouth for periods of 10 seconds or longer during sleep. |
| What are the 3 types of sleep apnea? | Central, obstructive, and mixed. Most common is obstructive. |
| Obstructive sleep apnea (OSA) occurs when what happens? | Muscles/structures of the upper airway relax during sleep and partially or completely block the airway. |
| What is the difference between apnea and hypopnea? | Apnea is completely blocked w/ no air flow Hypopnea is partially blocked w/ partial air flow. |
| How does the body correct apnea when it happens? | Each successive diaphragmatic movement becomes stronger until the obstruction is relieved. |
| What are the most common complaints of people with OSA? | Excessive daytime sleepiness and fatigue. |
| Central Sleep Apnea (CSA) is what? | Dysfunction in the brain's respiratory control center. |
| CSA is common in clients with? | Brain stem injury, muscular dystrophy, and encephalitis. |
| Narcolepsy is a dysfunction of what? | Mechanisms that regulate sleep and wake states. |
| Cataplexy is what? | Sudden muscle weakness during intense emotions. |
| How long does it take a narcolepsy patient to reach REM? | 15 mins. |
| What is sleep paralysis? | Feeling of being unable to move or talk just before waking or falling asleep. |
| Sleep deprivation is a problem many experience with? | Dyssomnia. |
| Parasomnias are more common in adults or children? | Children. |
| What is the current position babies should be placed to sleep to avoid SIDS. | Supine. |
| What are some common parasomnias? | Somnambulism (sleep walking), Night terrors, nightmares, nocturnal enuresis (bed-wetting), body rocking, and bruxism (teeth-grinding) |
| Define rest. | State of mental, physical, and spiritual relaxation that leaves them refreshed and rejuvenated. |
| Normal sleep requirements of age groups is on page... | 1035 Not typing all of that. |
| Sleep obtained by US citizens has increase or decreased? | Decreased 20% during past century. |
| Falling asleep while driving usually occurs? | Between 2-5am. |
| In order to promote sleep, when should one exercise? | 2 or more hours before sleep. |
| Certain sleep disorders are the result of what type of diet? | Semistarvation. |
| Who can be asked about one's sleep patterns? | Client, client's bed partners. |
| What is a brief method for assessing sleep quality? | Visual analog scale or numeric scale of 0-10 |
| How can a nurse get an idea of a client's sleep habits without having them participate in sleep study? | Sleep-wake log. |
| Which age groups prefer softly lit rooms as opposed to total darkness? | Infants and older adults. |
| How to prevent middle of the night bottle feedings for infants? | Feed last bottle as late as possible and never give a bottle to them in the crib. |
| What is melatonin? | Neurohormone produced in the brain that helps control circadian rhythms and promote sleep. |
| What are some drugs/herbal meds to help with sleep? | Valerian, Kava, Chamomile, Passionflower, Lemonbalm, Lavender. |
| What should be monitored during sleep after surgery? | Airway, resp rate, depth, and breath sounds. |
| What is the most effective therapy to reduce airway obstruction during sleep? | Use of a nasal continuous positive airway pressure device (CPAP). |
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