Sleep - Fall Semester UTHSCSA 3802
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| What is the cycle that occurs every 24 hours in the sleep-wake cycle? | Circadian rhythm
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| What is the cycle that is longer and slower than the circadian, with menstrual cycle being an example? | Infradian rhythm
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| What is the cycle that is shorter and faster than the circadian, with cardiac cycle being an example? | Ultradian rhythm
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| How many phases are there in the sleep cycle? | Two
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| What are the phases of the sleep cycle? | NREM and REM
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| How many stages are in the NREM phase? | Four
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| What percent of NREM is stage 1? | 5%
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| What percent of NREM is stage 2? | 50-55%
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| What percent of NREM is stage 3? | 10%
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| What percent of NREM is stage 4? | 10%
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| What percent of REM is in the total sleep time (TST?) | 20-25%
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| Is the sleep-wake cycle similar for everyone or is there individuality among each person? | Individuality
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| What three physiological cycles are synchronized with the sleep-wake cycle? | Body temperature, hormone levels and cell division.
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| Name three characteristics of NREM sleep? | Slow rolling eye movements/none, muscle relaxation and decreased P BP R.
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| What is the function of NREM sleep? | Physical restoration
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| Name six characteristics of REM sleep | Rapid darting eye movements, small twitches on the face, loss of muscle tone, increased P BP CO, fluctuating P BP R, and irregular P R.
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| What is the function of REM sleep? | Psychological/mental restoration
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| How many cycles per night for adults? | 4-6 cycles/night
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| How long are each cycle and what is the average? | 60-120 minutes and 90 minutes
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| What is the pattern for the adult sleep cycle? | NREM then REM
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| What is different about the sleep cycle for neonates? | TST 16 hours, 50% REM, 50% NREM, sleep starts with REM and NREM is not divided into stages.
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| What is different about the sleep cycle for a 3 months old? | Circadian rhythm begins and starts sleep with NREM.
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| What is different about the sleep cycle for a 6 months old? | NREM is divided into stages.
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| What is different about the sleep cycle for a 12 months old? | TST is 14 hours.
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| What is different about the sleep cycle for a 3 year old? | NREM is 33%.
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| What is different about the sleep cycle for a 6 year old? | TST is 10-12 hours.
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| What is different about the sleep cycle for an adolescent? | TST is 8-9 hours and REM is 25%
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| What is different about the sleep cycle for an adult? | TST is 6-8 hours.
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| What is different about the sleep cycle for an older adult? | Takes longer to fall asleep, awakens more frequently, less NREM 3&4, more NREM 1&2 and REM decreases.
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| What is the most popular position in which to sleep? | Fetal position
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| Name seven factors that may affect the quantity and quality of sleep? | Physical illness, drugs/medications, lifestyle, emotional stress, environment, nutrition and sensory deprivation.
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| Name four physical symptoms of sleep deprivation. | Fine motor clumsiness, decrease reflexes, slowed response time and decreased auditory & visual alertness.
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| Name three mind-related symptoms of sleep deprivation. | Reduced word memory, decreased reasoning & judgment and confusion & disorientation.
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| Name three physiological symptoms of sleep deprivation. | Cardiac arrhythmias, excessive sleepiness and increased sensitivity to pain.
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| Name six behavioral symptoms of sleep deprivation. | Irritability, withdrawn state, apathy, decreased motivation, agitation and hyperactivity.
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| Name three things that might cause REM deprivation. | Sleep only 1st half of usual TST, awakened every hour/frequently and taking medication(s) that suppresses REM sleep.
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| What may occur when a person is REM deprived and provide an example. | REM rebound, which is when you start seeing dreamscape images in reality.
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| What are the five ways in which insomnia is defined? | Difficulty falling asleep (longer than 30 mins), difficulty staying asleep/frequent awakening, difficulty going back to sleep after awakening, awakening too early, or any combination thereof.
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| What is the incidence rate of insomnia? | It is the most prevalent sleep disorder.
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| What is the cause? | Most commonly associated with poor sleep habits.
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| What are some ways to treat insomnia? | Symptomatic, so treatment varies but improved sleep hygiene measures and relaxation techniques help.
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| Name three insomnia therapies. | Stimulus-control therapy, relaxation training and sleep restriction therapy.
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| What is the name of the condition when cessation of breathing for a time occurs during sleep (5 or more episodes lasting longer than 10 seconds/hour per night)? | Sleep apnea.
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| What are the three types of sleep apnea? | Obstructive, central and mixed.
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| What is obstructive sleep apnea? | Upper airway is blocked, requiring respiratory effort.
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| What is central sleep apnea? | No respiratory effort, where impulse to breath temporarily fails (e.g. COPD with lots of 02).
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| What are some symptoms of sleep apnea? | Loud snoring with periods of apnea, frequent awakening at night, excessive daytime sleepiness, morning headaches, fatigue and irritability.
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| What are three ways to treat sleep apnea? | Behavioral therapy, physical/mechanical therapy and surgery.
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| What does behavioral therapy for sleep apnea entail? | Weight loss if obese, avoidance of alcohol & smoking and positional therapy.
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| What does physical/mechanical therapy for sleep apnea entail? | Dental appliance, positive airway pressure devices to keep the airway flowing and open (e.g. CPAP and BiPaP).
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| What does surgery for sleep apnea entail? | Nasal septum repair and palatal surgery (e.g. uvulopalatopharyngoplasty or UP3).
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| What are five measures to promote sleep? | Adequate assessment, planning activities to maximize time for rest & sleep, provide comfort measures, establish sleep environment and patient education.
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| Name four things you ask a patient to make a proper sleep assessment. | Time individual goes to sleep/awakens, number of hours of sleep, if naps are taken(when and how long), and if the patient feels rested.
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| What are eight useful additional data if a sleep problem is indicated? | Symptoms, medications, physical health, emotional status, major life changes, sleep environment, consumption of alcohol/caffeine and what was already tried to alleviate the problem.
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| What are six things that are good for establishing a healthy sleep environment? | Presleep/bedtime routine, decreased light & noise, avoid excessive physical & mental stimulation, consistent time for sleep, voiding before goign to bed, and avoiding alcohol/smoking.
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