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29 Cards in this Set
- Front
- Back
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Sleep |
Altered state of consciousnesswhere perception of and reaction to environment decreased Cyclicnature of sleep thought to be controlled by lower part of brain –Neuronsin reticular formation integrate sensory information from PNS and relay tocerebral cortex –RAS (Reticular Activating system)involved in sleep-wake cycle |
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Reticular Activating system (RAS) |
Reticular formation (located in brainstem) w/ projections to the hypothalmus and cerebral cortex |
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Circadian Rhythm |
-–Personawake when body temp highest and asleep when body temp lowest *3-6 mos. of age have regular sleep-wake cycles |
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Sleep Architecture |
-Basic organization of normal sleep -2 types that alternate in cycles during sleep -NREM -REM |
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NREM sleep |
•Occurswhen activity in RAS inhibited•Constitutes75% - 80% of sleep •Consistsof 4 stages |
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Stage 1 of NREM Sleep |
–Verylight sleep and lasts only a few minutes –Feelsdrowsy and relaxed –Eyesroll from side to side –HRand RR drop slightly –Canbe readily awakened and may deny sleeping |
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Stage 2 of NREM Sleep |
–Lightsleep lasts only about 10 to 15 minutes –Bodyprocesses continue to slow down –Eyesare generally still –HRand RR decrease slightly –Bodytemperature falls –44%to 55% of total sleep –Requiresmore intense stimuli to awaken |
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Stage 3 & 4 of NREM Sleep |
–Deepeststages of sleep (delta sleep or deep sleep) –HRand RR drop 20% to 30% below waking hours –Difficultto arouse –Notdisturbed by sensory stimuli –Skeletalmuscles very relaxed –Reflexesare diminished –Snoringis likely to occur –Swallowingand saliva production reduced –Essentialfor restoring energy and releasing important growth hormones |
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Physiologic changes in NREM |
•BPfalls •Pulserate decreases •Peripheralblood vessels dilate •COdecreases •Skeletalmuscles relax •BMRdecreases 10% - 30% •GHlevels peak •Intracranialpressure decreases |
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REM Sleep |
•Occursevery 90 minute •Lasts5 to 10 minutes •Acetylcholineand dopamine increase •Mostdreams take place •Brainis highly active •Brainmetabolism increases as much as 20% •Distinctiveeye movements occur •Voluntarymuscle tone dramatically decreased •Deeptendon reflexes absent •Maybe difficult to arouse or may wake spontaneously •Gastricsecretions increase •HRand RR often are irregular •Regionsof brain associated with learning, thinking, organizing information stimulated;����. |
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Paradoxical sleep |
REM is considered paradoxical b/c an EEG activity resembles that of wakefulness |
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Sleep patterns of Adults |
–Mosthealthy adults need 7-9 hours of sleep –Individualvariations , some can function with 6 hours of sleep, and others need 10 to function optimally |
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Sleep patterns of Older Adults (65-75) |
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Sundown syndrome |
Some older adults with dementia experience this sleep pattern with Sx: agitation, anxiety, aggresion, and sometimes delusion |
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Sleep Quality |
is Subjective determined by whether or not the person feels rested/ energetic or not when they awaken |
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Sleep Quantity |
Total of time the individual sleeps |
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Factors Affecting Sleep |
•Illness •Environment •Lifestyle •Emotionalstress •Stimulantsand alcohol •Diet •Smoking •Motivation •Medications |
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Drugs that Disrupt Sleep |
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Drugs that cause excessive daytime sleepiness |
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Common Sleep disorders |
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Insomnia |
•Difficultyfalling asleep •Wakingup frequently •Difficultystaying asleep •Daytimesleepiness •Difficultyconcentrating •Irritability •Riskfactors –Olderage –Female |
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Excessive Daytime sleepiness |
•Hypersomnia •Narcolepsy •Sleepapnea •Insufficientsleep |
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Hypersomnia |
•Sufficientsleep at night but cannot stay awake during day •Causedby medial or psychological disorderso |
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Narcolepsy |
•Causedby lack of hypocretin in CNS that regulates sleep •Clientshave sleep attacks •Sleepat night usually begins with sleep-onset REM period |
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Sleep Apnea |
•Frequentshort breathing pauses during night•Morethan 5 apneic episodes > 10 sec/hr considered abnormal •Symptomsinclude snoring, frequent awakenings, difficulty falling asleep, morningheadaches, memory and cognitive problems, irritability •Typesinclude obstructive, central, mixed |
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Parasomnia |
•Behaviorthat may interfere with or occur during sleep •Arousaldisorders –i.e.,Sleepwalking, sleep terrors •Sleep-waketransition disorders –i.e.,Sleep talking •Associatedwith REM sleep –i.e.,Nightmares •Others–i.e.,Bruxism |
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Parasomnias |
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SLEEP HISTORY |
•Whendoes client usually go to sleep? •Bedtimerituals? •Doesclient snore? •Canclient stay awake during day? •Takingany prescribed or OTC medications? *Always ask: Is there anything else I need to know about your sleep? |
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Reducing Environmental Distractions in Hospitals |
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