Rest And Sleep (Basics In Nursing)

Front 1

(def)

a pattern based on a 24-hour cycle, especially the repetition of certain physiologic phenomena, such as sleeping and eating

Back 1

circadian rhythm

Front 2

(def)

sleep during which the person experiences rapid eye movement

Back 2

REM sleep

Front 3

(def)

a deep restful sleep rate; also called slow wave sleep

Back 3

NREM sleep (non-REM sleep)

Front 4

(def)

the quantity and pattern of diminished activity for mental and physical rejuvenation

Back 4

rest

Front 5

(def)

a cluster or pattern of waking behavior that appears during sleep, such as somnambulism, sleeptalking, and enuresis

Back 5

Parasomnia

Front 6

(def)

a state in which an individual experience prolonged periods of time without sleep

Back 6

sleep deprivation

Front 7

(def)

inner rhythms that appear to control a variety of biologic processes

Back 7

biorhythms

Front 8

(def)

a stroking massage technique

Back 8

effleurage

Front 9

(def)

an altered state of consciousness in which the individual's perception of and reaction to the environment are decreased

Back 9

sleep

Front 10

(def)

an uncontrollable desire for sleep or attacks of sleep during the day

Back 10

narcolepsy

Front 11

(def)

a condition occurring during stage 3 or 4 of nonrapid eye movement sleep that is characterized by complex motor activity, usually culminating in leaving the bed and walking about

Back 11

somnambulism

Front 12

(def)

the compulsive, unconscious grinding or clenching of the teeth, especially during sleep or as a mechanism for releasing tension during periods of extreme stress in the waking hours

Back 12

bruxism

Front 13

(def)

a condition characterized by sudden loss of muscle tone, usually resulting in a fall, caused by strong emotions, such as anger, fear, or surprise; often associated with narcolepsy

Back 13

cataplexy

Front 14

(def)

when the physiological and psychological rhythms are most active, the person is awake and when they are inactive, the person is asleep

Back 14

circadian synchronization

Front 15

(def)

the polygraphic recording during sleep of multiple physiologic variables, both directly and indirectly related to the state and stages of sleep, to assess possible biologic causes of sleep disorder

Back 15

polysomnography

Front 16

(def)

a graphic chart on which is traced the electric potential produced by the brain cells, as detected by electrodes placed on the scalp; the resulting brain waves are called alpha, beta, delta, and theta

Back 16

electroencephalogram

Front 17

_______ implies calmness, freedom from anxiety and stress.

Back 17

Rest

Front 18

Most people can rest when what (6) needs are met?

Back 18

1. feel that things are under control
2. feel accepted
3. feel that they know what is going on
4. are free from irritation and discomfort
5. have a satisfying amount of purposeful activity
6. know they will receive help when it is needed

Front 19

(def)

a state of decreased mental and physical activity that leaves one feeling refreshed

Back 19

rest

Front 20

(def)

a recurrent altered state of consciousness during which there are changes in the body's physiologic processes and decreased responsiveness to external stimuli

Back 20

sleep

Front 21

What happens if the RAS (reticular activating system) of the brain is severely damaged?

Back 21

a person will be in a coma

Front 22

What happens when the RAS (reticular activating system) of the brain is stimulated?

Back 22

the person stays awake

Front 23

What happens when there is increased activity in the BSR (bulbar synchronizing region) of the brain?

Back 23

the person sleeps

Front 24

True/False:

Rest is the same as inactivity.

Back 24

False- the term rest does not imply inactivity.

Front 25

Sleep is a restorative process that facilitates what 4 processes?

Back 25

1. cellular growth
2. repair of damaged tissue
3. emotional stability
4. memory and learning

Front 26

The ______ _______ ________ is part of the upper brain stem and is responsible for wakefulness.

Back 26

Reticular Activating System

Front 27

The ______ _______ ________ is part of the median forebrain and is connected with sleep.

Back 27

Bulbar Synchronizing Region

Front 28

Sleep depends on a balance between what 2 systems?

Back 28

The RAS (reticular activating system) and the BSR (bulbar synchronizing region); sleepiness occurs when the RAS decreases and the BSR increases

Front 29

The ______ _______ is roughly a 24 hour internal clock that is synchronized by environmental cues such as lightness and darkness.

Back 29

circadian rhythm

Front 30

What hormone, naturally produced by the body, is sold OTC as a sleep aid?

Back 30

melatonin

Front 31

Melatonin levels rise in response to what?

Back 31

darkness

Front 32

What part of the brain synthesizes melatonin?

Back 32

pineal gland

Front 33

To produce and maintain a sleep-wake pattern, there is a balance between what (5) neurotransmitters?

Back 33

- serotonin
- norepinephrine
- dopamine
- GABA
- acetylcholine

Front 34

What are the 2 types of sleep?

Back 34

Non-Rapid Eye Movement (NREM)

Rapid Eye Movement (REM)

Front 35

Which type of sleep is characterized by a deep restful sleep in which metabolic processes are slowed?

Back 35

NREM (non-rapid eye movement)

Front 36

Which type of sleep is characterized by high levels of activity in the brain?

Back 36

REM (rapid eye movement)

Front 37

Most dreaming occurs during which type of sleep?

Back 37

REM (rapid eye movement)

Front 38

Describe Stage 1 NREM sleep.

Back 38

Very light sleep, drowsy, relaxed

Front 39

True/False:

It is difficult to awake someone in Stage 1 NREM sleep.

Back 39

False- a person is easily awakened

Front 40

What happens to the body physiologically during Stage 1 NREM sleep?

Back 40

- eyes roll
- gradual fall in vital signs (heart and respiratory rates drop slightly)

Front 41

Describe what an EEG will show during stage 1 NREM.

Back 41

slower alpha and beta waves

Front 42

How long does Stage 1 NREM last.

Back 42

only a few minutes

Front 43

True/False:

You have one complete sleep cycle each night.

Back 43

False- the sleep cycle happens continually throughout the night

Front 44

How long does stage 2 NREM last?

Back 44

about 15 minutes

Front 45

Describe the sleep experienced during stage 2 NREM.

Back 45

light sleep, relaxation process

Front 46

What happens to body temperature, heart and respiratory rates as we move onto stage 2 NREM?

Back 46

they continue to drop

Front 47

What type of waves appear on an EEG during stage 2 NREM?

Back 47

theta waves

Front 48

What nervous system is dominant during stage 3 NREM sleep?

Back 48

Parasympathetic system

Front 49

What happens to the metabolic processes during stage 3 NREM?

Back 49

they continue to slow

Front 50

True/False:

A person is difficult to awaken during stage 3 NREM.

Back 50

True

Front 51

What happens to the skeletal muscles during stage 3 NREM?

Back 51

they are relaxed

Front 52

True/False:

Snoring may occur during stage 3 NREM.

Back 52

True

Front 53

What type of waves are shown on an EEG during stage 3 NREM?

Back 53

theta

Front 54

How long does stage 3 NREM last?

Back 54

15-30 minutes

Front 55

Which stage of NREM is the most restorative?

Back 55

Stage 4

Front 56

Describe the sleep that occurs during stage 4 NREM.

Back 56

Deep sleep

Front 57

The heart and respiratory rates drop ____-____% during stage 4 NREM.

Back 57

20-30%

Front 58

Which stage of NREM is considered the most important? Why?

Back 58

Stage 4 - it restores the body physically

Front 59

How easily can a person be awoken during stage 4 NREM?

Back 59

They are very difficult to arouse

Front 60

During the sleep cycle, does Stage 4 NREM get longer or shorter as the night progresses?

Back 60

It gets shorter

Front 61

How long does stage 4 NREM last?

Back 61

between 15-30 minutes

Front 62

Does stage 4 NREM increase or decrease with age?

Back 62

decreases

Front 63

What type of dreaming is experienced in REM?

Back 63

vivid dreaming

Front 64

How often does each sleep cycle last?

Back 64

90 minutes

Front 65

Which is more restful, NREM sleep or REM sleep?

Back 65

NREM

Front 66

During which sleep stage does most dreaming occur?

Back 66

REM

Front 67

What happens to brain activity and gastric secretions during REM?

Back 67

they increase

Front 68

How long does REM sleep last?

Back 68

5-30 minutes

Front 69

What type of waves does an EEG show during REM sleep?

Back 69

Delta waves

Front 70

What happens to heart and respiratory rates during REM sleep?

Back 70

they become irregular

Front 71

How easily is a person awoken from REM sleep?

Back 71

they are very difficult to arouse

Front 72

What happens to body temperature during REM?

Back 72

it increases

Front 73

True/False:

Some apnea may occur during REM sleep.

Back 73

True

Front 74

What nervous system dominates REM sleep?

Back 74

Sympathetic

Front 75

During which stage of sleep does irregular muscle movements and erections in men occur?

Back 75

REM sleep

Front 76

During which stage of sleep does the sleeper review the days events, process and store the information, and gain perspective on problems (possibly resolving some)?

Back 76

REM sleep

Front 77

Does the length of REM sleep become longer or shorter as we progress through sleep cycles?

Back 77

it becomes longer

Front 78

List the sleep cycle beginning with Presleep and ending with REM.

Back 78

Presleep -> NREM Stage 1 -> NREM Stage 2 -> NREM Stage 3 -> NREM Stage 4 -> NREM Stage 3 -> NREM Stage 2 -> REM

Front 79

Once REM has been completed, the body recycles back to which stage of the sleep cycle?

Back 79

NREM Stage 2

Front 80

How many sleep cycles do you typically experience during a 7-8 hour sleep period?

Back 80

4-6 cycles

Front 81

As the sleep time progresses, the time spent in NREM Stages 3 and 4 __________ (increases or decreases)?

Back 81

decreases

Front 82

Time spent in NREM 2 and REM ________ (increase or decrease) prior to waking.

Back 82

increase

Front 83

Is the first half or second half of sleep the most restorative?

Back 83

the second half

Front 84

What are 9 factors that could affect sleep patterns?

Back 84

- age
- illness
- environment
- stress
- medications
- lifestyle
- alcohol and stimulants
- diet
- exercise

Front 85

Gastric ulcers, respiratory issues, increased age, and disorders such as hyperthyroidism may cause sleep disorders. In these cases, the sleep disorder would be considered what?

Back 85

a secondary sleep disorder

Front 86

What may happen to a person who is abruptly taken off of morphine or demerol in regards to sleep?

Back 86

The person may experience rebound REM, a condition that causes arrhythmia or exacerbates a pre-existing heart condition

Front 87

Newborns spend what % of time in REM?

Back 87

50%

Front 88

The elderly and adults spend what % of time in REM?

Back 88

25%

Front 89

Why do the elderly experience a decrease in the quality of sleep?

Back 89

because they have very little stage 4 activity

Front 90

Excessive alcohol intake disturbs/hastens which stage of sleep?

Back 90

REM

Front 91

What effect do stimulants, such as caffeine and nicotine, have on sleep?

Back 91

they delay sleep and cause the person to experience a lighter sleep

Front 92

Food products (such as milk, cottage cheese, cashews, turkey) contain what natural substance which promotes sleep?

Back 92

L-trytophan

Front 93

You should exercise how long before sleep?

Back 93

at least 2 hours

Front 94

What does the Electroencephalogram (EEG) measure?

Back 94

brain waves

Front 95

What does the Electromyogram (EMG) measure?

Back 95

muscle movement in the legs

Front 96

What does the Electro-oculogram (EOG) measure?

Back 96

eye movement during REM sleep

Front 97

What does an Electrocardiogram (ECG) measure?

Back 97

heart rhythm

Front 98

What is the most common sleep disorder?

Back 98

Insomnia

Front 99

What are the 3 different types of insomnia?

Back 99

1. Initial insomnia
2. Maintenance insomnia
3. Terminal insomnia

Front 100

(def)

type of insomnia characterized by difficulty in falling asleep

Back 100

initial insomnia

Front 101

(def)

type of insomnia characterized by difficulty staying asleep

Back 101

maintenance insomnia

Front 102

(def)

type of insomnia characterized by early morning awakening

Back 102

terminal insomnia

Front 103

(def)

sleep disorder characterized by excessive sleeping, more than 10 hours in a 24 hour period

Back 103

hypersomnia

Front 104

True/False:

When treating insomnia, you want to advise the client to go to bed at the same time and awake at the same time each day.

Back 104

True

Front 105

When treating insomnia, what are some things you want to avoid prior to bed? (4)

Back 105

- avoid large meals (for about 4 hrs. before bed)
- avoid caffeine for 6 hours before bed
- do not consume more than 1 alcoholic drink prior to bed
- avoid exercise for 3 hours prior to sleeping

Front 106

What are some positive things a person with insomnia can do to promote a good sleep schedule? (4)

Back 106

- have a bedtime ritual
- have exposure to natural light
- void prior to sleeping
- read a light novel

Front 107

What is the recommendation for sleeping medications in the treatment of insomnia?

Back 107

use them sparingly

Front 108

Hypersomnia can be cause by what?

Back 108

- neurological or metabolic disorders (depression, CNS damage, diabetes, etc.)

- psychological coping mechanism to avoid stress (may prescribe antidepressants)

Front 109

(def)

sudden wave of overwhelming sleepiness during the day; sleep begins in REM phase

Back 109

narcolepsy

Front 110

What are 3 causes of narcolepsy?

Back 110

1. genetics
2. lack of chemical hypocretin
3. malfunction of a human leukocyte antigen

Front 111

What are (2) types of drugs given to treat narcolepsy?

Back 111

1. drugs that stimulate the CNS
2. tricyclic antidepressants

Front 112

(def)

periodic cessation of breathing lasting 10 seconds to 2 minutes which is generally preceded by snoring

Back 112

Sleep apnea

Front 113

Sleep apnea occurs anywhere from ____-____ times a night.

Back 113

50-600

Front 114

What effect does sleep apnea have on sleep?

Back 114

the quantity and quality of sleep is poor

Front 115

What are 3 common causes of sleep apnea?

Back 115

- obesity/overweight
- hypertension
- defects in respiratory system (either structurally in the upper region or neurologically in the respiratory center of the brain)

Front 116

True/False:

Sleep Apnea can be a secondary condition.

Back 116

True - it can be caused by conditions such as hypertension, obesity, etc.

Front 117

What type of treatment is often used for sleep apnea?

Back 117

Continuous positive airway pressure (CPAP)

Front 118

(def)

a category of sleep disorders that involve abnormal and unnatural movements, behaviors, emotions, perceptions, and dreams that occur while falling asleep, sleeping, between sleep stages, or arousal from sleep.

Back 118

parasomnias

Front 119

What position should a client avoid sleeping in if they have sleep apnea?

Back 119

on their back

Front 120

How can bruxism be treated?

Back 120

with a dental device

Front 121

What is another term for sleep walking?

Back 121

somnambulism

Front 122

What stage of sleep does sleepwalking occur?

Back 122

Stage 4NREM

Front 123

How soon after falling asleep does somnambulism usually occur?

Back 123

1-2 hours

Front 124

True/False:

A night terror is an extremely vivid nightmare.

Back 124

False- a night terror is not the same as a nightmare; the person cannot recall what they were dreaming about upon awaking

Front 125

What population group is primarily affected by night terrors?

Back 125

children

Front 126

True/False:

A night terror occurs during REM.

Back 126

False

Front 127

How can restless leg syndrome be treated?

Back 127

with medication

Front 128

(def)

bed wetting

Back 128

nocturnal enuresis

Front 129

What stage of sleep does nocturnal enuresis occur in?

Back 129

Stage 3 or 4

Front 130

Is nocturnal enuresis more common in males or females?

Back 130

males

Front 131

What stage of sleep does sleep talking occur in?

Back 131

Right before REM

Front 132

True/False:

Nocturnal erections should be treated with medications.

Back 132

False- it is part of normal development

Front 133

What is the most usual cause of bruxism?

Back 133

anxiety

Front 134

What stage of sleep does bruxism occur in?

Back 134

stage 2

Front 135

What are 8 possible nursing interventions to promote sleep in a hospital setting?

Back 135

1. provide clean/dry linens
2. PM hygiene w/back rub
3. optimal room temperature
4. avoid loud talking
5. decrease volume of phone
6. give milk if allowed on diet
7. dim lights
8. close curtains/room door

Front 136

What is the cause of night terrors?

Back 136

genetics

Front 137

True/False:

Bed wetting is often inherited.

Back 137

True

Front 138

What stage of sleep do nocturnal erections occur in?

Back 138

REM

Front 139

What nursing diagnosis is used for a change in the quantity or quality of a client's sleep patter that causes discomfort or interferes with desired life style?

Back 139

Sleep Pattern, Disturbed

Front 140

What nursing diagnosis is used for a prolonged period of time without sustained, natural sleep?

Back 140

Sleep deprivation

Front 141

What are 7 symptoms of sleep deprivation?

Back 141

- hand tremors
- word loss
- reasoning hindered
- mood changes
- irritability
- decrease in motivation
- agitation

Front 142

How is nocturnal enuresis sometimes treated?

Back 142

with medication