Sleep

Front 1

Describe the functions and physiology of sleep

Back 1

*Functions
- restores normal levels of activity and balance to the nervous system
- necessary for protein synthesis
- psychological well-being
- sleep deprivation leads to illness (Maslows)
* Physiology
- Reticular Activating System (RAS)
- Hypothalamus- control center for sleeping & waking
- Darkness facilitates sleep w/ release of melatonin (hormone)
- Acetylcholine, dopamine, and norepinephrine are stimulated during wake cycles

Front 2

Reticular Activating System (RAS)

Back 2

- extends upward through the medulla, the pons, the mid brain, and into the Hypothalamus.
- experiences few stimuli from cerebral cortex & periphery of the body during sleep
*Ex. an alarm clock awaken us from sleep to consciousness; pain, pressure, noise

Front 3

Identify variables that influence rest and sleep

Back 3

*development considerations
*motivation
*culture
*lifestyle & habits
*physical activities and exercise
*dietary habits
- alcohol, caffeine, smoking
*environmental factors
*psychological stress
*illness
*medications
-diuretics, antiparkinsonian, antidepressants, antihypertensives

Front 4

Define Common Sleep Disorders

Back 4

☆ Dyssomnias- characterized by insomnia or excessive sleepiness
* Insomnia, hypersomnia, narcolepsy, sleep apnea, restless leg syndrome (RLS), & sleep deprivation

☆ Parasomnias- patterns of waking behaviors that appears during sleep
* Bruxism, enuresis, nocturnal myoclonus, sleep talking, & somnambulism (sleep walking)

Front 5

Insomnia

Back 5

- difficulty falling asleep, intermediate sleep, or early awakening from sleep

☆ Sleep hygiene- nonpharmacologic recommendations that help an individual get a better night's sleep
- avoiding naps
- restrict smoking, caffeine, alcohol
- sleep in dark cold rooms
- warm bath before bedtime

Front 6

Hypersomnia

Back 6

- characterized by excessive sleeping, especially daytime sleeping
• when awoken, often disoriented, irritated, restless, and slower speech and thinking process
• Causes: another sleep disorder (sleep apnea)
- depression
- obesity
- effects of certain meds
- drug and alcohol abuse

Front 7

Narcolepsy

Back 7

Condition characterized by an uncontrolled desire to sleep

- considered a neurologic disorder
+ sleep attacks
+ lack of hypocretin (neurotransmitter for arousal, wakefulness)
- hallucinations

Front 8

Sleep apnea

Back 8

A condition in which a person experience is the absence of breathing or diminished breathing efforts during sleep between snoring intervals.

- obstructive sleep apnea (OSA)
• overweight, thick neck, tongue, enlarged tonsils
- central sleep apnea (CSA)
• infants and premature babies > poor development of the lungs

Front 9

Restless Leg Syndrome

Back 9

The condition in which patient are unable to lie still and report experiencing unpleasant creeping, crawling, or tingling sensation in their legs
- Requip new med
- URGE symptoms
• urge to move legs
• rest induced
• gets better with activity
• evening symptoms more severe

Front 10

Sleep deprivation

Back 10

A decrease in the amount, consistency, and quality of sleep; results from decreased REM or NREM sleep

- sleep deprivation leads to illness (Maslows)

Front 11

1. Bruxism
2. Enuresis
3. Nocturnal myoclonus
4. Somnambulism

Back 11

1. Clenching or grinding of the teeth
2. Urinating during sleep (bed wetting)
3. Jerking muscle contractions
4. Sleepwalking

Front 12

Identify appropriate nursing diagnoses is related to sleep disorders

Back 12

- disturbed sleep patterns
- sleep deprivation
- physical or emotional discomfort or pain
- changes in bedtime rituals or sleep environment
- disruption of circadian rhythm
- exercise and diet before sleep
- drug dependency and withdrawal
- symptoms of physical illness

Front 13

List nursing implementations that promote rest and sleep

Back 13

- prepare a restful environment
- promote bedtime rituals
- offer appropriate bedtime snack and beverage
- promote relaxation and comfort
- respect normal sleep - wake patterns
- schedule nursing care to avoid disturbances
- stress and pain management
- teach about rest and sleep
- use medications to reduce sleep (last resort- many severe adverse reactions)

Front 14

Medications

Back 14

- sedative hypnotics/ benzos (ambien/restoril)
- usually PRN
OTC for sleep may contain antihistamines (benadryl)

Front 15

Anticholinergic effects

Back 15

- urinary retention
- constipation
- dry mouth
- confusion
- tachycardia
- blurred vision

Front 16

Circadian Rhythm

Back 16

Rhythm that complete a full cycle every 24 hours

Front 17

Delta sleep

Back 17

deep sleep, occurring during stage 3 and especially stage 4 in NREM sleep

Front 18

Non rapid eye movement (NREM)

Back 18

Characterizes four stages of sleep
- Stage 1+2- 5%-50% of sleep, light sleep
- Stage 3+4- 10% of sleep, deep sleep (delta sleep)
• Stage 1- light sleep, last few minutes, drowsiness
• Stage 2- person awake easily, snoring, daydreaming
• Stage 3+4- death of sleep increases, arousal increasingly difficult