What does sleep maintain?
Mood, memory, and cognitive performance
Which systems does sleep play a pivotal role?
Endocrine and Immune
What does getting an extra hour of sleep per night translate to?
33% reduction in the development of coronary artery calcification
more sleep, less risk for coronary disease
What are the 4 characteristics of sleep?
- 1. minimal physical activity
- 2. variable levels of consciousness
- 3. changes in body's physiologic processes
- 4. decreased responsiveness to external stimuli
What happens to aterial blood pressure during NREM sleep?
Arterial blood pressure falls
What happens to pulse rate during NREM sleep?
pulse rate decreases
What happens to peripheral blood vessels during NREM sleep?
What happens to cardiac output during NREM sleep?
What happens to skeletal muscles during NREM sleep?
What happens to the basal metabolic rate during NREM sleep?
What do the growth hormone levels do during NREM sleep?
How long is a sleep cycle?
How long does REM sleep last?
When do most dreams take place?
During REM sleep
What happens to the brain during REM sleep?
The brain is highly active and brain metabolism increases 20%
What happens to the voluntary muscle tone during REM sleep?
It dramatically decreases
What's absent during REM sleep?
Absent deep tendon reflexes
When do distinct eye movements occur?
During REM sleep
What is the study of sleep called?
What is the prevalence of inadequate sleep?
Greater than half of adults 65 and older report at least one chronic sleep complaint
What results from sleep disturbances? List 11 possible things.
- 1. cognitive impairment
- 2. poor concentration
- 3. irritability
- 4. difficulty making decisions
- 5. compromised endocrine and immune function
- 6. hypertension
- 7. heart attack
- 8. stroke
- 9. impaired healing of damaged tissues
- 10. obesity
- 11. diabetes
What can sleep deprivation result in? List 7 possible results.
- 1. confusion
- 2. exacerbate existing confusion or cause confusion
- 3. depression
- 4. decrease pain tolerance
- 5. profound fatigue
- 6. slowed responses
- 7. difficulty making decisions
*greater car accidents result from sleep deprivation
How many hours a day do newborns sleep?
How many hours do newborns stay awake?
What sleep phase do newborns enter into immediately?
What do we observe when newborns sleep?
Body movements and irregular respirations may be observed
Infants wake up every...
How many hours of sleep do infants sleep?
How are babies advised to sleep?
on their back to prevent SIDS
What did the Back To Sleep campaign do?
Decreased SIDS, Sudden Infant Death Syndrome by 50%
What kind of sleep do infants have?
50% light sleep
How many hours of sleep do toddlers get?
They get 12-14 hours/day including naps.
What do toddlers need to sleep?
Security objects like blankets
How many hours do preschool children get?
What do preschool children need to sleep good?
A consistent regular routine
How many hours a day do school age children sleep?
What is considered school age?
What is considered adolescent age?
How many hours of sleep do school age children need?
How many hours of sleep do adolescents need?
What can happen if adolescents don't get enough sleep?
Lower grades, negative moods, potential for car accidents
What happens to the circadian rhythm when one becomes adolescent age?
It shifts, wake later in AM, and stay up later at night.
How many hours of sleep do adults need?
What happens if adults do not get enough sleep?
Lower concentration and irritability.
How many hours of sleep do elders need?
Why do elders have a difficult time sleeping?
Illness and pain
What happens if elders do not get enough sleep?
Negative quality of life, mood, and alertness
What did the Sleep in America Study of 2003 find?
The better the health of older adults, the more likely they are to sleep.
List 11 factors that affect sleep.
- 1. Illness-increase need for more sleep
- 2. Respiratory conditions can cause SOB and nasal congestion
- 3. Gastric ulcers
- 4. Endocrine disorders– Hypothyroidism causes difficulty in sleeping
- 5. Hormonal– hot flashes/night sweats
- 6. Elevated temp– fever interferes
- 7. Diet– spicy foods interfere, alcohol, caffeine
- 8. Smoking can make it difficult
- 9. Lifestyle– stress
- 10. Motivation
- 11. Meds– narcotics suppress sleep, beta blockers cause nightmares, diuretics disrupt sleep
What are 4 common sleep disorders?
- 1. Insomnia
- 2. Hypersomnia
- 3. Narcolepsy
- 4. Sleep Apnea
How would you describe insomnia?
Inability to fall or remain sleep
How do you know if you have chronic insomnia?
If insomnia lasts longer than 1 month
Who are at risk for insomnia?
Older age and females
What are the manifestations of insomnia? List 8 things.
- 1. Difficulty falling asleep
- 2. Waking up frequently during the night
- 3. Difficulty returning to sleep
- 4. Waking up too early in the AM
- 5. Unrefreshing sleep
- 6. Daytime sleepiness
- 7. Difficulty concentrating
- 8. Irritability
What are two types of excessive daytime sleepiness?
Hypersomnia and Narcolepsy
This individual obtains sufficient sleep at night but still cannot stay awake during the day. What kind of sleep disorder does this person have?
This person has excessive daytime sleepiness combined with sudden muscle weakness, can have "sleep attacks" and may occur randomly (ex. while driving). What sleep disorder does this person have?
What sleep disorder can lead to hypersomnia?
What are 6 symptoms of sleep apnea?
- 1. Loud snoring
- 2. excessive daytime sleepiness
- 3. frequent episodes of obstructed breathing during sleep
- 4. morning headache
- 5. unrefreshing sleep
- 6. dry mouth upon awakening
What are 4 nonsurgical treatments of sleep apnea?
- 1. change sleep position
- 2. decrease wt
- 3. CPAP (Constant Positive Airway Pressure)
- 4. Drug therapy
What are 4 surgical treatments of sleep apnea?
- 1. Adenoidectomy
- 2. Uvulectomy
- 3. Remodeling posterior oropharynx
- 4. Tracheostomy
Who are more likely to develop sleep apnea? What is also a contributing factor?
Men and African Americans.
Obesity contributes to sleep apnea.
What are the 3 types of sleep apnea?
- 1. Obstructive
- 2. Central Apnea
- 3. Mixed– combo of Central and Obstructive
What happens with obstructive sleep apnea?
The person wakes a little at a time which leads to not very good sleep.
What would be some assessments for sleep?
- 1. How many hours?
- 2. Why do you wake up?
- 3. Do you have any rituals?
- 4. Do you take any meds to help with sleep? What meds do you take?
- 5. Any medical problems
- 6. Any pain?
- 7. Does the person have an enlarged neck, uvula, soft palate, are they obese?
What is the general term for the diagnostic testing of sleep?
This diagnostic test measures brain waves, what is it called?
This diagnostic testing measures the muscles (jaw), what is it called?
This diagnostic testing measures eyes (rapid eye movement), what is it called?
What 7 possible nursing diagnoses for sleep?
- 1. Risk for injury
- 2. Ineffective coping
- 3. Fatigue
- 4. Risk for impaired gas exchange
- 5. Knowledge deficit
- 6. Anxiety
- 7. Activity Intolerance
What has been used in the hospitals as a visual reminder to keep noise level down?
What's "SHHH" stand for?
What are the 5 effects of excessive noise on patients?
- 1. sleep disturbance
- 2. increased BP
- 3. increased HR
- 4. Stress
- 5. interferes with "speech" privacy (shut door, turn down tv)
What are 6 effects of excessive noise on the health care provider?
- 1. increased stress
- 2. increased annoyance
- 3. fatigue
- 4. emotional exhaustion
- 5. burnout
- 6. interferes with staff communication during report
What are the strategies for reducing noise?
- 1. design of the unit
- -location of equipment
- -sound blocking materials
- -staggering room doorways
- 2. moving tv speakers closer to listener (on call bell remote)
- 3. personal pagers for staff instead of using intercom
- 4. use of white noise– nature sounds
- 5. location of report
- 6. changing IV bags before alarm goes off
- 7. lowering volume of IV pump
- 8. restocking supplies during evening shift vs. night shift
What are some things the nurse can do to promote sleep?
- 1. minimize outside noise
- 2. maintain regular wake/sleep routine (same time)
- 3. dark quiet room
- 4. avoid heavy, spicy foods
- 5. avoid alcohol, caffeine
- 6. light carbs, warm milk
- 7. meds– last resort! Some meds interfere with sleep. Time the pain meds so don't interrupt sleep of pt.