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what happens without proper rest and sleep?
- ability to concentrate decrease
- ability to make judgements decrease
- participate in daily activities decease
- irritability increase
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The 24-hour circadian rhythm affects which pysiological assement data?
- body temperature
- heart rate
- blood pressure
- hormone secretion
- sensory acuity
- mood
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When does a persons body temperature usually peak during the day? when does it sharply fall?
- Peaks=afternoon
- Falls= after the person falls asleep
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what part of your body is your major sleep center?
hypothalamus
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What do the "special" cells located in the RAS do for us?
- maintain alterness
- wakefullness
- maintenance of consciousness
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what happens as stimuli to the RAS declines?
sleep occurs
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what are the 2 stages of normal sleep?
- non-rapid eye movement (NREM)
- Rapid eye Movement (REM)
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what are the four stages of NREM? how long does it take to progess through 1 cycle of NREM?
how long does each stage last? what happens to VS in each stage?
- 90 minutes= 1 cycle
- 1.) lightest level. last only a few minutes. decreased physiological activity begin w/ gradual fall in VS and metabolism. Sensory stimuli such as noise easily arouses person. when they awake they feel like they were day dreaming.
- 2.) sound sleep. Relaxation progresses. Arousal remains relatively easy. Stage last 10-20 minutes. Body functions contiune to slow.
- 3.) initial stages of deep sleep. Sleeper is difficult to arouse and rarely moves. muscles are completely relaxed. VS declines but remain regular. Stage last 15-30 minutes.
- 4.) Deepest stage of sleep. Very difficult to arouse sleeper. If sleep loss has occured sleeper will spend majority of sleep in this stage. VS are significantly lower than waking hours. stage approxiamely 15-30 mins. sleepwalking & enuresis may occur
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out of the 2 normal stages of sleep, which one do you have vivid dreams?
REM
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What is typified in REM?
- Rapidly moving eyes
- Fluctuating HR & RR
- Increased of fluctuating BP
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How many passes through the sleep cycle do you complete per ngiht? How long do each complete cycle last?
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In what order do we go through the sleep cycle?
1-4 and then reversal 4,3,2 then REM
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What % of sleep do we spend in NREM a night?
75-80%
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What is our HR (on average) when we are a sleep?
60 b/m
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what are the biological functions that decrease during sleep
- respirations
- BP
- muscle tone
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what types of diseases alter rythym of breathing during sleep?
- asthma
- bronchitis
- allergic rhinitis
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which sex has sleep problems more often? And what disease is it associated with?
- Females
- Coronary artery disease
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Sleep related breathing disorders are linked to increased....? What diseases and assessment findings?
- nocturnal angina
- increased HR
- ECG changes
- High BP
- risk for heart disease
- stroke
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Hypertension, in relation to sleep causes waht 2 specific things?
- early morning awakening
- fatigue
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Hypothyroidism decrease which stage of sleep?
stage 4 sleep
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Nocturia disrupts sleep and the sleep cycle. which diseases are associated w/ nocturia?
- older adults w/ reduced bladder tone
- cardiac disease
- diabetes
- urethritis
- pro-static disease
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What is restless leg syndroms (RLS)?
people experience recurrent rythmical movments of legs; occurs just before sleep. Client feels itching sensation deep in the muscle. relief is only achieved by moving the legs.
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There are two types RLS what are they and what do they indicate?
- primary RLS= nervous system disorder
- secondary RLS= low levels of iron, pregnancy, and uremia
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define Insomnia?
symptom clients experience when they ahve chronic difficulty falling asleep, frequent awakening from sleep/or a short non-restorative sleep
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what are the 3 different types of insomnia?
- Transient
- Hypersomnia
- Parasomnia
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define transient insomnia.
experienced as a result of situational stress such as family, work, school, jet lag, illness, loss of loved one
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define hypersomnia.
misalignment of timing of sleep and what the individual desires or the societal norm
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define parasomnias
undersirable behaviors that occur usually during sleep
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Someone who has chronic insomnia will have these symptoms
- feel sleepy
- fatigued
- depressed
- anxious
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define sleep apnea.
disorder characterized by the lack of airflow through the nose and mouth for a period of 10 seconds or longer during sleep
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what are some S/S?
- excessive daytime sleepiness
- sleep attacks
- fatigue
- morning headaches
- irritability
- depression
- difficulty concentrating
- decreased sex drive
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what are the 3 types of apnea?
- Central (CSA)
- Obstructive (OSA)
- Mixed
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Tell me everything you know about CSA :)
- less than 10% apnea is this kind
- involves dysfunction of brain's respiratory control center
- impulse to breathe fails, nasal airflow and chest wall movement cease. oxygen saturation falls.
- common in clients w/ brain stem injury, muscular dystrophy and encephalitis and people who breathe normally during the day
- Complain of insomnia
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what type of apnea does 12-18 million people in the use have?
Obstructive
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Who are common people to have Obstructive Apnea?
- postmenopausal women
- younger women
- children
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what cause the obstruction in obstructive apnea?
- muscles or structures of oral cavity or throat relax
- upper airway become partially/completely blocked
- diminishing airflow (hypopnea) or stopping (apnea) for 30 secs
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OSA puts individual at risk for what type of physiological issues
- cadiac dysrythmias
- right heart failure
- pulmonary hypertension
- angina attacks
- stroke
- HTN
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define Narcolepsy.
dysfunction of mechanisms that regulate the sleep and wake states
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what is cataplexy?
sudden muscle weakness during intense emotions such as anger, sadness, or laughter
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what is a symptom of narcolepsy?
sleep paralysis (feeling of being unable to move or talk jsut before waking or falling asleep)
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what are tx for narcolepsy:
- stimulants
- anti-depressents
- wakefulness promoting agents (modanfinil)
- short (20 min) naps
- exercise
- avoiding shifts in sleep
- eating light meals high in protein
- practicing deep breathing
- chewing gum
- vitamins
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what do narcoleptic need to avoid?
- alcohol
- heavy meals
- exhausting activities
- long-distance driving
- long periods of sitting in hot, stuffy rooms
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what type of things cause sleep deprivation cause?
- illness
- emotional stress
- medication
- environment distuvances
- variability of timing of sleep (shift work)
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what are physiological symptoms of sleep deprivation?
- ptosis
- blurred vision
- fine motor clumsiness
- decreased reflexes
- slowed response to time
- decreased reasoning & judgement
- decreased auditory & visual alertness
- cardiac arrhythmias
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what are the psychological symptoms of sleep deprivation?
- confusion
- disorientation
- increased sensitivity to pain
- irritable
- withdrawn
- apathetic
- agitation
- hyperactivty
- decreased motivation
- excessive sleepiness
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neonates-3 months need an average of how much sleep per day?
16 hours
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infants require how much sleep per day?
8-10 hours
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Toddlers require how much sleep per day?
12 hours
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preschoolers require how much sleep per day? 12 hours
12 hours
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school age children require how much sleep?
- @ age 6= 11-12 hours
- @ age 11= 9-10 hours
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how much slepp do adolescents require?
7.5 hours
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how much sleep do young adults need?
6-8.5
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What are factors affecting sleep?
- drugs
- substances
- lifestyle
- sleep patterns
- emotinal stress
- environment
- exercise/fatigue
- food/caloric intake
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