the biological clock; regular bodily rhythms that occur on a 24-hour cycle
decreased state of activity with the consequent feeling of being refreshed
state of rest accompanied by altered consciousness
The two major stages of sleep
Non rapid eye movement (NREM), rapid eye movement (REM)
75 percent of sleep is____
Non rapid eye movement sleep has___stages
Light sleep, where a person can be roused easily, is:
Stage l and Stage ll of NREM sleep.
Ten percent of total sleep time is spent in___
___stage lll and stage lV of NREM sleep.
Stage lll and Stage lV of NREM is also called___sleep.
The parasympathetic nervous system___
___dominates NREM sleep.
It is more difficult to arouse a person during___sleep
REM sleep consumes ____% of sleep time.
During REM sleep_____INCREASES
__pulse, resp, BP, metabolism, temp__
During REM sleep____DECREASES
___general skeletal muscle and deep tendon reflexes___
REM rebound (def).:
:when deprived of REM sleep on successive nights, the person will have more REM sleep at a later time to make up for the loss.
Sleep cycle (p.1082, fig. 34-2) -
Wake --> NREM l --> NREM 2 --> NREM 3 --> NREM 4 --> NREM 3 --> NREM 2 --> REM --> NREM 2
Q: How many cycles do people go through on an average night?
A: 4-5 cycles
: the term coined for the alternating between NREM and REM cycles
Deep sleep occurs more at the___of the night
Factors affecting sleep:
: culture, development, lifestyle/habits, motivation, environment, psychological stress, illness, medication
Culture effects on sleep:
:differences in bedtime rituals
development effects on sleep:
:age affects sleep time, ex., babies - 16-24hr; toddlers, 8-10,12; pre-schoolers, 9-16; school age, 8-10, adults, 8
motivation effect on sleep:
:situations arise where a person wants to stay up, and also not.
Physical activity/exercise effects on sleep:
:increases fatigue and promotes relaxation, UNLESS w/in 2 hours of bedtime, where it can hinder
Diet effects on sleep:
: alcohol = sleep, lots of alcohol = bad sleep, caffeine, smoking = hinders sleep
Environment effects on sleep:
: home is best. Noisy, big city, small city. What's around you effects how you sleep and if you have adapted to it or not.
Stress and sleep:
: High stress, low sleep.
Illness and sleep:
:Certain illnesses disturb certain stages. (p. 1087)
Medications and sleep:
:Drugs that decrease REM - barbiturates, amphetamines, anti-depressants. Diuretics, anti-hypertensives, steroids, decongestants cause problems. zoloft and ambien assist in sleep.
: sleep disorders characterized by insomnia or excessive sleepiness.
:patterns of waking behavior that appear during sleep.
Insomnias usually last for___
___ a few weeks
:insomnia over 5 weeks to 6 months.
: insomnia 4 weeks or less.
Approximately___suffer from chronic insomnia
: non-pharm steps to get better sleep. (Examples on p. 1088)
: uncontrollable desire to sleep.
:absence of breathing (apnea) or diminished breathing (hypopnea)
Restless Leg Syndrome:
:creeping, crawling, tingling in legs. People with iron deficiency and end stage renal disease seem to have this, but others as well.
URGE diagnosis for restless leg:
:U - urge to move legs, R - rest-induced, G - gets better with activity, E - evening symptoms more severe.
: Debilitating lack of sleep. Causes stress. Life shortening
:Patterns of waking that occur during REM and NREM
When 'Disturbed Sleep' is the problem, it receives either of two etiologies -
- 'Disturbed Sleep Pattern' is the problem is time-limited, or 'Sleep Deprivation' if the problem is prolonged.
Etiologies for 'Disturbed Sleep' (common ones):
: Physical discomfort or pain, Emotional discomfort or pain, Changes in bedtime rituals, Disruption of circadian rhythm, * Exercise before sleep, (list is on p. 1095)
When 'Disturbed Sleep' is the etiology, there are many diagnoses that are manifested from it, like -
- Anxiety related to inability to fall asleep, Activity intolerance, *Ineffective coping related to insomnia, (list on p. 1095)
Abnormally long sleep cycles can be the result of damage to the:
The Cerebral cortex and peripheral sensory organs stimulate the ________to bring about wakefulness.
__reticular activating system__
Eyes darting back and forth quickly is indicative of which type of sleep?
Circadian synchronization -
When an individual's sleep-wake patterns follow the inner biologic clock.
What is the name of the medical instrument that receives and records electrical currents from the brain?
The Arousal Threshold is usually the greatest in Stage ____ of NREM sleep.
Which patients admitted to a healthcare agency should have a sleep history taken?
NREM sleep deprivation is characterized by:
:fatigue, lethargy, depression, and difficulty with ADLs.
An individual's sleep cycle is fully developed by age:
The reticular activation system extends___
__upward toward the medulla, the pons, and the midbrain, into the hypothalamus.
During sleep the RAS experiences__
__few stimuli from the cerebral cortex and the periphery of the body.
Characteristics of REM sleep:
:Respirations are irregular and sometimes interspersed with apnea; Metabolism and body temp increase; It constitutes about 20-25% of sleep.
Newborns sleep an average of___hours per day
12 hours is the average___
___amount of sleep needed by preschoolers.
What amount of sleep in hours is generally considered adequate for adults?
5-7 hours of sleep.
A light protein and carbohydrate snack before bedtime____
Insomnia therapies include:
Sleep hygiene, cognitive behavioral therapy, and stimulus control.