Rest and Sleep
Terms
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- Reticular activating system
- controlled by CNS, controls wakefulness
- Bulbar synchronizing region
- controls sleepiness
- Two stages of sleep
- REM and Non-Rem
- Elderly REM
- Elderly have less Stage 4 & REM sleep,May take longer to fall asleep,May have safety issues
- Purpose of Sleep
- restoration for next cycle,hormone release for repair and renewal of cells during Non-REM sleep, REM important for cognitive function
- Beta-blockers and sleep
- can interfere with sleep cycle and cause nightmares, insomnia, wakefulness due to increased h/r and bp.
- Factors Affecting Sleep
- Illness (pain, nausea, vomiting, emotional distress and dyspnea), Drugs/substances (caffeine, alcohol, prescription drugs), Life Style (shift work etc),Stress,environment,Exercise and fatigue,Food and caloric intake
- Sleep Disorder
- conditions that if left untreated result in disturbed nightime sleep and associated disorders
- Polysomnogram
- diagnostic tool for sleep disorders
- Insomnia (3 Types)
- Chronic difficulty falling asleep, Frequent awakenings, Short or non-restorative sleep
- Sleep Apnea
- disorder where person cannot sleep and breathe at same time, cessation of respirations from 10 seconds to one to two minutes with 10 - 100 events per night.
- Types of Sleep Apnea
- Obstructive (most common, muscles of oral cavity and throat relax during sleep and obstruct airway.Central Sleep Apnea(results from dysfunction of brain's respiratory control center)
- Parasomnias
- Sleep disorder that produces undesirable physical symptoms as a result of autonomic nervous system changes and skeletal muscle activity during sleep.
- Common Parasomnias
- Somnambulism, Nocturnal Enuresis, Bruxism, Night Terrors
- Treatment for Obstructive Apnea
- CPAP, Side lying, avoid alcohol, weight loss, surgery (uvulopalatopharyngoplasty (UPPP), Laser assisted uvulopalatoplasty (LUAP).
- Signs and Symptoms of Obstructive apnea
- snoring respirations, enlarged tonsils, nasal polyps, deviated septum. Excessive daytime sleepiness.
- Uvulopalatopharyngoplasty
- removal of the uvula and tonsils
- Narcolepsy
- CNS dysfunction of mechanisms that regulate sleep/wake states.
- Central Sleep Apnea- definition
- Dysfunction of brain's respiratory control center
- Central Sleep Apnea- Causes
- Brain stem injury, encephalitis, muscular dystrophy.
- Nocturnal Enuresis
- Present in 10% of children at 5 years of age and 1% at 15 years of age. More common in boys than girls, Most often first born,Family tendency
- Bruxism
- Teeth Grinding, occurs mainly in children untreated can cause TMJ and tooth damage
- Bruxism cause
- stress
- Bruxism treatment
- occlusion block/guard
- Night Terrors
- person awakes frightened and screaming, short duration, tachycardia and hypertension
- Common Sleep Agents
- halcion and ambien
- Used as sleep agents- benzodiazepenes
- Xanax (alprazolam), Valium (diazepam), Dalmane(flurazepam), Ativan (lorazepam), Serax (oxazepam), Restoril (Temazepam) Versed
- Number one nursing intervention for sleep disturbances in hospital
- Control noise.