Chapter 25, 27, 29 & 30
(2026-2027)
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,sleep and rest activities Approximately one-third of a person's lifetime is spent in sleep and rest activit
Major role of sleep - Modulating metabolic, endocrine, and cardiovascular systems
-Quantity and quality of sleep affects wellness
Age-Related Changes That Affect Sleep and Rest • Patterns of sleep affected by complex interactions among physiologic,
environmental, and psychosocial factors
• Age-related changes that affect sleep and rest
Sleep quantity and quality • Sleep efficiency: percentage of time asleep in bed
• Diminished sleep efficiency due to sleep latency and increased awakenings
• Sleep quality
• Sleep cycles and sleep stage
• Circadian rhythm: biologic clock
Decline in hours slept by age increases how long it takes us to fall asleep takes longer
- 30 yrs old: 8 hours
- 40 yrs old: 7.5 hours
- 50 yrs old: 7 hours
- 60 yrs old: 6.5 hours
- 70 yrs old: 6 hours
- 80 yrs old: 5.5 hrs
Non-REM sleep - gradual increase in length of light sleep stages with less time in deep sleep
- more recent shifts in and out of light sleep
REM (dream stage) - shorter episodes
- begins earlier in the night
- less intense
Sleep initiation longer time to fall asleep
Sleep maintenance More frequent arousals
Sleep efficiency Reduced amount of sleep during time in bed, more time in napping to
compensate
Sleep schedule shift in nocturnal sleep phase to earlier bedtime and wakening
Circadian rhythm the biological clock; regular bodily rhythms that occur on a 24-hour cycle
Older adults resting vs sleep Older adults spend increasing amounts of time in bed, not always attempting to
sleep, with adecreasing proportion of time in actual sleep. Older adults spend an
additional 3 to 4 hoursresting in order to attain the same amount of sleep
attained by younger adults
Is the following statement true or false? True
❖ Age-related changes have little impact on the overall
quantity of sleep of older adults, but they do havea
significant impact on the quality of sleep and the quantity
of rest
, Risk Factors that affect sleep - psychosocial factors
- environmental conditions
- pathologic conditions
- Effects of bioactive substances
psychosocial risk factors that can affect sleep Anxiety, boredom, and social isolation
Environmental risk factors that can affect sleep Noise, lack of privacy, temperature of room, light, and hotor humid conditions
Pathologic risk factors that affect sleep Chronic conditions, nocturia, obstructive sleep apnea, and restless leg
- frequency of getting up during the night, polyuria, retention issues, breathing
issues
Effects of bioactive substances risk factors of sleep Adverse effects of medications, caffeine, and alcohol
when does the sleep-wake circadian rhythm generally The sleep-wake circadian rhythm generally causes adults to become sleepy
cause adults to become sleepy between 10 pmand midnight and to wake feeling rested between 6 am and 8 am
Is the following statement true or false? False
• The sleep-wake circadian rhythm generally causes
adults to become sleepy between 8 pm and10 pm and to
wake feeling rested between 7 am and 9 am
what disease conditions are likely to be exacerbated angina, hypertension, duodenal ulcers, coronary artery disease, and COPD
during sleep - breathing conditions can get worse while sleeping
• Which disease condition is likely to be exacerbated A. Coronary artery disease
during sleep? • Disease conditions that are likely to be exacerbated during sleep include
A. Coronary artery disease angina, hypertension,duodenal ulcers, coronary artery disease, and COPD
B. Diabetes mellitus
C. Hyperthyroidism
D. Prostatitis
Consequences of age-related sleep changes • Longer time needed to fall asleep
• Frequent arousals during night
• More time in bed to achieve same quantity of sleep
• Diminished quality of sleep (less dreaming and deep sleep)
Health consequences of age related sleep changes increased risk for stroke, cancer, obesity, diabetes,depression, metabolic
syndrome, and substanceabuse
Pathologic Conditions Affecting Sleep - Pathologic Conditions Affecting Sleep
- Sleep-related movement disorders
- Restless legs syndrome (RLS)
- Periodic limbmovementsduring sleep(PLMS)
Snoring Snoring can signal apotentially serious conditionknown as sleep apnea,
ortemporary interruption ofbreathing during sleep
Sleep Apnea - Sleep apnea can be caused by problems with the central nervous system and
the brain or may be caused by partial obstruction of the airway when the muscles
in the throat, soft palate, and tongue relax during sleep
- .If sleep apnea is suspected, the older person should be referred to a sleep
center for an overnight sleep study using polysomnography.
- sleep apnea needs to be taken seriously since it causes decreased
oxygenation which leads to hypoxia
- assessing low oxygenation also assessing orientation, since it can be a change
in mental status when they patient just has sleep apnea