Sleep regulation is regulated by sequence of physiological states integrated by what? CNS
What is the sleep center of the body? hypothalamus
Reticular Activating System (RAS) Maintains alert and wakefulness
Process S regulates the length and depth of sleep
Process C The biological clock which impacts duration of sleep
NREM non rapid eye movement (75%)
N1 = lightest sleep
N2: relaxation progresses
N3 = deepest page
REM rapid eye movement (25%)
90 minutes after sleeping
vivid dreams happen here
Presleep period 10-30 minutes
Three stages of REM and NREM 90-110 minutes
Function of sleep Time of restoration, memory consolidation, and preparation for next
period fo wakefulness
,How does sleep restore biological processes? Low HR, RR, temp, and BP
What two things happens in the tissues during sleep? Protein synthesis and cell division for
tissues
When do dreams occur? REM and NREM (important for learning, memory, and adaptation
to stress)
What does sleep deprivation cause? Affects he immune system, metabolism, nitrogen
balance, and protein catabolism
How does no sleep affect the heart? Increases stroke risk
restless leg syndrome Before onset of sleep, continued movement of legs and feel itching
Does sleep affect the GI tract? Yes....
Peptic ulcer disease - acid reflux, secretions
Insomnia Chronic difficulty falling asleep, frequent awakenings from sleep, short periods of
sleep, or sleep that is not restful
sleep apnea Difficulty sleeping due to lack of airflow through the mouth
obstructive sleep apnea Most common, stop of airflow despite effort to breath due to
muscles relaxing
What are major risk factors for obstructive sleep apnea? Obesity and hypertension
(smoking, >65, large neck circumference, and menopause)
,mixed sleep apnea Combination of both central and obstructive. Usually begins as central
apnea followed by onset of ventilatory effort without airflow
central sleep apnea sleep disorder with periods of interrupted breathing due to a disruption
in signals sent from the brain that regulate breathing
Untreated sleep apnea increases what? Chances of hypertension, diabetes, heart disease,
and heart failure
Narcolepsy Excessive daytime sleepiness and person suddenly feels overwhelming need to
sleep
Cataplexy Symptom of narcolepsy where patietn has sudden muscle weakness with intense
emotions (avoid alcohol, heavy meals, and hot rooms)
Parasomnias Sleep walking, night terrors, nocturnal enuresis (bed wetting), bruxism (teeth
grinding, and body rocking most common in children)
Should infants sleep on their stomach? NOOOOOOOOOOOO
Sleep laboratory studies EEG to monitor stages of sleep wakefulness during nighttime sleep
Normal sleep requirements Dont take naps or benadryl
limit alcohol, caffeine and nicotine
elevate head of bed and provide extra pillows
which confusion and dizziness
, What are some factors influencing sleep Drugs and substances
lifestyle
usual sleep patterns (NO ELECTRONICS)
environment
execise and fatigue
food and caloric intake
Epworth Sleepiness Scale 8 questions about pt being sleepy during certain activities (16-24
severe risk)
Pittsburgh Sleep Quality Index assesses sleep quality and patterns
Numeric scale Sleep on a scale of 1-10
GET SLEEP HISTORY AND USE OPEN ENDED QUESTIONS Hehe
Acute care for sleep Reduce noise levels, keep pt clean, avoid waking for vital signs unless
ordered, put patient inside prone position OSA
Restorative sleep Exposure to sunlight each day, bronchodilators improve airway
Pharmacological medications for sleep Benzodiazepines (ambien) can be used short term
What are physiological factors affecting oxygenation? Decreased oxygen carrying capacity
hypovolemia
decreased Inspired oxygen concentration
increased metabolic rate