Nursing 120 Exam 3 Review
What is sleep? - ANS A state of rest accompanied by altered consciousness and relative
inactivity.
What is rest? - ANS A condition in which the body is in a decreased state of activity, results in
feeling refreshed.
How do we wake up? - ANS The RAS is activated with stimuli from the cerebral cortex and from
peripheral sensory organs.
Stimuli - noise, alarm clock, etc.
Brainstem - ANS -RAS and bulbar synchronizing region - both located in the brainstem and
work together to
control the cyclic nature of sleep.
-Hypothalamus - ANS Control center for sleeping and waking. Injury causes altered sleep
patterns.
NREM - stages 1-4 - ANS Stage 1 & 2: 55% of sleep, light sleep.
-Stage 3 & 4: 20% of sleep, deepest states.
-Vitals are decreased, essential for physiological restoration and growth.
REM - ANS -Almost paralyzed, vitals are increased
Stage 1 sleep - ANS -Very light, only a few minutes long. VS & metabolism begin to decrease,
awakens easily, feels
relaxed and drowsy.
Stage 2 sleep - ANS -Deeper sleep, 10-20 minutes long. VS & metabolism continues to
decrease. Requires slightly
more stimulation to awaken, increased relaxation
Stage 3 sleep - ANS Initial stage of deep sleep, 15-30 minutes long. VS continues to decrease
but remains regular.
Difficult to awaken, relax with little movement.
Stage 4 sleep - ANS -Delta sleep, 15-30 minutes long. VS low. Very difficult to awaken,
physiologic rest and
restoration.
-Enuresis, sleep walking, sleep talking are possible.
, -Repair and renewal of tissue.
-REM sleep - ANS -Vivid dreaming, about 90 minutes after falling asleep. Longer with each
sleep cycle.
-Average length is 20 minutes. Varying VS. Very difficult to awaken.
-Cognitive restoration
-A client in REM sleep would be considered to be restoring what human functions?
-Learning, memory, belonging, critical thinking.
Factors affecting sleep - ANS -Developmental considerations, motivation (want to stay awake,
party), culture - bedtime rituals,
lifestyle and habits (working night shift, physical activity and exercise).
-Exercise will increase fatigue and promote REM & NREM. Exercise within 2-3 hours of
Sleep can hinder effective sleep.
-Dietary habits
-Carbs before bed promote calmness. Avoid caffeine and smoking. Alcohol used within
6 hours of sleep can hinder sleep.
-Environmental factors
-Same vs new environment, dark and cool environment.
-Psychological stress
-REM decreases
-Illness
-Ulcers, epilepsy, end-stage renal disease, CAD, liver failure, thyroid.
Sleep requirements - ANS -Infants: 14-20 hours
-Growing children: 10-14 hours
-Adolescents: varies widely
-Adults: 7-9 hours
-Older adults: 5-7 hours
Developmental considerations - ANS -Infant: sleeps through night at 6-18 weeks. REM
constitutes most of the sleep cycle. Place
infant on back to sleep.
-Toddler: naps during the day, moves from crib to bed, starts to resist going to bed.
-Child: at 5 years, no longer naps. Nightmares and night terrors are common. Sleep need
increases when physical growth peaks.
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-Adolescent: during growth spurt, will require more sleep. Lack of sleep is associated with
obesity.
-Adult: total sleep time decreases, decreased stage 4 sleep.
-Older adult: Stage 4 sleep is extremely decreased or absent. Frequent naps during the day.
-Medications
-Affect sleep quality. Barbiturates, amphetamines, and antidepressants decrease REM.