Sleep Patterns and Phases of Sleep
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Questions and Answers

Which of these stage(s) of sleep are affected by sedative-hypnotic drugs?

  • Stage N3 and REM
  • Stage N1 and REM
  • Stage N2 and REM (correct)
  • Stage N1 and Stage N3

    • What happens to the body when the REM sleep is suppressed for an extended period?

  • The body's sleep cycle gets disrupted and the person will get more sleep in the future.
  • The body experiences mental imbalance and can experience restlessness and vivid dreams when the drug is stopped. (correct)
  • The body enters a state of deep sleep to compensate
  • The body adapts to the new sleep cycle

    • Which of these is NOT a characteristic of rebound sleep?

  • NREM sleep is deeper and longer after sleep deprivation.
  • The body tries to recover physically and mentally.
  • The body prioritizes deep sleep over REM sleep. (correct)
  • Increased REM sleep after REM suppression.

    • What stage of sleep is considered the most restorative and is specifically targeted for restoration after sleep deprivation?

    <p>Stage N3 (B)</p> Signup and view all the answers

    What stage of sleep is often associated with vivid dreams?

    <p>REM (C)</p> Signup and view all the answers

    What is the purpose of sleep hygiene as described in the text?

    <p>To promote sleep efficiency and reduce reliance on medications. (B)</p> Signup and view all the answers

    Which of the following is NOT a nursing implication for sedative-hypnotic drugs?

    <p>Encourage regular exercise closer to bedtime for better sleep. (D)</p> Signup and view all the answers

    What is the MAIN purpose of sedative-hypnotic drugs?

    <p>To treat insomnia. (D)</p> Signup and view all the answers

    Which stage of NREM sleep lasts the longest during an average sleep cycle?

    <p>Stage N2 (B)</p> Signup and view all the answers

    What percentage of total sleep is made up by Stage N3 in young adults?

    <p>10-15% (A)</p> Signup and view all the answers

    How often does REM sleep occur during a typical night of sleep?

    <p>Every 90 minutes (D)</p> Signup and view all the answers

    Which of the following best describes Stage N1 of NREM sleep?

    <p>Lightest sleep lasting a few minutes (C)</p> Signup and view all the answers

    What is the primary characteristic of REM sleep?

    <p>Dreaming and irregular breathing patterns (D)</p> Signup and view all the answers

    Which sleep disorder is characterized by waking early without returning to sleep?

    <p>Terminal insomnia (D)</p> Signup and view all the answers

    Which phase of sleep is predominantly affected by age, resulting in less time spent in deep sleep (Stage N3)?

    <p>NREM Sleep (A)</p> Signup and view all the answers

    What is a common effect of insomnia on daily functioning?

    <p>Fatigue and daytime drowsiness (A)</p> Signup and view all the answers

    What impact do benzodiazepines generally have on light sleep and deep sleep?

    <p>Increase light sleep (N2) and decrease deep sleep (N3) and REM sleep. (A)</p> Signup and view all the answers

    Which stage of sleep typically increases when using benzodiazepines?

    <p>N2 sleep (B)</p> Signup and view all the answers

    What is a potential long-term effect of using benzodiazepines for sleep?

    <p>Disruption of normal sleep patterns and tolerance. (A)</p> Signup and view all the answers

    What does the sleep cycle refer to?

    <p>The progression through different stages of sleep throughout the night. (A)</p> Signup and view all the answers

    Why is short-term use of benzodiazepines recommended?

    <p>Long-term use leads to significant adverse effects. (C)</p> Signup and view all the answers

    Which of the following is a characteristic of deep sleep (N3)?

    <p>Decreased metabolic activity and hard to awaken. (A)</p> Signup and view all the answers

    What is a common effect experienced by users of benzodiazepines upon waking?

    <p>Morning drowsiness or sedation. (D)</p> Signup and view all the answers

    What should be monitored when using benzodiazepines due to risk factors involved?

    <p>Liver function and signs of blood dyscrasias. (A)</p> Signup and view all the answers

    Flashcards

    Sedative-Hypnotics Effects

    Medications that promote sleep while affecting sleep stages.

    Rebound Sleep

    Compensatory sleep occurs after deprivation, enhancing certain stages.

    REM Rebound

    Increased REM sleep duration/intensity after suppression.

    NREM Rebound

    Deep restorative sleep (N3) increases after deprivation.

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    Types of Sedative-Hypnotics

    Mainly classified into benzodiazepines and non-benzodiazepines.

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    Primary Uses of Sleep Medications

    Temporary treatment for insomnia; reduce anxiety before procedures.

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    Nursing Assessment for Sleep Meds

    Check CNS, vital signs, sleep patterns, and anxiety levels.

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    Good Sleep Hygiene Practices

    Measures promoting better sleep like routines and environment.

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    Definition of Sleep

    A natural state of unconsciousness allowing recovery.

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    Health Benefits of Sleep

    Supports immune system and mental health.

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    Risks of Inadequate Sleep

    Increases risks for obesity, heart disease, and diabetes.

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    NREM Sleep

    Non-Rapid Eye Movement sleep divided into 3 stages.

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    Stages of NREM Sleep

    Stage N1: Light sleep; N2: Light sleep with drifting; N3: Deep, restful sleep.

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    REM Sleep

    Rapid Eye Movement sleep characterized by dreaming and irregular breathing.

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    Insomnia Definition

    Difficulty falling, staying asleep, or waking too early.

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    Causes of Insomnia

    Lifestyle changes, stress, caffeine/alcohol, large meals, or illness.

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    Stress Management Techniques

    Methods used to reduce stress, such as relaxation techniques and soft music.

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    Alternative Medications for Insomnia

    Medications like antidepressants, anticonvulsants, and antipsychotics used to treat insomnia.

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    Benzodiazepines Overview

    Drugs used for sedation, sleep induction, and anxiety relief with a wide safety margin.

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    GABA-A Receptors

    Brain receptors that benzodiazepines act on to produce sleep effects.

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    Short-term Benzodiazepine Use

    Recommended use of benzodiazepines for less than 4 weeks to avoid tolerance and rebound insomnia.

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    Common Adverse Effects

    Side effects like drowsiness, sedation, and impaired alertness from benzodiazepines.

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    Addiction & Withdrawal

    Possible physical and psychological dependence on benzodiazepines, with withdrawal symptoms like anxiety.

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    Drug Interactions with Benzodiazepines

    Effects of alcohol, opioids, and sedatives that can increase toxicity of benzodiazepines.

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    Study Notes

    Sleep and Sleep Pattern Disturbance

    • Sleep is a natural state of unconsciousness allowing the body to rest and recover, making up about one-third of adult life.
    • Optimal sleep duration for adults is 7-8 hours.
    • Less than 5 hours of sleep significantly increases the risk of heart attack.
    • Inadequate sleep increases risks of obesity, heart disease, and type 2 diabetes.
    • Sleep supports immune system and mental health.

    Phases of Sleep

    • NREM Sleep (Non-Rapid Eye Movement): Divided into three stages (N1, N2, N3).
      • Stage N1: Lightest sleep (2-5% of total sleep), lasts a few minutes, characterized by drifting sensations.
      • Stage N2: Light sleep (50% of total sleep) with occasional drifting sensations.
      • Stage N3: Deep, restful, dreamless sleep (10-15% in young adults, less in older adults). Characterized by decreased blood pressure, breathing, and metabolism.
    • REM Sleep (Rapid Eye Movement): Occurs every 90 minutes, features dreaming, irregular breathing, and increased heart rate (20-25% of total sleep). Important for stress release and emotional balance.

    Sleep Disorders: Insomnia

    • Definition: Difficulty falling asleep, staying asleep, or waking too early.
    • Types: Initial, intermittent, terminal insomnia; transient, short-term or chronic.
    • Prevalence: 10% of adults and 20% of older adults have chronic insomnia.
    • Causes: Lifestyle changes, stress, caffeine/alcohol, large meals before sleep, illness.
    • Effects: Fatigue, daytime drowsiness, and difficulty with work or daily tasks.

    Sedative-Hypnotic Therapy

    • Sedatives: Promote relaxation and rest (may not induce sleep).
    • Hypnotics: Induce sleep.
    • Ideal hypnotic characteristics: Quick onset of natural sleep, proper duration, no hangover effects, and no habit formation.

    REM Rebound

    • Body compensates for sleep deprivation by spending more time in certain stages of sleep during subsequent sleep periods.
    • Caused by sleep deprivation and suppression of REM sleep.
    • Characterized by REM rebound (increased intensity/duration of REM sleep) and NREM rebound (body focuses on deep, restorative sleep).
    • Purpose: Helps the body recover physically and mentally and restores balance in sleep patterns.

    Types of Sedative-Hypnotic Drugs

    • Classified into Benzodiazepines and Non-benzodiazepines.

    Drug Therapy for Sleep Disturbance: Benzodiazepines

    • Commonly used for sedation, sleep induction, anxiety relief, and seizure control.
    • Safe with a wide margin between therapeutic and toxic doses.
    • Act on GABA-A receptors in the brain.
    • Examples: Estazolam, flurazepam, quazepam, temazepam, triazolam.
    • Effects: Increase light sleep, decrease deep and REM sleep, leading to tolerance and rebound insomnia.
    • Short-term use is recommended.
    • Special uses include short-acting benzodiazepines for anesthesia and short procedures, and Lorazepam for pre-surgery anxiety.

    Drug Therapy for Sleep Disturbance: Non-Benzodiazepine

    • Cause CNS depression to promote sleep, acting as antagonists by blocking orexin receptors and or facilitating GABA action.
    • Types: Antihistamines, Tricyclic antidepressants, and Benzodiazepine receptor agonists (Zaleplon, Zopidem, Eszopiclone, Ramelteon, Tasimelteon), Orexin Receptor Antagonists.

    Nursing Implications

    • Assessment: Check baseline vitals, hepatic disease history.
    • Administration: Take before bed or after being in bed with difficulty falling asleep, avoid with heavy meals.
    • Monitoring: Watch for morning hangover, adverse effects, and adjust dose as needed. Monitor for gradual discontinuation to avoid withdrawal symptoms.

    Therapeutic Outcomes

    • Mild sedation.
    • Short-term use for sleep induction and maintenance.

    Additional Considerations

    • Drug Interactions: Alcohol, opioids, and sedatives increase toxic effects, while smoking and rifampin reduce effectiveness.
    • Withdrawal: Stopping suddenly can cause withdrawal (anxiety, seizures, delirium).
    • Adverse Effects: Common effects can include: drowsiness, hangover, headache, muscle/joint pain, and mental depression. More serious effects include physical dependence, withdrawal symptoms, and/or confusion, and agitation. Older adults or long-term users may be more sensitive to these affects.
    • Pregnancy and Breastfeeding: Avoid use, or take with caution during pregnancy and breastfeeding.
    • Monitoring: Regular monitoring is necessary for adverse side effects like liver issues, blood dyscrasias or other symptoms.

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    Pharm Chapter 13 Notes PDF

    Description

    Explore the crucial aspects of sleep, including its importance for physical and mental health, optimal durations, and the dangers of sleep deprivation. This quiz also breaks down the phases of sleep, detailing NREM and REM stages and their characteristics.

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