STUDY GUIDE # 14

SLEEP
Instructions:
a) Refer to the following pages for your answers: Pages 1066 - 1075 of your book in a pdf file. If you’re using an
actual book, please be the one to identify from the pdf its corresponding pages in your book.
b) The number before each question is just for organization purposes because there are test items that will be merged
in iStudy, thus, only then a perfect score will be known.
c) The answers will be entered into iStudy.

Fill in the Blanks

1. Sleep is a human need.
Reasons that make sleep a requirement: (#s 2-6)
2. To cope with daily with stresses
3. To prevent fatigue.
4. To conserve energy
5. To _restore the mind and body
6. To enjoy_life more fully
7. Sleep enhances daytime functioning, and is vital for cognitive, physiological, and psychosocial function.
8. Sleep is in important factor in a person’s quality of life, yet sleep disorders and sleep deprivation are an
unmet public health problem.
9. It is estimated that 50 -70 million Americans suffer from a chronic disorder of sleep and wakefulness that
hinders daily functioning and adversely affects health
10. Many members of the general public and health professionals are unaware of the consequences of
chronic sleep loss.
11. Sleep has come to be considered an altered state of consciousness in which the individuals perception of
and reaction to the environment are decreased.
12. The cyclic nature of sleep is thought to be controlled by centers located in the lower part of the brain.
13. The upper part of the reticular formation consists of a network of ascending nerve fibers called reticular
activating system.
14. _serotonin_ is thought to lessen the response to sensory stimulation and gamma-aminobutyric acid to
shut off the activity in the neurons of the RAS.
15. Another key factor to sleep is exposure to darkness
16. During darkness and preparing for sleep, the pineal gland in the brain begins to actively secrete natural
hormone melatonin.
17. During sleep, the growth hormone is secreted and cortisol is inhibited.
18. With the beginning of daylight, melatonin is at its lowest level in the body and the stimulating hormone,
cortisol, is at its highest.
19. In humans biologic rhythms are controlled from within the body and synchronized with environmental
factors such as light and darkness.
20. The most familiar biologic rhythm is the circadian rhythm.
21. Although sleep and waking cycles are the best known of the circadian rhythms, body temperature, blood
pressure, and many other _physiological functions_also follow a circadian pattern.
22. When a person’s biologic clock coincides with the sleep / wake cycles, the person is said to be in
circadian _synchronization.
23. Changes in the architecture of one’s sleep can be linked to physiological or psychological changes.
24. NREM sleep occurs when activity in the RAS is inhibited
Stages of Sleep: (#s 25-27)
25. Stage 1: is the stage of very light sleep and lasts only a few minutes
26. Stage 2: is the stage of sleep during which body processes continue to slow down.
27. Stage 3: is the deepest stage of sleep, differing only in the percentage of delta waves recorded during a
30-second period.
28. During stage 1, the person feels drowsy and relaxed, eyes roll from sides to sides, heart and respiratory
rates drop slightly.
29. During stage 1, the sleeper can be readily awakened and may deny that he or she was sleeping.
30. During stage 2 of sleep, the eyes are generally still, heart and respiratory rates decreases slightly, and
body temperature falls
31. An individual in stage 2 requires more intense stimuli than in state 1 to awaken such as touching or
shaking.
32. During deep sleep or delta sleep, the sleeper’s heart and respiratory rates drop 20% to 30% below those
exhibited during waking hours.
33. During stage 3, the person is not disturbed by sensory stimuli, the skeletal muscles are very relaxed,
34. Stage 3 is essential for restoring energy and releasing important growth hormones.
35. Sleep deprivation in hospitalized clients contributes to their anxiety and fear.
36. Sleep deprivation also causes immunosuppression, inflammation, alterations of sympathetic and
parasympathetic equilibrium, and increases insulin resistance.
37. REM sleep usually recurs about every 90 minutes and lasts 5 to 30 minutes.
38. During REM sleep, the brain is highly active and brain metabolism may increase as much as 20%.
39. During REM sleep, levels of acetylcholine and dopamine increase with the highest levels of
acetylcholine release occurring during REM sleep.
40. REM sleep is also called paradoxical sleep because electroencephalogram (EEG) activity resembles that
of wakefulness.
41. Distinctive eye movements occur, voluntary muscle tone is dramatically decreased, deep tendon reflexes
are absent.
42. In REM sleep, the sleeper may be difficult or arouse or may wake spontaneously, gastric secretions
increase, and heart and respiratory rates often are irregular .
43. During the sleep cycle passing through NREM and REM sleep, the complete cycle usually last for about
90 to 110 minutes in adults.
44. The healthy adult sleeper usually experiences four to six cycles of sleep during 7 to 8 hours
45. During the early part of the night, the deep sleep periods are longer
46. As the night progresses, NREM is less and REM sleep increases and dreams tend to lengthen
47. Sleep exerts physiological effects on both the nervous system and other body structures.
48. Sleep is also necessary for protein synthesis, which allows repair processes to occur.
49. Individuals with inadequate amounts of sleep tend to become emotionally irritable, have poor
concentration, and experience difficulty making decisions.
50. Although maintaining a regular sleep/wake rhythm is important than the number of hours actually slept,
recent research shows that sleep deprivation is associated with significant cognitive and health problems.
51. Although reestablishing the sleep/wake rhythm is important, it is appropriate to allow and encourage
daytime napping in hospitalized clients.
52. One study found that sleep deprivation impairs an individual’s judgment and increases the risk for
workplace injury or critical errors leading to negative outcomes.
53. The medical community has recognized that when residents worked in excess of 80 hours per week,
the rate of medical errors increased.
54. Changes _in schedules can impair nurse’s sleep patterns and contribute to inattention, resulting in health
care delivery errors.
55. Children who have a TV and / or computer in their bedroom are more likely to get _less sleep.
Factors Affecting Sleep: (#s 56 – 64)
56. Illness
57. Environment
58. Medications
59. Lifestyle
60. Emotional Stress
61. Stimulants and Alcohol
62. Diet
63. Smoking
64. Motivation
Common Sleep Disorders (#s 65 – 67)
65. Insomnia
66. Excessive Daytime Sleepiness
67. Parasomnias
68. Research has proven that nurses who work long _ hours have greater chance of making errors when
caring for clients.
69. All nurses must recognize the impact of sleep deprivation and fatigue on their ability to deliver safe and
effective care.
70. Nurses should avoid substances such as alcohol or caffeine prior to sleeping because they can cause
altered sleep patterns, which cause fatigue during work hours.
71. It is important that both nurses and employers recognize that 12-hour shift contribute to errors in the
delivery of care.
72. The nurse should avoid working 12-hour shifts on _two_consecutive days to minimize the risk of fatigue.

Review Test Your Knowledge in pages 1083 - 1089

th
Reference: Berman, A. & Synder, S. (2016) Kozier & Erb’s Fundamentals of Nursing. 10 ed. Pearson
Education, Inc.

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