Key Concepts
Sleep is a (blank) of health and can be considered one of the vital signs
barometer or indicator
This is the most common form of sleep disordered breathing (SDB)
This is recommended as 1st line non-pharmacological treatment for chronic insomnia.
Cognitive behavioural therapy for insomnia (CBTI)
A (blank blank) of sleep concerns is necessary before pharmacological treatment is initiated.
thorough assessment
Insomnia affects this percentage of older adults with dementia.
60-70%
This stage of sleep is very important for older adults but declines with aging.
REM
Name 3 sleep disorders that can affect older adults
Insomnia, sleep apnea, restless legs syndrome, rapid eye movement sleep disorder, advanced sleep phase disorder, irregular sleep-wake disorder
These are 3 solution categories that can enhance sleep:
1. Health sleep habits
2. Relaxation techniques
3. Circadian rhythm interventions
*see BOX 18.8, p235
This is an important nursing action to take for patients who are prescribed medications for insomnia
Education
This is the term for behavioural changes in some people with dementia in the afternoon or evening.
Sundowning
Name 3 main risk factor categories for sleep disturbances in older adults.
(see BOX 18.3, p233)
Physical health
Psychological health
Physical environment
These are 2 risk factors for OSA
1. High body mass index (BMI)
2. Lage neck circumference
*see also BOX 18.11, p236 for others
(Blank) and (blank) have been found to be modestly effective in improving sleep with the benefical effects sustained for 24 months.
Conventional exercise and Tai Chi
The American Geriatrics Society Beers Criteria advise against the use of benzodiazepines for treating insomnia in older adults because they are associated with these 3 things:
1. MVAs
2. Impaired cognition
3. Falls
Degenerative changes in this area of the brain impact circadian rhythms and contribute to insomnia in people with dementia.
Hypothalamus
This is the term for the predictable pattern of normal sleep (2 words)
Sleep architecture
This is the percentage of adults in North America and Europe who have RLS
7-10%
A sleep diary should be kept for this period of time as an objective measure of sleep disturbances:
2 to 4 weeks
In 2019 the US FDA added a "black box warning" on insomnia medications like Ambien and Lunesta. What is a "black box warning?"
These medications can have side effects leading to serious injury or death.
The brain's ability to clear this protein is closely linked with Alzheimer's disease and buildup of this protein may be preventable.
beta-amyloid (p231)
Healthy People 2030 outlined a sleep related goal that aims to improve these 5 things:
1. Health
2. Productivity
3. Well-being
4. Quality of life
5. Safety
A significant number of people with RBD eventually develop one of these 3 diseases:
1. Parkinson's disease
2. Lewy body dementia
3. Multiple system atrophy
Decreasing nighttime noises including this common noise in care settings can help to mitigate sleep deprivation and delirium
Call bells
All sleeping medications including OTC and prescription have these and nurses need to be aware of them and educate patients about them
Adverse effects
Doing this over your lifespan can help reduce amyloid buildup and could reduce Alzheimer's symptoms, or delay onset or progression of the disease.
Practicing good sleep hygiene