Class 3 - Sleep Assessment

Question 1

The Epworth sleepiness scale is used to measure how sleepy you are. What do the results mean?

Answer 1

0-7
- It is unlikely that you are abnormally sleepy
8-9
- You have an average amount of daytime sleepiness
10-15
- You may be excessively sleepy depending on the situation
- You may want to consider seeking medical attention.
16-24
- You are excessively sleepy and should consider seeking medical attention

Question 2

How should you conduct a sleep assessment? (9)

Answer 2

• Ask, how do you feel when you wake up?
• history
• exam findings: physical exam
• Micrognathia, retrognathia, enlarged tonsils
• BMI
• medication review
• diagnostic tests
• polysomnogram (EEG)
• focused interviews

Question 3

Why should you assess for micrognathia, retronathia, and enlarged tonsils?

Answer 3

• position and size of lower mandible
• can affect airways

Question 4

Why do you need to physically assess?

Answer 4

• cause impairment, resp. sistem, cardiac, BMI

Question 5

Why should you assess medical history and medications?

Answer 5

SSRIs can affect neurotransmitters

Question 6

How can one manage sleep disorders? (4)

Answer 6

Primary prevention
- What can you eliminate to sleep better?
Secondary prevention (screening)
- polysomnogram, interviews, interventions
Collaborative interventions
- sleep hygiene
Pharmacologic Agents

Question 7

Benzodiazepines are used to help sleep. Why are the risky to use?

Answer 7

• Diazepam (valium) and Lorazepam (ativan)
• they make you feel crappy the next day

Question 8

melatonin can be used to help fall asleep. Why is it risky? (3)

Answer 8

• receptor agonists
• ramelteon (rozerem)
• short term bc it can cause dependence

Question 9

What are some sleep health strategies? (5)

Answer 9

• make sleep a priority
• gear down (try not to work out)
• Organize home and work life to promote good quality sleep
• good sleep environment that is dark, quiet, cool. and comfortable
• avoid watching TV or working in the bedroom
• Eat a small snack before bed time

Question 10

What should you NOT do before bed? (3)

Answer 10

• heavy, spicy meals 2-3 hours before
• alcohol, which promotes onset but causes early awakening and disturbances
• exercise, at least 3 hours before

Question 11

What are sleep HYGIENE health strategies? (7)

Answer 11

• non-pharmacological tx is the best line of treatment, may be combined w meds
• distraction
• imagery
• relaxation
• massage
• pacing
• yoga
  etc.

Question 12

What are sleep enhancement interventions that you can do for a patient? (4)

Answer 12

1. Adjust
   - adjust environment (light. noise, temp)
2. Encourage
   - encourage to establish bedtime routine to facilitate wakefulness to sleep
3. Facilitate
   - facilitate maintenance of the patient’s usual bedtime routines during inpatient care
4. Encourage
   - encourage elimination of stressful situations before bedtime