π Essential for Mental Health Nursing, Physiology, and Staff Nurse Competitive Exams
π° Definition of Sleep:
Sleep is a reversible state of altered consciousness where the body and mind rest. It is essential for physical restoration, brain function, emotional regulation, and memory consolidation.
β It is actively regulated by the brain and follows a circadian rhythm (24-hour cycle).
βSleep is not a passive state, but an active biological process for restoration.β
Q5. How many sleep cycles does an average adult have per night? π °οΈ 1β2 π ±οΈ 2β3 β π ²οΈ 4β6 π ³οΈ 8β10 Answer: β (c) 4β6
π΄π Dyssomnias
π Essential for Mental Health Nursing, Psychiatric Disorders, and Staff Nurse Competitive Exams
π° Definition:
Dyssomnias are a group of sleep disorders characterized by difficulty in initiating or maintaining sleep, excessive sleepiness, or disturbances in the sleep-wake cycle.
β They affect the quantity, quality, and timing of sleep.
βDyssomnias disturb how long and when you sleep β not what you dream.β
π¨ Circadian rhythm disorders = seen in shift workers, travelers
β Top 5 MCQs for Practice:
Q1. Which of the following is an example of dyssomnia? π °οΈ Sleepwalking π ±οΈ Night terrors β π ²οΈ Insomnia π ³οΈ Bedwetting Answer: β (c) Insomnia
Q2. Which disorder is associated with excessive sleepiness and cataplexy? π °οΈ Insomnia π ±οΈ Sleep apnea β π ²οΈ Narcolepsy π ³οΈ Bruxism Answer: β (c) Narcolepsy
Q3. CPAP therapy is used in which dyssomnia? π °οΈ RLS π ±οΈ Insomnia β π ²οΈ Obstructive Sleep Apnea π ³οΈ Jet lag Answer: β (c) Obstructive Sleep Apnea
Q4. Which drug is used to promote wakefulness in narcolepsy? π °οΈ Diazepam β π ±οΈ Modafinil π ²οΈ Haloperidol π ³οΈ Melatonin Answer: β (b) Modafinil
Q5. Circadian rhythm sleep disorder is caused by: π °οΈ Viral infection π ±οΈ Iron deficiency β π ²οΈ Disrupted sleep-wake cycle π ³οΈ Bed position Answer: β (c) Disrupted sleep-wake cycle
πποΈ Parasomnias
π Essential for Psychiatric Nursing, Physiology, and Mental Health Nursing Exams
π° Definition:
Parasomnias are abnormal behavioral, experiential, or physiological events that occur during sleep or sleep-wake transitions.
β These include unusual movements, behaviors, emotions, perceptions, or dreams during NREM or REM sleep.
βIn parasomnias, the body acts while the brain sleeps.β
Sleepwalking (Somnambulism): πΈ Walking or performing activities while asleep πΈ Eyes open, but unresponsive πΈ No memory on waking
Sleep Terrors (Night Terrors): πΈ Sudden arousal with scream, intense fear πΈ Tachycardia, sweating, confusion πΈ Difficult to console, no recollection after
Confusional Arousals: πΈ Disoriented behavior upon waking πΈ Common in children and elderly πΈ Person appears awake but is confused
π¨ B. REM-Related Parasomnias:
Nightmares: πΈ Frightening dreams that awaken the sleeper πΈ Occurs during REM sleep πΈ Person remembers the dream clearly
REM Sleep Behavior Disorder (RBD): πΈ Loss of normal REM muscle paralysis πΈ Person acts out vivid dreams (kicking, shouting) πΈ Risk of injury to self or partner
π¦ C. Other Parasomnias:
Sleep Talking (Somniloquy): πΈ Speaking aloud during sleep πΈ Harmless, may occur with other parasomnias
Sleep-related Eating Disorder: πΈ Eating during partial arousal from sleep πΈ No memory of event, potential weight gain/injury
Enuresis (Bedwetting): πΈ Involuntary urination during sleep πΈ Common in children below 5β6 years
π§ Causes / Risk Factors:
Sleep deprivation
Fever (in children)
Stress and anxiety
Genetic/family history
Alcohol or sedative use
Obstructive Sleep Apnea (OSA)
Neurological disorders (e.g., Parkinsonβs β in RBD)
Q1. Which of the following is a NREM parasomnia? π °οΈ Nightmare π ±οΈ REM sleep behavior disorder β π ²οΈ Sleepwalking π ³οΈ Sleep paralysis Answer: β (c)
Q2. REM Sleep Behavior Disorder is characterized by: π °οΈ Complete paralysis during REM β π ±οΈ Acting out vivid dreams π ²οΈ Loud snoring π ³οΈ Sleep talking Answer: β (b)
Q3. Which drug is used in REM sleep behavior disorder? π °οΈ Diazepam π ±οΈ Sertraline β π ²οΈ Clonazepam π ³οΈ Phenytoin Answer: β (c)
Q4. Parasomnia seen in children with high fever is: π °οΈ Narcolepsy β π ±οΈ Sleep terrors π ²οΈ Insomnia π ³οΈ Bruxism Answer: β (b)
Q5. Best investigation for parasomnias is: π °οΈ ECG π ±οΈ CT scan β π ²οΈ Polysomnography π ³οΈ Liver function test Answer: β (c)
π¦΅π€ Sleep-Related Movement Disorders (SRMDs)
π Important for Mental Health Nursing, Medical-Surgical Nursing & Staff Nurse Exams
π° Definition:
Sleep-related movement disorders are a group of conditions involving involuntary, repetitive movements during sleep or sleep transitions, which disturb the quality or quantity of sleep.
β These movements are typically simple, stereotyped and may go unnoticed by the patient but affect restfulness.
βWhen sleep is interrupted by movement, the body rests but the brain does not recover.β
π¨ RLS is linked to low ferritin and dopamine imbalance
β Top 5 MCQs for Practice:
Q1. Which disorder is characterized by an urge to move the legs at night? π °οΈ Narcolepsy π ±οΈ Sleep apnea β π ²οΈ Restless Legs Syndrome π ³οΈ Sleepwalking Answer: β (c)
Q2. Periodic Limb Movement Disorder is best detected by: π °οΈ CT scan β π ±οΈ Polysomnography π ²οΈ EEG π ³οΈ Blood pressure monitoring Answer: β (b)
Q3. Which of the following is a treatment for RLS? π °οΈ Haloperidol β π ±οΈ Pramipexole π ²οΈ Risperidone π ³οΈ Diazepam Answer: β (b)
Q4. Bruxism primarily affects which part of the body? π °οΈ Feet π ±οΈ Stomach π ²οΈ Spine β π ³οΈ Jaw/Teeth Answer: β (d)
Q5. Rhythmic movement disorder is most common in: π °οΈ Teenagers π ±οΈ Elderly β π ²οΈ Infants and toddlers π ³οΈ Adults with epilepsy Answer: β (c)
π§π Sleep Disorders in Children
π Important for Pediatric Nursing, Mental Health Nursing & Community Health Exams
π° Definition:
Sleep disorders in children refer to disturbances in sleep quality, duration, or behavior that negatively impact a childβs development, behavior, academic performance, and family functioning.
β Sleep is crucial for brain growth, immunity, and emotional regulation in children.
π₯ Behavioral insomnia = common & treatable with CBT
β MCQs for Practice:
Q1. Night terrors occur during: β π ²οΈ NREM sleep
Q2. Best management for enuresis in 7-year-old: β π ±οΈ Behavioral therapy + moisture alarm
Q3. Common cause of sleep apnea in children: β π ²οΈ Enlarged tonsils and adenoids
π§ ποΈ CBT for Insomnia (CBT-I)
π Essential for Mental Health Nursing, Psychiatric Nursing & Nurse Counseling Roles
π° Definition:
CBT for Insomnia (CBT-I) is a structured, evidence-based psychotherapy that helps individuals change unhelpful thoughts and behaviors related to sleep.
β Recommended as first-line treatment for chronic insomnia.
Polysomnography (PSG) is a comprehensive sleep study that records multiple physiological parameters during sleep to diagnose sleep disorders such as insomnia, sleep apnea, narcolepsy, parasomnias, and periodic limb movement disorder.
β It is the gold standard for sleep assessment.
βPolysomnography turns sleep into scienceβwhere every breath, beat, and blink is monitored.β
π§ Nurse ensures patient comfort, safety & accurate data recording
π₯ Avoid caffeine and sedatives 24 hours before test
β Top 5 MCQs for Practice:
Q1. Polysomnography is primarily used to diagnose: π °οΈ Epilepsy π ±οΈ Depression β π ²οΈ Sleep apnea π ³οΈ Hypoglycemia Answer: β (c)
Q2. Which parameter is NOT monitored during PSG? π °οΈ EEG π ±οΈ Pulse oximetry π ²οΈ ECG β π ³οΈ Blood sugar Answer: β (d)
Q3. Which of the following is essential before a sleep study? π °οΈ Administer caffeine β π ±οΈ Avoid sedatives and alcohol π ²οΈ Daytime sleep π ³οΈ Heavy meal Answer: β (b)
Q4. Which sleep disorder requires MSLT in addition to PSG? π °οΈ Insomnia β π ±οΈ Narcolepsy π ²οΈ Bruxism π ³οΈ OSA Answer: β (b)
Q5. Nurse’s main role during PSG is: π °οΈ Interpret EEG data π ±οΈ Administer anesthesia β π ²οΈ Ensure patient comfort and accurate monitoring π ³οΈ Start IV fluids Answer: β (c)
π¦ Polysomnography = gold standard for diagnosing sleep apnea & PLMD
β Top 5 MCQs for Practice:
Q1. The best first-line treatment for chronic insomnia is: β π ±οΈ CBT-I (Cognitive Behavioral Therapy for Insomnia)
Q2. Which of the following is NOT a sleep hygiene principle? π °οΈ Avoid caffeine at night π ±οΈ Use bed only for sleep β π ²οΈ Drink energy drinks before bed π ³οΈ Fixed sleep schedule Answer: β (c)
Q3. Sleep deprivation in nurses can result in: π °οΈ Improved alertness β π ±οΈ Fatigue and poor decision-making π ²οΈ Faster reflexes π ³οΈ Reduced infection risk Answer: β (b)
Q4. Which nursing diagnosis is appropriate for a patient with sleep apnea? β π ±οΈ Risk for injury
Q5. What tool is used to assess daytime sleepiness? π °οΈ GCS β π ±οΈ Epworth Sleepiness Scale π ²οΈ PHQ-9 π ³οΈ MMSE Answer: β (b)
πποΈ Sedative-Hypnotic Medications
π Essential for Mental Health Nursing, Pharmacology, and Nursing Drug Administration Exams
π° Definition:
Sedative-hypnotic drugs are CNS depressants used to produce calming (sedative) or sleep-inducing (hypnotic) effects. They are commonly prescribed to treat anxiety, insomnia, muscle spasms, seizures, and as pre-anesthetic medications.
β These drugs act on the GABA receptors, enhancing inhibitory neurotransmission.
βSedatives calm the mind, hypnotics induce sleep β both require careful use.β
Q1. Which of the following is a non-benzodiazepine hypnotic? π °οΈ Diazepam π ±οΈ Clonazepam β π ²οΈ Zolpidem π ³οΈ Haloperidol Answer: β (c) Zolpidem