A nurse is caring for an older adult client who reports that they wake up frequently during the night. The nurse should identify that which of the following is a characteristic of older adult sleep patterns that might explain the client's frequent awakenings?

Older adults tend to spend more time in stage 4 sleep.

Older adults tend to spend more time in stage 3 sleep.

Older adults tend to spend less time in stage 1 sleep.

Older adults tend to spend more time in stage 2 sleep.

Answer and Explanation

The Correct Answer is D

A. Older adults experience a decrease in stage 4 sleep, which is the deepest, slow-wave sleep responsible for physical restoration, tissue repair, and immune system support. The reduction in stage 4 contributes to lighter sleep, less restorative rest, and increased susceptibility to awakenings during the night.

B. Stage 3 sleep, another component of deep, slow-wave non-REM sleep, also decreases with age. This decline reduces the total amount of restorative sleep, which can lead to daytime fatigue, difficulty concentrating, and increased nighttime awakenings.

C. Stage 1 sleep, the lightest stage of non-REM sleep, does not significantly decrease with age. Older adults continue to enter stage 1 sleep as a normal part of the sleep cycle. However, the proportion of light sleep relative to deep sleep increases, making the overall sleep more fragmented and easier to disrupt.

D. Older adults spend more time in stage 2 sleep, which is a lighter stage of non-REM sleep characterized by sleep spindles and slower brain activity. While stage 2 is important for memory consolidation and some restorative processes, it is easier to awaken from than stages 3 and 4. The increased proportion of stage 2 sleep contributes to frequent nighttime awakenings, lighter sleep, and shorter total sleep time, which are common complaints among older adults.

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Correct Answer is B

Explanation

A. A cool shower may actually be stimulating and reduce the body’s natural drop in core temperature, which is necessary to initiate sleep. A warm shower or bath is recommended because it promotes relaxation and a gradual decline in body temperature that facilitates sleep onset.

B. Going to bed only when sleepy and leaving the bed if unable to fall asleep (to engage in relaxing activities such as listening to soft music) helps prevent negative associations with the bed and promotes healthy sleep hygiene. This approach is consistent with cognitive-behavioral therapy for insomnia (CBT-I) techniques and encourages the client to associate the bed with sleep rather than frustration or wakefulness.

C. Limiting daytime naps to 20–30 minutes is recommended to avoid interference with nighttime sleep. Naps longer than 30 minutes, even if limited to 1 hour, can reduce sleep drive and make it harder to fall asleep at night.

D. Exercising too close to bedtime, especially vigorous activity within 1–2 hours of sleep, can be stimulating and delay sleep onset. Moderate exercise is beneficial for sleep but should be done earlier in the day to avoid interference with the natural sleep-wake cycle.

A. Diabetes mellitus B. Central sleep apnea C. Hypersomnia D. Restless leg syndrome (RLS)

Correct Answer is A

Explanation

A. Shift work disrupts the normal circadian rhythm, leading to irregular sleep patterns, altered eating habits, and metabolic changes. These disruptions increase the risk for insulin resistance and impaired glucose metabolism, which can contribute to the development of type 2 diabetes mellitus. Multiple studies have shown a higher prevalence of diabetes in individuals who perform night shifts or rotating shifts compared to those with consistent daytime schedules.

B. Central sleep apnea is caused by a failure of the brain to send appropriate signals to the respiratory muscles, often associated with heart failure, stroke, or opioid use. It is not specifically linked to shift work or circadian rhythm disruption.

C. While shift workers may experience excessive daytime sleepiness due to sleep deprivation or circadian misalignment, hypersomnia is a sleep disorder characterized by excessive sleep despite adequate sleep opportunities and is not a direct consequence of shift work. Shift work primarily causes circadian rhythm–related sleep disturbances rather than intrinsic hypersomnia.

D. RLS is a neurological disorder characterized by uncomfortable sensations in the legs with an urge to move them, often worse at night. It is not caused by shift work, although sleep disruption may exacerbate symptoms in individuals with preexisting RLS.

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A nurse is caring for an older adult client who reports that they wake up frequently during the night. The nurse should identify that which of the following is a characteristic of older adult sleep patterns that might explain the client's frequent awakenings?

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Naxlex Comprehensive Predictor Exams

An employee health nurse is providing teaching about sleep promotion to a group of newly licensed nurses. Which of the following statements should the nurse include?

Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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