(Select All That Apply):. A nurse is assessing a client for possible sleep and wakefulness disorders. Which of the following are common symptoms that the nurse should consider? Select all that apply.

Choice A rationale:

Hypersomnolence refers to excessive daytime sleepiness and an increased need for sleep. It is not characterized by abnormal movements of the limbs or body during sleep. Hypersomnolence can be a symptom of various sleep disorders but is not directly related to the condition described.

Choice B rationale:

Periodic limb movement disorder (PLMD) involves repetitive and involuntary movements of the legs and sometimes the arms during sleep. These movements are distinct from the abnormal movements described in the question. PLMD can cause sleep disturbances and daytime fatigue but is not the disorder characterized by stereotyped movements during sleep.

Choice C rationale:

Sleep-related rhythmic movement disorder (SRMD) is characterized by repetitive or stereotyped movements during sleep or while falling asleep. These movements can include head banging, body rocking, or rolling. SRMD is often seen in children and tends to decrease with age. It is a parasomnia, which is a category of sleep disorders involving unusual behaviors during sleep.

Choice D rationale:

Circadian rhythm sleep-wake disorder involves disruptions in the sleep-wake cycle due to misalignments between a person's internal body clock and external cues like light and darkness. It is not characterized by abnormal movements of the limbs or body during sleep. Circadian rhythm sleep-wake disorder can lead to difficulties falling asleep or staying awake at appropriate times but is distinct from the disorder described.

Choice A rationale:

Medication (short-term use) is not the commonly recommended intervention for a sleep disorder characterized by excessive daytime sleepiness despite adequate nighttime sleep. While medication might be considered in certain cases, it is usually not the first-line treatment option for this condition. Medications can have side effects and may not address the underlying causes of the sleep disorder.

Choice B rationale:

Relaxation techniques can be helpful for improving sleep quality and managing stress, but they are not typically the primary intervention for excessive daytime sleepiness despite adequate nighttime sleep. Relaxation techniques focus more on promoting relaxation and reducing stress, which might indirectly improve sleep patterns but may not directly address the specific disorder described.

Choice C rationale:

Cognitive behavioral therapy (CBT) is commonly recommended for a sleep disorder characterized by excessive daytime sleepiness despite adequate nighttime sleep. CBT for insomnia (CBT-I) is an evidence-based approach that addresses the psychological and behavioral factors contributing to sleep disturbances. It focuses on improving sleep hygiene, modifying negative thought patterns about sleep, and establishing a consistent sleep schedule. CBT has shown effectiveness in treating sleep disorders without the potential side effects of medications.

Choice D rationale:

Avoiding alcohol and caffeine is generally a good practice for promoting healthy sleep, but it alone is not the commonly recommended intervention for a sleep disorder characterized by excessive daytime sleepiness despite adequate nighttime sleep. While avoiding alcohol and caffeine can help prevent sleep disturbances, it might not fully resolve the underlying disorder causing excessive sleepiness.