Practice Question
A nurse is assisting with teaching a client about the sleep-wake cycle. The nurse should include that which of the following factors can interfere with the sleep-wake cycle?
Answer Choices:
Correct Answer:
Drinking caffeinated beverages in the evening.
Rationale:
Drinking caffeinated beverages in the evening
🟣Caffeine is an adenosine receptor antagonist, increasing alertness and lengthening sleep latency.
🟣Evening intake suppresses/offsets melatonin timing, shifting the circadian phase later and delaying sleep onset.
🟣With a half-life of ~5–7 hr, caffeine persists into bedtime, reducing slow-wave sleep and causing fragmentation.
🟣Even mid-afternoon doses can impair sleep efficiency in sensitive individuals, especially with repeated daily use.
🟣Avoiding caffeine for ≥6 hr before bed and limiting total daily intake stabilizes sleep architecture and continuity.
Emotional stress
🟣Stress elevates cortisol and sympathetic catecholamines, producing hyperarousal that impairs sleep initiation and maintenance.
🟣Cognitive rumination increases EEG beta activity at bedtime, lowering sleep efficiency and promoting nocturnal awakenings.
🟣Chronic stress can destabilize SCN–HPA axis signaling, subtly phase-shifting circadian timing and degrading REM/SWS balance.
🟣Evidence-based strategies (e.g., CBT-I, relaxation, breath work) reduce physiologic arousal and improve sleep continuity.
🟣Consistent wind-down routines and stimulus control help prevent conditioned wakefulness in the sleep environment.
A bright light
🟣Evening bright/blue-enriched light activates melanopsin retinal ganglion cells, suppressing pineal melatonin and delaying circadian phase via the SCN.
🟣Exposure from LEDs/screens near bedtime lengthens sleep latency and reduces sleep depth, altering sleep architecture.
🟣Wavelengths around 460–480 nm exert the strongest melatonin-suppressing effect, especially in otherwise dim environments.
🟣Managing light as a zeitgeber—dim at night, bright in the morning—realigns circadian rhythms and stabilizes the sleep–wake cycle.
🟣Practical steps: limit screens 1–2 hr pre-bed, use night modes/filters, and maintain a dark, cool bedroom to protect REM and SWS.
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This question is from Custom VNIOO FON EXAM 5 which contains 47 questions.
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Question Details
- Category: LPN Nursing Exam(s)
- Subcategory: LPN ATI Exams
- Domain: 💫PN Custom Exam(s)
- Answer Choices: 5