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Journal of Neuroscience Nursing:
doi: 10.1097/JNN.0b013e3181ec1e38
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Sleep in Older Adults With Alzheimer's Disease

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GENERAL PURPOSE STATEMENT: To provide registered professional nurses with an understanding of sleep problems and related interventions in older adults with Alzheimer's disease (AD).

LEARNING OBJECTIVES: After reading the preceding article and taking this test, you should be able to:

1. Describe the characteristics of normal sleep.

2. Identify the pathophysiology and resultant sleep problems in older adults with AD.

3. Discuss treatment options for older adults with AD.

1. The lightest stage of sleep is

a. delta sleep.

b. non-rapid eye movement (NREM) stage 1.

c. rapid eye movement (REM) sleep.

d. slow-wave sleep.

2. Electrical activity during sleep is detected with an

a. electroencephalogram.

b. electrooculogram.

c. electromyogram.

d. polysomnograph.

3. Sleep efficiency is the ratio of

a. sleep onset latency to time in bed.

b. the amount of nighttime sleep to daytime sleep.

c. time asleep to time in bed.

d. waking frequency to time asleep.

4. REM and NREM cycles in adults last about

a. 30 minutes.

b. 60 minutes.

c. 90 minutes.

d. 120 minutes.

5. Increased awakenings result in

a. increased REM sleep.

b. increased NREM stage 1 sleep.

c. decreased NREM stage 2 sleep.

d. decreased REM sleep.

6. Sleep apnea often is associated with

a. daytime sleepiness.

b. increased delta sleep.

c. sundowning.

d. taking longer to fall asleep.

7. Which statement about phase-delayed sleep rhythms is true?

a. They are more prominent in non-AD dementia.

b. They result in late onset of sleep.

c. They cause frequent awakenings during the night.

d. They cause longer periods of NREM sleep.

8. One of the main causes of sleep disturbances in AD is from change in the

a. cholinergic basal forebrain nuclei.

b. serotoninergic dorsal raphe nuclei.

c. hypothalamic suprachiasmatic nucleus.

d. noradrenergic locus coeruleus.

9. Which is known as the "sleep hormone?"

a. melatonin

b. serotonin

c. noradrenalin

d. acetylcholinesterase

10. All of the following are hallmarks of AD except

a. extracellular senile plaques.

b. overstimulation of the pineal gland.

c. neurofibrillary tangles.

d. neuronal loss.

11. Which gene has been associated with sleep disturbances in patients with AD?

a. amyloid precursor protein gene

b. presenilin-1

c. apolipoprotein E

d. presenilin-2

12. Research studies show a link between sleep problems in persons with AD and

a. diabetes mellitus.


c. cachexia.

d. depression.

13. Which intervention can delay onset of sleep?

a. evening light exposure

b. morning light exposure

c. selective serotonin reuptake inhibitors

d. sedative-hypnotic drugs

14. The first step in evaluating sleep problems should be to

a. review medical records to identify causal factors.

b. start a trial with a mild sedative-hypnotic agent.

c. perform a broad assessment of the living environment.

d. complete a 1-2 week sleep diary.

15. Timing of light exposure should be based on

a. the number of awakenings.

b. sleep efficiency.

c. sleep-wake rhythms.

d. the duration of awakenings.

16. Engage a patient in light therapy by

a. providing the therapy at least 4 times per day for 15 minutes each.

b. scheduling a daily routine in front of the light box.

c. avoiding evening light with AD patients.

d. providing light intensity of 1,000 lux.

17. A sleep hygiene program for older adults with AD includes

a. providing a cup of tea before bed, if requested.

b. allowing flexible times to go to bed and to rise.

c. providing a glass of wine in the evening, if requested.

d. limiting daytime napping to short durations.

18. Controlling the environment for sleep includes

a. maintaining one light turned on in the bedroom.

b. keeping the television on low volume during the night.

c. maintaining an adequate bedroom temperature.

d. preventing exposure to artificial bright light in the morning.

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© 2010 American Association of Neuroscience Nurses


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