The Big Picture
Sleep is an important part of staying healthy. Your body needs sleep to fight illness, learn, grow, and function during the day. Not getting enough sleep can seriously affect your health.
Some people have repeated problems with their sleep. These problems are called sleep–wake disorders. They can make daily activities more difficult and cause distress.
As a Continuing Care Assistant (CCA), you may support clients who have sleep problems. You need to recognize possible problems, understand factors that affect sleep, and know what observations to report and record.
Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.
Quick tip: Tap, click, or press Enter on any term with a dotted underline and an ⓘ icon to see its plain-English definition.
Start Here If You’re Overwhelmed
Focus on these core ideas:
- Sleep–wake disorders involve repeated sleep problems that cause distress and interfere with daytime functioning.
- Sleep supports the immune system, nervous system, physical and mental functioning, learning, and cell growth.
- Adults generally need 7 to 8 hours of sleep each day.
- REM sleep is associated with dreaming. Sleepwalking and bedwetting occur during deep sleep.
- Breathing pauses during sleep or waking with a headache every morning may suggest sleep apnea, which requires medical treatment.
- CCAs observe, report, and record sleep patterns and note possible sleep-related effects of medications or alcohol.
Jump to:
Course Notes: Key Ideas You Need to Know
What Are Sleep–Wake Disorders?
Sleep–wake disorders are conditions involving repeated disturbances in normal sleep patterns. These disturbances cause distress and affect how well a person functions during the day.
Scientists and medical professionals do not fully understand why the body needs sleep. They do know that too little sleep can cause serious health problems.
Many sleep disorders can be managed easily once they are properly diagnosed.
Why Sleep Is Important
Sleep is essential for several important functions in the body.
- Immune system: Sleep helps the body’s ability to fight disease and sickness.
- Nervous system: Sleep supports normal nervous system functioning.
- Physical functioning: Sleep helps the body function normally.
- Mental functioning: Sleep supports the ability to function mentally.
- Learning: Sleep is necessary for learning.
- Cell growth: Sleep supports normal, healthy cell growth.
Key fact: Sleep supports both physical and mental health. It is essential for normal, healthy functioning.
The 10 Types of Sleep–Wake Disorders
Sleep–wake disorders are generally divided into 10 conditions.
- Lack of sleep: Includes insomnia disorder, which involves insufficient sleep.
- Breathing-related sleep disorders: Includes obstructive sleep apnea, a medical condition.
- Hypersomnolence disorder: Involves excessive sleep.
- Narcolepsy: A neurological disorder affecting the brain’s ability to control sleep and wakefulness cycles.
- Circadian-rhythm sleep–wake disorders: A separate category of sleep–wake disorders.
- Nightmare disorder: A category involving nightmares.
- Nonrapid eye movement (NREM) sleep disorder: A category involving NREM sleep.
- Rapid eye movement (REM) disorder: A category involving REM sleep.
- Willis–Ekbom disease: Also called restless legs syndrome.
- Substance/medication-induced sleep disorder: A category of sleep disorder associated with substances or medications.
Insomnia Is the Most Common Sleep Disorder
Insomnia means a lack of sleep.
It is the most common sleep disorder and occurs more often in:
- Women
- Older persons
Remember that insomnia involves a lack of sleep, while hypersomnolence involves excessive sleep.
How Much Sleep Do People Need?
Sleep needs vary depending on several factors, including age.
| Age Group | Usual Sleep Needs |
|---|---|
| Infants | About 16 hours a day |
| Teenagers | About 9 hours a day |
| Adults | An average of 7 to 8 hours a day |
| Older adults | About as much as younger adults |
Infants sleep for much of the day. Teenagers generally need more sleep than adults.
Older adults need about the same amount of sleep as younger adults, but their sleep patterns often differ.
How Sleep Changes With Age
Older adults usually:
- Sleep for shorter periods.
- Spend less time in the deep stages of sleep.
About 50% of adults over age 65 have some type of sleep disorder.
It is unclear whether these sleep disorders are a normal part of aging or a result of medications commonly used by older adults.
Key difference: Needing about the same amount of sleep does not mean sleeping for the same lengths of time. Older adults often sleep in shorter periods.
Understanding Deep Sleep and REM Sleep
Deep sleep and rapid eye movement (REM) sleep are both essential parts of the normal sleep cycle.
They are associated with different activities in the body.
Deep Sleep
Two activities that occur during deep sleep are:
- Sleepwalking
- Bedwetting
REM Sleep
REM stands for rapid eye movement.
Dreams occur during REM sleep.
During REM sleep, several changes occur in the body:
- Muscles stiffen.
- Eyes move.
- Heart rate increases.
- Breathing becomes faster and more irregular.
- Blood pressure rises.
Difference: Dreams occur during REM sleep, while sleepwalking and bedwetting occur during deep sleep.
Factors That Can Interfere With Sleep
Certain foods, medicines, and substances affect the balance of chemicals involved in sleep.
These effects may interfere with normal sleep patterns.
| Substance | Possible Effect on Sleep |
|---|---|
| Caffeine | Can cause insomnia |
| Antidepressant medications | Can cause loss of REM sleep |
| Smoking | Can cause loss of REM sleep and deep sleep |
| Alcohol | Can cause loss of REM sleep and deep sleep |
CCA action: Instruct clients to avoid foods and medicines that interfere with the balance of chemicals involved in sleep.
Nova Scotia CCA Note
Sorrentino’s Canadian Textbook for the Support Worker, 5th Edition advises telling clients to avoid medicines that interfere with sleep. In Nova Scotia, this does not give a CCA permission to independently change medication directions or tell a client to stop taking a prescribed medication.
Nova Scotia’s current CCA standards require medication assistance to stay within the CCA’s permitted duties, the care plan, and instructions from a regulated healthcare professional, such as a nurse. If a medication may be affecting a client’s sleep, the CCA should report the concern rather than independently decide to change the medication.
Why this matters in Nova Scotia: Knowing that a medication can interfere with sleep does not give a CCA authority to change the client’s medication treatment.
Official source: Continuing Care Assistant Occupational Standards of Practice
Last checked: October 9, 2026
Recognizing Possible Sleep Apnea
Sleep apnea is a medical disorder involving sleep-related breathing problems.
Watch for these possible warning signs:
- The client appears to stop breathing for periods during sleep.
- The client wakes with a headache every morning.
Either observation should raise suspicion of sleep apnea.
Supporting a Client With Possible Sleep Apnea
CCA action: If the client appears to stop breathing during sleep or wakes with a headache every morning, suspect sleep apnea and encourage the client to seek medical attention. Sleep apnea is a medical disorder that must be treated.
The client might also benefit from sleeping on their side with a pillow between the knees.
Supporting Clients Who Sleep Too Much
Excessive sleeping may indicate a sleep disorder.
Clients who tend to sleep too much should see a doctor for a physical checkup.
The checkup is important to rule out narcolepsy, a medical condition affecting the brain’s control of sleep and wakefulness.
What the CCA Should Observe, Report, and Record
CCAs have important responsibilities when supporting clients with sleep–wake disorders.
Observe Sleep Patterns
Observe how long the client sleeps during each stage of sleep.
Pay attention to possible signs of sleep problems, including:
- Periods when the client appears not to breathe
- Waking with a headache every morning
- Excessive sleeping
Report and Record Sleep Information
The CCA should observe, report, and record how long the client sleeps during each sleep stage.
Also make a note of the client’s use of:
- Prescription drugs
- Nonprescription drugs
- Alcohol
These substances might be contributing to sleep disorders.
Key fact: Observation, reporting, and recording are all part of the CCA’s sleep-related responsibilities.
Nova Scotia CCA Note
Sorrentino instructs CCAs to observe, report, and record sleep information. In Nova Scotia, the current standards describe the CCA’s responsibility as an observational point-of-care assessment. This means observing the person during care, recognizing changes, and knowing when to report concerns to a supervisor.
This is different from a nursing assessment. A CCA does not perform the detailed clinical evaluation used to make care and treatment decisions. CCAs follow the care plan and document observations according to their employer’s instructions.
Why this matters in Nova Scotia: When a client has sleep problems, the CCA’s responsibility is to recognize and communicate relevant changes, not independently assess or diagnose the sleep disorder.
Official source: Continuing Care Assistant Occupational Standards of Practice
Last checked: October 9, 2026
Exam Clue Words
Pay attention to words that change how you understand a sleep-related rule.
- Must be treated: Sleep apnea is a medical disorder requiring treatment. Suspected sleep apnea should lead to encouragement to seek medical attention.
- Should see a doctor: Clients who tend to sleep too much should have a physical checkup to rule out narcolepsy.
- Observe, report, and record: These are three responsibilities involving how long the client sleeps during each sleep stage. Observing alone does not cover all three.
- Every morning: Waking with a headache every morning is one possible warning sign of sleep apnea.
- In most cases: Sleep disorders can often be managed easily after proper diagnosis. This does not mean every sleep disorder is easily managed.
Common Mix-Ups
| Wrong Idea | Better Idea |
|---|---|
| Older adults need much less sleep than younger adults. | They need about as much sleep but often sleep for shorter periods. |
| Dreams and sleepwalking occur during the same sleep stage. | Dreams occur during REM sleep. Sleepwalking occurs during deep sleep. |
| Insomnia means sleeping too much. | Insomnia involves a lack of sleep. Hypersomnolence involves excessive sleep. |
| Sleep apnea is a sleep problem that does not require treatment. | Sleep apnea is a medical disorder that must be treated. |
| A CCA only needs to observe sleep patterns. | The CCA must also report and record how long the client sleeps during each sleep stage. |
Fast Review
Use these facts for a quick review before your CCA exam.
- Sleep–wake disorders: Repeated sleep disturbances that cause distress and interfere with daytime functioning.
- Importance of sleep: Supports immunity, nervous system functioning, physical and mental functioning, learning, and cell growth.
- 10 categories: Sleep–wake disorders are generally classified into 10 conditions.
- Insomnia: The most common sleep disorder. It occurs more often in women and older persons.
- Sleep needs: Infants need about 16 hours, teenagers about 9 hours, and adults an average of 7 to 8 hours daily.
- Older adults: Need about as much sleep as younger adults but often sleep in shorter periods and spend less time in deep sleep.
- Adults over 65: About 50% have some type of sleep disorder.
- REM sleep: Dreams occur, muscles stiffen, eyes move, heart rate and blood pressure rise, and breathing becomes faster and irregular.
- Deep sleep: Sleepwalking and bedwetting occur during this stage.
- Sleep-disrupting substances: Caffeine can cause insomnia. Antidepressant medications can cause loss of REM sleep. Smoking and alcohol can cause loss of REM sleep and deep sleep.
- Sleep apnea: Possible signs include breathing pauses and waking with a headache every morning. It requires medical treatment.
- CCA responsibilities: Encourage medical attention for suspected sleep apnea. Observe, report, and record how long the client sleeps during each sleep stage. Note prescription drugs, nonprescription drugs, and alcohol use.
Final Pep Talk
There are several sleep disorders and sleep stages to remember, so focus on understanding the differences rather than memorizing everything at once. Review the sleep needs, warning signs, and CCA responsibilities in small groups until you can recognize them with confidence.