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The purpose of an intentional mask leak is to... ✔✔Wash out CO2 and prevent rebreathing Recommended guidelines state that HSV can be considered when.... ✔✔Cheyne Stokes and central Apneas have not been eliminated. What is aerophagia? ✔✔The swallowing of air What is maxillomandibular advancement? ✔✔Treatment that involves cutting and advancing the upper and lower jaw bones; enlarging and stabilizing the posterior airway. What is the PRIMARY function of the EPAP setting? ✔✔To eliminate desaturations and arousals. According to guidelines, how many Hypopneas need to occur in peds pts prior to increasing pressure? ✔✔1
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The purpose of an intentional mask leak is to... ✔✔Wash out CO2 and prevent rebreathing Recommended guidelines state that HSV can be considered when.... ✔✔Cheyne Stokes and central Apneas have not been eliminated. What is aerophagia? ✔✔The swallowing of air What is maxillomandibular advancement? ✔✔Treatment that involves cutting and advancing the upper and lower jaw bones; enlarging and stabilizing the posterior airway. What is the PRIMARY function of the EPAP setting? ✔✔To eliminate desaturations and arousals. According to guidelines, how many Hypopneas need to occur in peds pts prior to increasing pressure? ✔✔ 1 What are the AASM guidelines for supplemental O2 during PAP studies? ✔✔1lmp during PAP titration when SPO2 is less than or equal to 88% for 5 or more minutes and in the absence of obstructive events.
If a pts Apneas are fixed at 10cm, but Hypopneas and snoring still occur at 16cm, what levels of BiLevel should be used? ✔✔IPAP: 14 EPAP: 10 Which of the following can reduce the effectiveness of CPAP and why: Nasal spray, Alcohol, Anti depressants. ✔✔Alcohol: impairs arousal response which can lead to longer than normal events and severe desats. Inhibits upper airway activity What syndrome would a pt with COPD and OSA have? ✔✔Overlap syndrome What are hypoxemia and hypercapnia? ✔✔Hypoxemia: very low 02 in the blood Hypercapnia: very high CO2 in the blood. What would a patient with both hypoxemia and hypercapnia most likely be diagnosed with? ✔✔Hypoventilation What is an MWT's MOST important use? ✔✔Measure patients ability to resist the urge to fall asleep Tricyclic antidepressants, large amounts of caffeine and large amounts of chocolate have been known to trigger what? ✔✔REM sleep behavior disorder
The respiratory event that requires oxygen desaturation and/ or an arousal as part of the scoring criteria is ✔✔Obstructive hypopnea An ECG arrhythmia commonly seen when recording PSG's, particularly in patients that have obstructive sleep apnea and cardiac disease. It can be identified by the morphology of an irregularly irregular ventricular rhythm associated with replacement of consistent P waves by rapid oscillations that vary in size, shape, and timing ✔✔Atrial fibrillation The stage that is the greatest portion of the epoch ✔✔The stage that is the greatest portion of the epoch What is the best response when a patient asks the technologist if they have sleep apnea and will need to wear a CPAP mask? ✔✔Provide the patient with educational material about sleep apnea Which of the following is the MOST LIKELY cause of a 35 minute REM latency ✔✔Untreated depression A breathing pattern characterized by at least three cycles of crescendo breathing with duration of at least 10 minutes is ✔✔Cheyne Stokes respiration An important responsibility of the scoring tech is to ✔✔Confirm accuracy of report components
Which type of calibration is based on a series of patient instructions intended to verify the signal response and quality ✔✔Physiological The most important reason for performing a MWT is to ✔✔Measure the patient's ability to resist the urge to fall asleep The importance of selecting sampling rates according to RECOMMENDED guidelines is to ✔✔Minimize aliasing effect The syndrome characterized by prolonged episodes of severe hypoxemia and associated PaCO elevation that worsens during sleep is ✔✔Obesity hypoventilation The patient's medical history indicates the patient has been taking tricyclic antidepressants for the past 5 years. The technologist should anticipate that the patient may have an increased likelihood of ✔✔REM Sleep Behavior Disorder According to RECOMMENDED guidelines, the sampling rate to provide the optimal resolution for recording EEG in a patient with suspected nocturnal seizure is ✔✔500Hz The electrode located 30% above the left pre-a crease is ✔✔C
DC Channel ✔✔PSG channel derived from an external piece of equipment such as a PAP device or oximeter. Stray Capacitance ✔✔When electrical signals from external sources interfere w/ signals derived from the pt. Amperes are measured in what units? ✔✔Coulombs/second Time Axis ✔✔Horizontal positioning of the pen.
Filter Settings for Respiratory Effort & Airflow ✔✔LFF= 0.1Hz HFF= 15Hz Filter Settings for EOG ✔✔LFF= 0.3Hz HFF= 35Hz High Level Disinfection ✔✔Used for items that come into contact w/ non-intact skin, blood, and mucous membranes. DO THE NAPS OCCUR EVERY 2 HOURS FROM THE TIME THE PREVIOUS NAP ENDED OR EVERY 2 HOURS ON THE HOU R OR HALF-HOUR? ✔✔Every 2 hours on the hour or half hour. HOW LONG BEFORE A NAP BEGINS SHOULD THE SUBJECT CEASE SMOKING? ✔✔ 30 minutes WHAT EPOCH SIZE IS BEST FOR RECORDING THE "MSLT"? ✔✔ 30 seconds. A MEAN SLEEP LATENCY OF INDICATES WHAT? ✔✔Pathological sleepiness. A normal mean sleep latency is how many minutes? ✔✔ 10 - 20 minutes How many naps must have unequivocal periods of REM to arrive at a Diagnosis of Narcolepsy? ✔✔ 2 naps.
What is the Narcoleptic Tetrad? ✔✔Excessive daytime sleepiness, hypnagogic hallucinations, sleep paralysis, cataplexy. How is the mean sleep latency calculated? ✔✔Sum of all latencies, divided by total# of naps. During REM, inhibition of thermoregulatory mechanisms lead to what state? ✔✔Poikilothermia. What equation best expresses time constant? ✔✔TC= C x R TC=Time Constant C= Capacitance R= Resistance What sleep stage requires at least 20% but no more than 50% of the epoch to consist of wave of 2 cps or slower w/amplitudes greater than 75 uV. ✔✔Stage 3. AN EPOCH THAT DOES NOT MEET THE CRITERIA FOR ACTIVE SLEEP OR QUITE SLEEP IS CALLED WHAT? ✔✔Intermediate Sleep TRACE ALTERNANT PATTERN IS ASSOCIATED WITH WHAT STAGE OF SLEEP IN THE INFANT? ✔✔Quiet Sleep (NREM Sleep)
Pre-sleep Questionnaire ✔✔standardized form that reviews issues related to sleep, but tech asks additional questions for clarification, as needed. The questionnaire determines if the patient's preceding 24 hrs was normal for that individual. Bed-Partner Questionnaires ✔✔Filled out by the patient's bed partner (or roommate or parent in some cases) with the patient's permission. The partner typically is aware of snoring or periods of apnea even though the patient may not be aware. Morning Questionnaire ✔✔Takes place in the morning after PSG; May come in the form of a checklist, or the tech may ask specific questions regarding sleep quality,onset to sleep time,number of arousals,TST,Differences between sleeping at home and in lab, and Sleepiness upon awakening.-If pt reports sleep was very different from home, repeat PSG may be warranted. Morning/Evening Questionnaires ✔✔asks 19 questionnaires about time preferences to determine if patient is a morning,evening, or neutral person. Excessive Daytime Sleepiness ✔✔increasing societal problem related to lack of adequate sleep, causing the patient to feel sleepy during the waking hours to the point that the patient may fall asleep or feel the need to nap. Fatigue ✔✔General feeling of tiredness, weakness, or lack of energy and may be related to physical or emotional problems.
"Do you feel the need to sleep during the daytime?" "Do you feel drowsy?"---are questions a tech should ask to determine if they are experiencing EDS or Fatigue? ✔✔EDS "Do you feel as though you have no energy?" "Do you feel weary or weak?"---are questions a tech should ask to determine if they are experiencing EDS or Fatigue? ✔✔Fatigue Stanford Sleepiness Scale ✔✔brief assessment used a number of different times a day to determine if people have excessive daytime sleepiness (EDS). Epworth Sleepiness Scale ✔✔evaluates how likely a person is to fall asleep during a number of different activities. The person rates each situation on a scale of 0-3 corresponding to the chance of falling asleep (none, slight, moderate, or high). Sleep-Wake Activity Inventory (SWAI) ✔✔Measures a number of different aspects of sleep disorders:excessive daytime sleepiness, nocturnal sleep,relaxing ability,energy, etc.-asks patient to score 9 different statements about sleepiness on a 1-9 scale. (A score of 50 or more is normal, 40 - 50 suggests EDS, 40 or less indicated EDS. Fatigue Severity Scale ✔✔list of nine descriptions related to fatigue; patient scores each statement on a 1-7 scale (strongly disagree to strongly agree). Scores of 9-35=normal; scores above 35 suggest high degree of fatigue.