Question 1

Most people who snore do not have OSA,but almost all patients with OSA snore.&#10;A) Both statements are true.&#10;B) Both statements are false.&#10;C) The first statement is true, the second statement is false.&#10;D) The first statement is false, the second statement is true.

Accepted Answer

In the Wisconsin Sleep Cohort Study of subjects aged 30 to 60 years,44% of men and 28% of women were habitual snorers,but only 4% of the men and 2% of the women had OSA.

Question 2

Which of the following are the most common sites of airway narrowing or closure during sleep for a patient with obstructive sleep apnea (OSA)?&#10;A) the retropalatal and retroglossal regions&#10;B) septal deviation and enlarged turbinates&#10;C) hypertrophic adenoids and tonsils&#10;D) redundant parapharyngeal folds

Accepted Answer

The most common sites of airway narrowing or closure during sleep are the retropalatal and retroglossal regions.Anatomic narrowing may occur at any site in the upper airway,from the nasal cavity to the larynx.Most patients with OSA have more than one site of narrowing.

Question 3

Which of the following is true of tongue-retaining devices (TRDs)used to treat patients with sleep-related breathing disorders?&#10;A) They typically are made of acrylic resin and are composed of two pieces that cover the upper and lower dental arches.&#10;B) Over 70 different types of TRDs have been approved by the FDA for treatment of obstructive sleep apnea (OSA).&#10;C) TRDs are capable of providing continuous positive airway pressure (CPAP).&#10;D) TRDs generally are made of silicone in the shape of a bulb or cavity.

Accepted Answer

The tongue is stuck into the bulb,which is then squeezed and released,producing a suction that holds the tongue forward in the bulb.Mandibular advancement devices (MADs)typically are made of acrylic resin and cover the upper and lower dental arches.Only one design of tongue-retaining device has been approved by the FDA for treatment of OSA.

Question 4

Which of the following is true about primary snoring?&#10;A) Primary snoring is associated with fragmentation of sleep architecture.&#10;B) Primary snoring is not associated with disrupted sleep or complaints of daytime sleepiness.&#10;C) Primary snoring is also known as upper airway resistance syndrome (UARS).&#10;D) Primary snoring is characterized by episodes of complete cessation of breathing due to airway obstruction during sleep.

Accepted Answer

Primary snoring is sometimes referred to as simple snoring or benign snoring.Findings on an overnight sleep study are normal.UARS is a clinical entity midway between primary snoring and obstructive sleep apnea (OSA)that is characterized by snoring,complaints of daytime sleepiness,and fragmentation of sleep.OSA is characterized by loud snoring and excessive daytime sleepiness with episodes of complete cessation of breathing (apnea)or significantly decreased ventilation (hypopnea)due to airway obstruction during sleep,along with significant fragmentation of sleep architecture.

Question 5

Which of the following components of a polysomnogram (PSG)is used to monitor eye movements?&#10;A) ECG&#10;B) EEG&#10;C) EMG&#10;D) EOG

Accepted Answer

The electrooculogram (EOG)is used to monitor eye movements.The electrocardiogram (ECG)monitors heart rate and rhythm,the electroencephalogram (EEG)is used to monitor brain waves,and the electromyogram (EMG)is used to monitor jaw muscular activity.

Question 6

Which of the following is the most successful surgical treatment for OSA in children?&#10;A) uvulopalatopharyngoplasty (UPPP)&#10;B) radiofrequency volumetric tissue reduction (RVTR)&#10;C) adenotonsillectomy&#10;D) laser-assisted uvulopalatoplasty (LAUP)

Accepted Answer

Adenotonsillar hypertrophy is the most common cause of upper airway obstruction in children; adenotonsillectomy is curative in 75% to 100% of such cases.

Question 7

Approximately what percentage of patients who try positive airway pressure (PAP)for treatment of obstructive sleep apnea (OSA)are able to tolerate it?&#10;A) 100&#10;B) 75&#10;C) 50&#10;D) 25

Accepted Answer

Compliance with PAP has long been a problem,with only about 50% of patients who try it able to tolerate it.Of those who do use PAP,the average patient uses it for only about 4 to 5 hours per night and for only about 5 nights per week.Adverse effects with PAP are common and include mask leaks,skin ulceration or irritation under the mask,epistaxis,rhinorrhea,nasal congestion,sinus congestion,dry eyes,conjunctivitis,ear pain,and claustrophobia.

Question 8

Which of the following is characteristic of REM sleep?&#10;A) synchronous brain waves&#10;B) low-voltage EEG waves&#10;C) mental inactivity&#10;D) physiologic stability

Accepted Answer

A key feature of REM sleep is the presence of periodic rapid movement of the eyes with low-voltage EEG waves resembling those typical of wakefulness.REM sleep is characterized by asynchronous brain waves,an active brain,physiologic instability,and muscular inactivity.The REM sleep state often is described as "an active brain in a paralyzed body." Dreaming occurs during REM sleep.

Deck 9: Sleep-Related Breathing Disorders