Deck 30: Disorders of Sleep

Question 1

Which of the following parameters is NOT typically monitored with a polysomnogram?

A)SaO₂
B)electroencephalogram (EEG)
C)breathing effort
D)exhaled PCO₂

Answer 1

D

Question 2

What value for the apnea-hypopnea index (AHI) is consistent with moderate obstructive sleep apnea?

A)5 to 15
B)15 to 30
C)above 30
D)below 5

Answer 2

B

Question 3

What term is used to describe a significant decrease in airflow during sleep but not a complete cessation of breathing?

A)apnea
B)minor apnea
C)hypopnea
D)dyspnea

Answer 3

C

Question 4

The definition of sleep apnea uses what criteria for defining an episode of apnea?

A)5 seconds
B)10 seconds
C)15 seconds
D)20 seconds

Question 5

Which of the following characteristics is not typically associated with sleep apnea?

A)male patient
B)over the age of 40 years
C)hypotensive
D)loud snoring during sleep

Question 6

Which of the following complaints is frequently seen in a patient with obstructive sleep apnea?

A)dizziness
B)chest pain
C)shortness of breath with exertion
D)excessive daytime sleepiness

Question 7

Which of the following is NOT a parameter used to confirm the metabolic syndrome associated with obstructive sleep apnea?

A)low triglycerides
B)insulin resistance
C)hypertension
D)impaired glucose intolerance

Question 8

Central sleep apnea occurs more often than obstructive sleep apnea.

Question 9

Why should the patient with obstructive sleep apnea not use alcohol?

A)Alcohol decreases the arousal threshold.
B)Alcohol increases upper airway muscle tone.
C)Alcohol increases the arousal threshold.
D)Alcohol reduces the cardiovascular compensatory mechanisms.

Question 10

Which of the following factors has been shown to positively correlate with obstructive sleep apnea?

A)age
B)height
C)obesity of the upper body
D)blood pressure at rest

Question 11

Which of the following conditions is not associated with untreated obstructive sleep apnea?

A)systemic hypotension
B)pulmonary hypertension
C)heart failure
D)myocardial infarction

Question 12

What is the name of the respiratory pattern where a crescendo-decrescendo pattern of hyperpnea alternates with periods of apnea?

A)Cheyne-Stokes
B)Kussmaul
C)agonal
D)Biot's

Question 13

Which of the following conditions are associated with central apnea?
I)congestive heart failure
II)primary central nervous system lesions
III)high-altitude hypoxemia
IV)obesity

A)I and IV
B)II and III
C)I, II, and III
D)I, II, III, and IV

Question 14

What is believed to be the cause of systemic hypertension in patients with sleep apnea?

A)hypervolemia
B)increased sympathetic tone
C)elevated CO₂
D)tachycardia

Question 15

What percent of the adult population is believed to have obstructive sleep apnea?

A)<1%
B)2% to 4%
C)5% to 10%
D)unknown

Question 16

What are the criteria to define hypopnea?

A)20% decrease in airflow and 4% oxygen desaturation
B)20% decrease in airflow and 2% oxygen desaturation
C)30% decrease in airflow and 4% oxygen desaturation
D)30% decrease in airflow and 2% oxygen desaturation

Question 17

What is the primary cause of obstructive sleep apnea?

A)small or unstable pharyngeal airway
B)deviated septum
C)unstable larynx
D)large tongue

Question 18

Which of the following physical exam findings is associated with obstructive sleep apnea?

A)large tonsils
B)microcephaly
C)macroglossia
D)deviated nasal septum

Question 19

Which of the following medical therapies is considered first-line treatment for obstructive sleep apnea (OSA)?

A)continuous positive airway pressure (CPAP)
B)surgery
C)oxygen therapy
D)antibiotics

Question 20

Which of the following behavioral interventions is least useful for the treatment of sleep apnea?

A)weight loss
B)avoidance of alcohol
C)avoidance of sedatives
D)avoidance of daytime naps

Question 21

What term is used to describe CPAP units that use a computer to adjust CPAP levels as needed by the patient during sleep?

A)min-CPAP
B)max-CPAP
C)retro-CPAP
D)auto-CPAP

Question 22

Patients with more severe levels of OSA usually need higher levels of CPAP to eliminate the apnea episodes.

Question 23

Which of the following is NOT a common side effect of positive-pressure therapy?

A)dry nasal mucosa
B)claustrophobia
C)skin irritation
D)headache

Question 24

How does CPAP improve breathing in the patient with OSA?

A)stimulation of the phrenic nerve
B)pneumatic splinting of the upper airway
C)stimulation of upper airway muscles
D)repositioning of the epiglottis

Question 25

Medications have proved ineffective for most patients with sleep apnea.

Question 26

Uvulopalatopharyngoplasty has a success rate of less than 50%.

Question 27

What is considered to be the major problem with the use of CPAP in patients with obstructive sleep apnea?

A)patient compliance
B)frequent pneumothorax
C)cardiovascular complications
D)expense

Question 28

Available evidence has shown that bilevel pressure is associated with better patient compliance than the conventional CPAP.

Question 29

In what way do BiPAP units differ from CPAP units?

A)BiPAP applies different pressure levels on inspiration and exhalation.
B)BiPAP units cost significantly more that CPAP units.
C)BiPAP operates on electricity.
D)BiPAP simulates spontaneous breathing.

Question 30

What is the amount of CPAP that is typically required to abolish upper airway obstruction in patients with OSA?

A)3 to 5 cm H₂O
B)10 to 20 cm H₂O
C)2.5 to 7.5 cm H₂O
D)7.5 to 12.5 cm H₂O

Question 31

Oral devices may prove useful for cases of mild OSA.