For Poly Test 1 Flashcards
1
Q
What are the modified EEG derivations?
A
F4-M1 C4-M1 O2-M1 Back up electrodes are F3-M2 C3-M2 O1-M2
2
Q
What are the recommended EOG derivations and electrode positions?
A
E1-M2
E2-M2
Another acceptable EOG derivations and electrode position is
E1-Fpz and E2-Fpz
3
Q
What are the recommended positions of the EOG?
A
E1 is placed 1cm below the left lower outer canthus
E2 is placed 1cm above the right upper outer canthus
4
Q
What are the recommended EMG placement of the Chin?
A
Midline 1 cm above the inferior edge of the mandible
2 cm below and to the right of the the inferior edge of the mandible
2 cm below and to the right of the the inferior edge of the mandible
5
Q
With EOGs what does vertical and horizontal eye movement deflections show?
A
Vertical show In-Phase deflections
Horizontal shows out of phase deflections
Looking left the back of the retina is negative and the front of the cornea is postive so the postive portion you get a downward deflection & right eye you get a negative deflection
6
Q
Rules for Obstructive Apnea
A
A drop of ≥90% from baseline along WITH Cessation of airflow for 10 seconds or more with Ab & Thoracic effort that is terminated by an arousal and/or desaturation but doesn’t need arousals or desaturation to be an apnea.
7
Q
Rules of Central Apnea
A
A drop of ≥90% from baseline along with Cessation of airflow for 10 seconds or more WITHOUT Ab & Thoracic Effort that is terminated by an arousal and/or or desaturation. With central apnea you have Chemoreceptor irregularities seen in patients with stroke or neurologic disorder
8
Q
Rules of Mixed Apnea
A
A drop of ≥90% from baseline along with Cessation of airflow ≥ 10s (in Adults) with respiratory effort. There is a absent inspiratory effort in the initial portion followed by resumption in inspiratory effort in second portion of event
9
Q
Rules of Hypopnea
A
The peak signal drops by 30% or MORE in THE nasal pressure or PAP flow (titration study) that last 10 seconds or more with either a (1A) ≥3% or (1B) ≥ 4% oxygen desaturation from baseline or the event is associated with an arousal. (1B doesn’t have arousal)
10
Q
Rules of RERA (Respiratory Effort Related Arousal)
A
A sequence of breaths lasting ≥ 10 seconds with an increase in respiratory effort or by flattening of the inspiratory portion of the nasal pressure or PAP device flow waveform leading to arousal from sleep
11
Q
Rules of Upper Airway Resistance Syndrome - UARS
A
Typically greater then 10 arousals/hour, normally no oxygen desaturations. Muscles of the upper airway relax and cause airway narrowing. Results in RERAs NOT apena or hypopnea. Results in an arousal secondary to increased work of breathing, measured in most labs by nasal pressure transducer. Gold Standard is esophageal balloon. UARS = RERAs
12
Q
Determination of Arousals - Criteria
A
Abrupt shift in EEG frequency for greater then 3 seconds. Must have 10 seconds of intervening sleep before calling the EEG event. In REM must include simultaneous increase in chin EMG (EMG increase must be greater 1 second).
13
Q
Score Cheyne-Stokes Breathing if both rules are met
A
a. An episodes of 3 or more consecutive central apneas and/or central hypopneas separated by a crescendo and decrescendo change in breathing amplitude with a cycle length of 40 or more seconds.
b. There are ≥5 central apneas and/or central hypopneas per hour of sleep associated with the crescendo/decrescendo breathing pattern recorded over ≥2 hours of monitoring.
14
Q
When would you score stage W?
A
When 50 % or more of the epoch has alpha rhythm over the occipital region.
15
Q
How would you score stage W without visually noticeable alpha rhythm?
A
With out Alpha you look for:
Eyes blinking at a frequency of 0.5 - 2 Hz
Reading eye movements
Irregular, Conjugate (same) rapid eye movement associated with normal or high chin muscle tone.
What happens if the patient is disconnected from the recording equipment? Score as stage W (Brief episodes of sleep during this time, if they occur, are not considered significant for the stage scoring summary)
16
Q
What is the Frequency for BATD?
A
Beta = 13 Hz and up Alpha = 8 to 13 Hz Theta = 4 to 7 Hz Delta = Less than 4 Hz
17
Q
What is the Frequency and amplitude of Delta (N3) slow wave activity?
A
Frequency is 0.5-2 Hz
Peak to peak amplitude of greater than 75 uv
Measured in the frontal EEG
18
Q
Voltage / Sensitivity = What
A
the signal Deflection (mm)
19
Q
What stage has a Frequency of greater than 13 cps. Has a wave compressed at 10 mm/s, low amplitude, mixed frequency when awake with eyes open.
A
Beta Activity
20
Q
What stage has a frequency of 8 to 13. Is Maximal in occipital leads (O1,O2), with eyes closed. Has a variable amplitude and attenuates (reduces) with eyes open.
A
Alpha Activity.
21
Q
When to score Stage W?
A
Score epochs as stage W when greater than 50 % of the epoch has alpha rhythm over the occipital region.
22
Q
For any epochs without visual alpha rhythm score stage W if any of the following is present:
A
- Eye blinks at a frequency of 0.5-2 hz
- Reading eye movements
- Irregular conjugate (same) rapid eye movements associated with high or normal chin EMG
23
Q
What are the 4 eye movements seen in stage W of sleep recording?
A
Eye Blinks
Reading eye movements
Rapid eye movements
Slow eye movements
24
Q
When to score Stage N1.
A
EEG has Less than 50% is alpha activity
Low amplitude, mixed frequency (LAMF) predominantly 4-7 hz
May have vertex sharp waves
No K complex or spindles ( in 1st half of epoch)
EOG shows slow eye movements (SEM’s)
The EMG is variable, and may decrease from wake. Snore artifacts may occur in the EMG
25
What is a characteristic of N1 sleep?
Vertex sharp waves with a duration of less than < 0.5 sec.
| Maximal seen over the central region and distinguished from backround activity
26
When does Stage N1 begin?
When you see any of the following.
The activity is 4 -7 Hz
You see vertex sharp waves or slow eye movements.
27
What is the Frequency range for theta (N1) activity?
4 - 7 Hz
28
What are some common characteristics of N2?
Spindles that are seen in the central region.
| K complexs that are not associated with an arousal and are seen in the frontal region
29
What does Benzodiazepine hypnotics increase?
The density or number of sleep spindles seen in a given time period.
30
What is the minimum lifespan of a sleep spindle?
.5 seconds form 2 to 4 a cycles in adults and 6 to 7 cycles in young
31
What is a characteristics of K- complexes?
It has a negative sharp wave followed by a positive deflection
the duration is at least 0.5 seconds
There is no specific amplitude criteria
K complexs are seen maximally in the frontal EEG.
32
When do you begin scoring N2?
When 1 or both of the following occur during the first half of that epoch or the last half of the previous epoch.
One or more K complex that is not associated with an arousal and there is more than one spindle.
33
What could end stage N2?
An arousal or transition to stage W
34
Where are K complexes seen Maximally?
K complexs are seen maximally in the frontal EEG.
35
What are the Rules for major body movements?
Stage W if alpha is present for part of the epoch.
It's still Stage W if no alpha is present and the epoch either precedes or follows the epoch with movement
Otherwise, score the epoch as the same stage as the epoch that follows it.
36
When would you score as a major body movement?
When movement and muscle artifacts obscure the EEG for more than Half (15 sec) of an epoch to the extent that the sleep stage cannot be determined.
37
According to the AASM Scoring Manual, what is the frequency range for eye blinks?
0.5 - 2 Hz
38
According to the AASM Scorning Manual, what is the duration of a vertex wave in N1?
<0.5 (Half second or less)
39
For Patients who do not generate alpha rhythm, what may begin Stage N1?
Onset of slow eye movements
40
The AASM Scoring Manual notes that K complexes are usually Maximal in amplitude when recorded from which of the following derivations?
F4 - M1
41
If an Epoch contains a Major body movement and alpha rhythm, what is the sleep stage of that epoch?
Stage W
42
What does bruism look like? Hint: look at the Chin EMG
a. Bruxism may consist of brief (phasic) or sustained (tonic) elevations of chin EMG activity that are at least twice the amplitude of background EMG.
b. Brief elevations of chin EMG activity are scored as bruxism if they are 0.25-2 seconds in duration and if at least 3 such elevations occur in a regular sequence.
c. Sustained elevations of chin EMG activity are scored as bruxism if the duration is more than 2 seconds.
d. A period of at least 3 seconds of stable background chin EMG must occur before a new episode of bruxism can be scored.
e. Bruxism can be scored reliably by audio in combination with polysomnography by a minimum of 2 audible tooth grinding episodes/night of polysomnography in the absence of epilepsy.
43
What is the sensitivity, L/H filter and sampling rate for The EEG and EOG channels?
Sensitivity 5-7 Uv/mm LFF/HFF 0.3-35 Hz Sampling rate 200 - 500 Hz
44
What is the sensitivity, L/H filter and sampling rate for The EMG and snoring sound channels?
Sensitivity 10 Uv/mm LFF/HFF 10-100 Hz Sampling rate 200 - 500 Hz Note: the snoring channel has no sensitivity
45
What is the sensitivity, L/H filter and sampling rate for The EKG channels?
Sensitivity 20 Uv/mm LFF/HFF 0.3-70 Hz Sampling rate 200 - 500 Hz
46
What is the sensitivity, L/H filter and sampling rate for The Respiratory channels?
(Airflow, Nasal Pressure, Rib cage movements) No Sensitivity LFF/HFF 0.1-15 Hz Sampling rate 25 - 100 Hz
47
What is the sensitivity, L/H filter and sampling rate for Oximetery?
No Sensitivity, No LFF/HFF, Sampling rate 10 - 25 Hz
48
What is the sensitivity, L/H filter and sampling rate for Esophageal Pressure?
No Sensitivity, No LFF/HFF, Sampling rate 25 - 100 Hz
49
What is the sensitivity, L/H filter and sampling rate for The body position?
No Sensitivity, No LFF/HFF, Sampling rate 1 - 1 Hz
50
What is the placement of the chin electrodes?
One electrode in the midline 1cm above the inferior edge of the mandible; below 2cm to the right of the midline; below 2cm to the left of the midline.
51
What are the criteria for stage W?
Alpha rhythm in the occipital regions; conjugate (same) vertical eye movements of 0.5 - 2Hz; trains of conjugate (same) eye movements consisting of a slow phase followed by a rapid phase in the opposite direction; rapid eye movements; and normal or high chin EMG
52
What are the rules for scoring stage W?
More than 50% of the epoch has alpha rhythm over the occipital region If Stage W doesn't have alpha then look for a) eye blinks of 0.5 - 2 Hz b) reading eye movements; c) irregular conjugate rapid eye movements associated with normal or high chin muscle tone
53
What are the criteria for scoring a stage as N1?
Slow eye movements that are reasonably regular and have an initial deflection usually lasting >500 msec; low amplitude, mixed frequency (4-7 Hz) activity; vertex sharp waves; and sleep onset
54
What are the criteria for scoring a stage as N2?
If one or both happen during the first half of the epoch or the last half of the previous epoch. a) one or more k complexes unassociated with arousals b) one or more trains of sleep spindles
55
What are the criteria for scoring stage N3?
20% or more of epoch consists of slow wave activity (0.5 - 2 Hz with peak to peak amplitude of >75 uV measured over the frontal regions mirrored in the EOGs)
56
What is a vertex sharp wave?
Sharply contoured waves with a duration of <0.5 seconds maximal over the central regions and distinguishable from the background activity.
57
What is the criteria for scoring stage N1?
Attenuated (reduced) alpha rhythm replaced by low amplitude mixed frequency activity for more that 50% of epoch
58
How is sleep latency different in those that do not generate alpha rhythm?
Shorter than normal
59
What are the scoring criteria for stage R sleep?
a) low amplitude, mixed frequency EEG; b) low chin EMG tone; c) rapid eye movements
60
What are the rules for stage N1 in patients that do not generate alpha?
4-7 Hz activity with slowing background frequencies by at least 1 Hz from Wake, vertex sharp waves and slow eye movements
61
What kind of eye movements are typical in N3 sleep?
Eye movements are not typically seen during stage N3 sleep
62
What are some characteristics of stage R sleep?
Rapid eye movements, low chin EMG tone; Sawtooth waves 2-6 Hz over central regions, often preceding a burst of rapid eye movements; transient (short time) muscle activity
63
What is the rule that defines the continuation of stage N2 sleep?
Continue to score epochs with low amplitude, mixed frequency EEG activity without K complexes or sleep spindles as stage N2 if they are preceded (come before) by a) K complexes unassociated with arousals or b) sleep spindles
64
What criteria define the end of a period of stage N2 sleep?
End stage N2 sleep when 1 of the following occur: a) transition to stage W; b) an arousal changes it to stage N1 until a K complex unassociated with an arousal or a sleep spindle occurs; c) a major body movement followed by slow eye movements and low amplitude mixed frequency EEG without nonarousal associated K complexes or sleep spindles; d) transition to stage N3; e) transition to stage R.
65
What is the rule that defines the continuation of a period of stage R sleep?
Continue to score stage R sleep, even in the absence of rapid eye movements, for epochs following 1 or more epochs of stage R if the EEG continues to show low amplitude mixed frequency activity without K complexes or sleep spindles and the chin EMG tone remains low.
66
What are the rules defining the end of stage R sleep?
a) there is a transition to stage W or N3; b) an increase in chin EMG tone above the level of stage R is seen and criteria for N1 are met; c) an arousal occurs followed by low amplitude, mixed frequency EEG and slow eye movements, which would be scored as N1; d) a major body movement followed by slow eye movements and low amplitude mixed frequency EEG without non-arousal associated K complexes or sleep spindles; e) one or more non-arousal associated K complexes or sleep spindles are present in the first half of the epoch in the absence of rapid eye movements, even if chin stays low.
67
What are the rules for scoring epochs with major body movement?
a) if alpha rhythm is present for part of the epoch, score as W; b) if no alpha is discernible, but an epoch scorable as stage W either precedes or follows the epoch with a major body movement, score as W; c) otherwise, score the epoch as the same stage that follows it.
68
What is the rule for scoring arousals?
Score arousal in every stage if there is an: Abrupt shift of EEG frequency including alpha, theta and/or frequencies > 16 Hz (but not spindles) that lasts 3 seconds with 10 seconds of stable sleep preceding the change. Scoring of arousal during REM requires a concurrent increase in submental EMG lasting at least 1 second.
69
Scoring Bruxism
a. Bruxism may consist of brief (phasic) or sustained (tonic) elevations of chin EMG activity that are at least twice the amplitude of background EMG.
b. Brief elevations of chin EMG activity are scored as bruxism if they are 0.25-2 seconds in duration and if at least 3 such elevations occur in a regular sequence.
c. Sustained elevations of chin EMG activity are scored as bruxism if the duration is more than 2 seconds.
d. A period of at least 3 seconds of stable background chin EMG must occur before a new episode of bruxism can be scored.
e. Bruxism can be scored reliably by audio in combination with polysomnography by a minimum of 2 audible tooth grinding episodes/night of polysomnography in the absence of epilepsy. An additional masseter electrodes may be placed at the discretion of the investigator or clinician.
70
What are the scoring rules for sinus tachycardia during sleep?
A sustained sinus heart rate of greater than 90 beats per minute for adults.
71
What are the scoring rules for bradycardia during sleep?
A sustained heart rate of less than 40 beats per minute for ages 6 through adult.
72
What are the scoring rules for asystole?
Cardiac pauses greater than 3 seconds 6 through adult.
73
What are the scoring rules for wide complex tachycardia?
A rhythm lasting a minimum of 3 consecutive beats at a rate greater than 100 per minute with QRS duration of Greater Than or Equal to 120 msec.
74
What are the scoring rules for narrow complex tachycardia?
A rhythm lasting a minimum of 3 consective beats at a rate of greater than 100 per minute with QRS duration of LESS than 120 msec
75
What are the scoring rules for atrial fibrillation?
An irregularly irregular ventricular rhythm associated with replacement of consistent P waves by rapid oscillations that vary in size, shape and timing.
76
Define sleep onset.
The start of the first epoch scored as any stage other than W it is lights out to the first epoch of sleep.
77
What is the rule for an arousal to be associated with a K-complex?
It must occur 1 second after the termination of the K-complex to be an arousal.
78
What are the criteria for ending N2?
Transition to W, N1, N3 or R; an arousal to N1; a major body movement followed by slow eye movements and LVMF EEG w/o N2 criteria
79
What are the characteristics of N3?
EEG of 0.5-2Hz, best seen in C3/C4; 20% of epoch Amplitudes >75uV; EMG is variable, but often lower than N2 and sometimes as low as R; 20-25% of total sleep time.
80
Describe sawtooth waves.
Sharply contoured EEG activity of 2-6Hz, best observed in C3/C4 during REM; they often come before (precede) a burst of REMs.
81
```
Calibration voltage (uV) / Sensitivity (uV/mm) = Signal deflection (mm)
Calibration voltage (uV) / Signal deflection (mm) = Sensitivity (uV/mm)
Signal deflection (mm) x Sensitivity (uV/mm)= Calibration
```
```
Voltage (uv) Calibration voltage (uV) / Sensitivity (uV/mm) = Signal deflection (mm)
Calibration voltage (uV) / Signal deflection (mm) = Sensitivity (uV/mm)
Signal deflection (mm) x Sensitivity (uV/mm)= Calibration Voltage (uv)
```
82
T or F DC amplifers have no LFF or TC filter to filter out lower frequency signals.
True
83
What is a Differential Amplifiers that amplify the difference between two inputs and, by cancelation, eliminate identical signals occuring at both inputs.
Common Mode Rejection
84
With polarity a negative and positive potential difference will cause what type of signal deflection?
A negative potential difference will cause an upward signal deflection
A positive potential difference will cause an downward signal deflection.
85
What does the HFF and LFF do?
The HFF reduces (attenuates) the signal above the cut off frequency of the filter.
The LFF reduces (attenuates) the signal below the cut off frequency.
86
What does a 60 Hz notch filter do?
A 60 Hz notch filter filters out a narrow band of frequencies and helps to eliminate interference. It is only used as a last resort.
87
What does the sensitivity/gain setting do?
It makes the amplifier more or less sensitive to voltages. Sensitivity (also called gain) directly affects the amplitude of a signal.
88
What sensitivity setting will adequately record most normal background EEG activity?
7 uV/mm (5-7uVmm) in adults
| 10 uV/mm in Children
89
What does the Nyquist sampling theorem state?
the sampling rate must be at least twice the frequency that you want to record in order to adequately represent the data.
90
When does Aliasing occur?
When the sampling rate is inadequate to reproduce the signal being sampled.
91
Explain the 3 different epoch windows for EEG
EEG sleep staging is performed in a 30 second epoch
Respiratory scoring is typically performed in a 120 second epoch . Epileptiforms (seizure activity, spikes, etc) are typically fast, small waveforms and are read in a 10 second epoch window.
92
What is the capnography interfaced with?
The Capnography is interfaced with a DC to AC convertor.
93
What is the Recommended PSG paramaters
1. EEG Derivations
2. EOG Derivations
3. Chin EMG
4. Leg EMG Derivations
5. Airflow Parameters
6. Effort Parameters
7. Oxygen Saturation
8. Body Position
94
What is the EPWORTH SLEEPINESS SCALE?
```
The Epworth Sleepiness Scale an eight question survey widely used in the field of sleep medicine as a subjective measure of a patient's sleepiness.
• No chance of dozing =0
• Slight chance of dozing =1
• Moderate chance of dozing =2
• High chance of dozing =3
```
95
When you finish up the EPWORTH SLEEPINESS SCALE test, add up the values of your responses.
What is the range of the scale?
Your total score is based on a scale of 0 to 24. The scale estimates whether you are experiencing excessive sleepiness that possibly requires medical attention
1 - 6 Congratulations, you are getting enough sleep!
7 - 8 Your score is average
9 and up Seek the advice of a sleep specialist without delay
the higher the # the more likely a person would fall asleep during the day time.
MSLT
96
What is Ohms law?
Ohm's Law is made from 3 mathematical equations that shows the relationship between electric voltage, current and resistance.
V = I x R (Voltage = Current multiplied by Resistance)
R = V / I (Resistance = Voltage divided by Current)
I = V / R (Current = Voltage Divided by Resistance)
V is voltage measured in volts (the size of the water tank),
I is current measured in amperes (related to the pressure (Voltage) of water thru the pipes and faucet) and
R is resistance measured in ohms as related to the size of the pipes and faucet:
97
What is Sundowning?
Sundowning refers to a state of confusion at the end of the day and into the night. Sundowning can cause a variety of behaviors, such as confusion, anxiety, aggression or ignoring directions. Sundowning can also lead to pacing or wandering. Sundowning isn't a disease, but a group of symptoms that occur at a specific time of the day that may affect people with dementia, such as Alzheimer's disease.
98
What is Tachypnea?
a condition of rapid breathing
99
What is Wittmaach-Ekborn syndrome related to?
Restless Leg syndrome
100
After completing an overnight CPAP study what is the appropriate method for disinfecting it?
Alkaline gluteraldehyde
101
What should the technologist do to avoid electrical current leakage?
Assure proper grounding
102
What is A specific biophysical signal collected called?
Montage
103
Why is an Instrument calibration used?
To determined and document correct instrument functions
104
What should you do if a piece of equipment gives you a shock?
Protect yourself and the patient by not using it
105
A low frequency filter allows what kinds of rhythms to pass?
Rhythms with a higher frequency to pass
106
The right and left eye electrode (E1 and E2) are referenced to an electrode place over the opposite mastoid. According to polarity convention, an eye movement to the right should result in what happening?
An upward pen deflection in the right eye channel and a downward pen deflection in the left eye channel.
107
What is the low frequency filter mostly or closely related to?
The time constant
108
What are some characteristics Narcolepsy Symptoms?
EDS, Cataplexy, Hypnagogic Hallucinations, Sleep Paralysis, Fragmented Nocturnal Sleep
109
What are some of the characteristics Circadian Rhythm Disorders?
Shift Work, Jet Lag, Delayed/Advanced Sleep Phase Syndrome.
110
What are some of the characteristics of Parasomnias?
Sleepwalking, Sleeptalking, Nightmares, REM Sleep Behavior Disorder, Sleep Eating, Night Terrors.
111
How many CPS do Sawtooth Waves have?
2-6 CPS (Seen in REM).
112
How many CPS do Spindle have?
11-16 CPS
113
Rules for Arousal Scoring
Event must last at least 3 secs, w/ at least 10 secs of sleep preceding the change.
114
What does Time Constant measure?
Measure of how a signal is displayed & is determined by the voltage of signal & the low & high frequency filters used.
115
Neurotransmitters Involved in Wakefulness
Acetylcholine, Norepinephrine, Histamine, Serotonin, Dopamine & Orexins.
116
Neurotransmitters Involved in REM
Acetylcholine, Norepinephrine & Glutamate.
117
Neurotransmitters Involved in NREM
GABA
118
Normal Heart Rate During SLEEP
40-90 BPM
119
Leakage Current Must Be Below what voltage?
100 uV
120
Mobitz I (Wenckebach Block)
Rhythm: irregular
QRS: clustering, dropped
PRI: progressive lengthing
121
What are some of the characteristics Asystole
Cardiac pause for more than 3 seconds, Flat line Not good!
122
What are some of the characteristics Premature Ventricular Contraction (PVC)?
When ectopic focus in the ventricle fires independently. QRS appears WIDE & BIZARRE.
123
What are some of the characteristics Ventricular Fibrillation?
Chaotic. Waves & complexes can't be analyzed. Cannot circulate blood, causing death.
124
What are Life-Threatening Rhythms That Require Electrical Shock
V-Tach & V-Fib
125
What does MSLT (Multiple Sleep Latency Test) Measure?
Measures Sleepiness Start 1st NAP 1.5 to 3 hours after LON, 20 minute opportunity, 5 NAPS, PSG required beforehand. Sleeping environment. "Try to go to sleep."
126
What does MWT (Maintenance of wakefulness Test) Measure?
If the person can stay awake (Drivers/Pilots)
Start 1st REST PERIOD 1.5 to 3 hours after LON. 20-40 minute opportunity, 4 REST PERIODS, Non-Stimulating environment. End test after Sleep Onset. "Try to stay awake."
127
What are some Narcolepsy Symptoms?
Cataplexy (caused by laughter, anger, excitement, while fighting sleep attack, etc), Hypnagogic Hallucinations, Sleep Paralysis, Nighttime Awakenings, EDS.
128
What % of the epoch in stage N3 has slow wave sleep?
20% of epoch has Slow Wave activity
129
What does PAP Measured In?
CmH2O
130
What is the FALL Time Constant?
the amount of time in seconds it takes for the calibration signal to fall to 37% of the original amplitude is determined by the low filter setting
131
What is the RISE Time Constant?
63%
132
Tonic REM
NO Eye Movement
133
Phasic REM
Eye Movement
134
What is the pressure of Bi-Level PAP?
The pressure is >15, patents gets uncomfortable breathing, or needs ventilatory support.
135
What are 3 Types Of Respiratory Control?
Voluntary, Mechanical, Chemical.
136
How do you calculate BMI Calculation?
BMI Calculation ( Weight in Pounds / ( Height in inches x Height in inches ) ) x 703
137
What are the PLMS Scoring Requirements?
Sequence of 4. 0.5-10 sec. duration. Amplitude increase of 8 uV
138
What are some of the characteristics of Cheyne Stokes Breathing?
A breathing rhythm with a specified crescendo and decrescendo change in breathing amplitude
139
What is Dominant Posterior Rhythm in children?
An EEG pattern with frequency appropriate to age which is observed over the occipital regions during relaxed wakefulness with eyes closed and attenuates (Reduced) with eye opening or attention
140
What are some of the characteristics Excessive Fragmentary Myoclonus?
Limb EMG activity of a specified frequency and duration often unassociated with visible movement; not a defined disorder
141
What are some characteristics of Hypopnea?
Reduction in airflow lasting at least 10 seconds in adults or the equivalent of 2 breaths in chilldren
142
What are some characteristics REM Behavior Disorder?
Parasomnia characterized by relative atonia during REM & associate w/ potentially harmful dream-enacting behaviors
143
What are some characteristics of Rhythmic Movement Disorder?
Repetitive stereotyped and rhythmic motor behaviors that occur predominantly during drowsiness or sleep and involve large muscle groups
144
What stages become longer and shorter as the night of sleep goes on?
REM become longer and N3 slow wave sleep become shorter.
145
What are two characteristics of REM sleep behavior disorder (RBD)?
Sustained muscle activity in REM sleep in the chin EMG
| Excessive transient muscle activity during REM in the chin or limb EMG
146
What does a Low pass filter do?
Reduces the ampluitude of high frequency activity
147
What does a Low frequency filter do?
Reduces the ampluide of high frequency activity.
148
According to the AASM scoring manul, What is the recommended high frequency fitler setting for EMG?
100 Hz
149
What would a LFF HP filter setting of 1 Hz would do?
Reduce the ampliude of slow waves
150
A muscle artifact in the EEG channel is obsercuring sleep onset. What would temporarly be adjusted to minimize a this muscle artifact.
A High frequency filter
151
What is the recommended low frequency filter setting for respiratory channels?
0.1 Hz
152
According to the AASM Scoring Manual, which of the following is the recommended high pass filter setting for an EEG?
0.3 Hz
153
What is the time constant defined as?
The amount of time in seconds that it takes a square wave to decay to 37% of its amplitude.
154
What is the mimium sampling rate rate for the EEG, EOG, EMG, ECG, and snoring channels? Hint: Nyquist
200 Hz
155
What is the recommended minimum digital resolution?
12 bits
156
What forms the basis of the EEG signal?
Inhibitory and excititory post synaptic potentials
157
What is the frequency of AC current in the United States?
60 Hz
158
What is a property of the eye that enables EOG recording?
The cornea is electro-positive and the retina is electro negative
159
What is plugged in to the DC amplifier?
SpO2/Pulse oximetry amplifier
160
What is the differrence in Bipolar and referential derivations?
An Exploring/Bi-polar
electrode is placed over a specific site (C3 or C4)
A reference elctrode is placed over a remote, relatively inactive site (C4-M1 or C3-M2) in EEG and EOG
161
What are the 2 basic mechanisms of central sleep apnea?
Post-hyperventilation central apnea
| Central sleep apnea secondary to hypoventialtion with opioid use
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What are the 5 subtypes of cental slee apnea syndrome?
1. Primary CSA
2. CSA due to Cheyne stokes breathing pattern (CHF 30-40% of patients)
3. CSA due to medical condition which is caridac, renal or neurologic
4. CSA due to high altitude periodic breathing which is 4000 meters/13000 ft
5. CSA due to drug or substance opioids
