Quiz - Sleep

Question 1

Amplitude

Answer 1

Voltage of EEG waves; generally expressed in microvolts

Question 2

Voltage

Answer 2

Electric potential or potential differences expressed in volts

Question 3

Frequency

Answer 3

Number of complete cycles, repetitive waves or complexes in one second; measured in hertz (Hz) (cps)

Question 4

Epoch

Answer 4

30 second picture of physiologic tracings

Question 5

Alpha

EEG Waveform

Answer 5

8 - 13 Hz

Question 6

Theta

EEG Waveform

Answer 6

4 - 7 Hz

Question 7

Sleep Spindles

EEG Waveform

Answer 7

12 - 14 Hz

Question 8

K-Complex

EEG Waveform

Answer 8

0.5 seconds

Question 9

Delta

Answer 9

…

Question 10

Wake

Answer 10

EEG - Electroencephalogram
 - Low Voltage
 - Mixed Frequency EEG
 - Alpha 8 - 13 Hz (cps)
EOG - Electoculogram
 - Open - blinking (REM)
EMG - Electromyogram
 - Very high muscle tone

Question 11

Wake

Answer 11

Characterized by the patient being awake. During wakefulness, the patient may be physically active or inactive. In active patients, movement artifact occurs because of muscle or body movements. Eye blinks are seen as well. When the eyes are closed, the occipital channels often present alpha activity.

Question 12

Stage N1 NREM

Answer 12

EEG - Electroencephalogram
 - Low voltage
 - Mixed frequency EEG
 - Theta 4 - 7 Hz (cps)
 - Vertex sharp waves
EOG - Electroculogram
 - Slow rolling eye movements
EMG - Electromyogram
 - Slightly lower muscle tone than wake
Drowsy stage

Question 13

Stage N1 NREM

Answer 13

Comprises 10% of total sleep time in normal healthy adults. Often called a transitional stage of sleep, meaning it represents the transition from wakefulness to sleep. Patient is easy to arouse and may still be able to hear noises in the room and think they are still awake.

Question 14

Stage N2 NREM

Answer 14

EEG - Electroencephalogram
 - Low voltage
 - Mixed frequency EEG
 - Presence of spindles 12 - 14 Hz (cps) or
 - K-Complexes 0.5 seconds
EOG - Electroculogram
 - No eye movements
EMG - Electromyogram
 - Slightly lower muscle tone than N1

Question 15

Stage N2 NREM

Answer 15

Comprises approximately 50% of total sleep time in normal healthy adults.

Question 16

Stage N3 NREM

Answer 16

EEG - Electroencephalogram

• 75 uv Delta 0.5 - 2.0 Hz
• Delta Sleep

Question 17

Stage N3 NREM

Answer 17

Comprises 25% of total sleep time in normal healthy adults. It is often very difficult to arouse a patient from N3. Referred to as Slow Wave Sleep (SWS). It is that stage where human growth hormone is released. It is the stage where physical restoration and repair of body tissue and muscles occur. Decreases with age.

Question 18

Stage R REM

Answer 18

EEG - Electroencephalogram
 - Low voltage, mixed frequency
 - Sawtooth waves
EOG - Electroculogram
 - Rapid Eye Movement (REM)
EMG - Electromyogram
 - Lowest of recording (atonia)

Question 19

Stage R REM

Answer 19

Comprises 25% of total sleep in normal healthy adults. Dreaming occurs. Beneficial in restoring the mind, in creating long term memory and in restoring wakefulness and alertness. Tends to be short at the beginning of the sleep period but progressively increases as the night goes on. Body core temp is not regulated during REM. Irregular respirations. Muscle atonia.

Question 20

Hypopnea

Answer 20

Significant decrease in ventilation without apnea

Question 21

Cheyne - Stokes

Answer 21

Most common

Gradual increase then gradual decrease in respiration rate and tidal volume followed by apnea

Question 22

Arousal

Answer 22

State of responsiveness to sensory stimulation

Question 23

Event

Answer 23

Occurrence or result of occurrence

Question 24

Apnea Hypopnea Index (AHI)

Answer 24

Number of apneas and hypopneas x 60/TST = events per hour
Normal < 5
Mild OSA < 15
Moderate OSA - 16 - 30
Severe OSA > 30

Question 25

Apnea

Answer 25

Complete cessation of airflow greater than/equal to 10 seconds. Caused by obstruction or abdominal nervous system control. 84 different sleep disorders

Question 26

Central Sleep Apnea (CSA)

Answer 26

Not as common as OSA, caused by CNS lesion, stroke, CHF, and alternate sickness

Question 27

Mixed Sleep Apnea (MSA)

Answer 27

Combo OSA/CSA
Initially CSA (no effort/air) evolves into obstructed (no airflow/some effort)

Question 28

Polysomnogram (PSG)

Answer 28

• An overnight test used to confirm sleep disorders breathing
• Goal is to obtain 6 - 7 hours of testing
• Patient completes a questionnaire regarding sleep patterns and daytime symptoms prior to testing

Question 29

Multiple Sleep Latency Test (MSLT)

Answer 29

Involves 4 or 5 naps each separated by 1.5 hours of wakefulness. The MSLT is the benchmark standard for screening for narcolepsy.

Question 30

Treatment options for sleep apnea

Answer 30

• Behavioral modification
• Medical appliances
• Surgical intervention

Question 31

Treatment goals for sleep apnea

Answer 31

• Eliminate apnea, hypopnea and snoring
• Normalize oxygenation and ventilation
• Improve sleep continuity - evaluated during pap titration

Question 32

Narcolepsy

Answer 32

Tendency to sleep at inappropriate times (exact cause is not known)

Question 33

Insomnia

Answer 33

Inability to fall or stay asleep

• Transient (few nights < 4 weeks)
• Short-term (4 weeks - 6 months_
• Chronic (>6 months)

Question 34

Parasomnias

Answer 34

Sleepwalking/talking, night terrors, bruxism