Scoring and Sleep Stages

Question 1

What is orthopnea?

Answer 1

Difficulty breathing except in an upright position.

Question 2

What is Cheyne-Stokes breathing? How long does it usually last?

Answer 2

Gradually increasing, then decreasing rate and depth. Lasts 30-180 seconds. (Cheyne-Stokes is a good guess on test questions.)
D-6

Question 3

What causes Cheyne-Stokes Breathing? (x6)

Answer 3

Central sleep apnea, meningitis, drug overdose, increased intracranial pressure, Damaged respiratory area of brain, CHF. (If there’s a breathing pattern you don’t know on the test, choose this one.)

Question 4

“Crescendo-decrescendo” describes what pattern of breathing?

Answer 4

Cheyne-Stokes

Question 5

What is Biot’s Breathing?

What’s another name for Biot’s?

Answer 5

Increased respiratory rate and depth with irregular periods of apnea. Each breath has the same depth.
Also called Ataxic breathing

Question 6

What causes Biot’s breathing?

Answer 6

CNS problems, Meningitis

Question 7

What’s another word for Cheyne-Stokes Breathing?

Answer 7

Periodic breathing

Question 8

What is Kussmaul’s Breathing?

Answer 8

Increased respiratory rate (over 20) with increased depth and labored breathing sounds

Question 9

What causes Kussmauls breathing?

Answer 9

Metabolic acidosis, renal failure

Question 10

What is paradoxical breathing?

Answer 10

When inhalation results in a decreasing or asymmetrical chest movement.

Question 11

What causes paradoxical breathing?

Answer 11

Difficult breathing against a closed airway.

Question 12

What is apneustic breathing?

Answer 12

Series of slow, deep breaths, each one held for 30-90 seconds.

Question 13

What causes apneustic breathing?

Answer 13

Head injury, tumor.

Question 14

For examination purposes, what is the definition of Apnea?

Answer 14

A 90% decrease in airflow that lasts 10 seconds or longer. (D-7)

Question 15

According to Medicare/Medicaid Services, a hypopnea is marked by a ___% decrease in SpO2.
American Academy of Sleep Medicine says that it’s ___%.

Answer 15

Medicare: 4%
AASM: 3%

Question 16

Positive airway pressure is the most common form of sleep apnea treatment. What kinds of surgery are there?

Answer 16

Uvulopalatopharyngoplasty (UP3), nasal reconstruction, maxillomandibular advancement, tracheostomy, and upper airway stimulation device.

Question 17

Besides surgery and PAP, there are three other options to treat OSA. What are they?

Answer 17

Weight loss, positional therapy, and oral appliances (especially if the chin is really far back.)

Question 18

What is the ultimate solution to treat OSA?

Answer 18

Tracheostomy

Actual test question. It says “ultimate”, not “best” solution.

Question 19

What is a brain disorder that often causes central sleep apnea? (This disorder is often seen on the test.)

Answer 19

Parkinson’s disease

Question 20

What is central sleep apnea?

Answer 20

A 90% cessation of airflow at the nose and mouth and cessation of chest movement lasting 10 seconds or longer.

Question 21

What conditions can cause central sleep apnea?

Answer 21

Brain & spinal problems, severe obesity, CHF, sleeping at high altitudes.

Question 22

What’s the treatment for central sleep apnea? (No drugs)

Answer 22

O2, BiPAP, ASV, or VPAP.

Question 23

What is the drug treatment for central sleep apnea? (Drugs only)

Answer 23

Acetazolamide (Diamox) and Dimethylxanthine (Theophylline)

D-10

Question 24

What is mixed apnea?

Answer 24

A combination of obstructive and central sleep apnea (D-11)

Question 25

What is a Respiratory Effort Related Arousal?

Answer 25

Abruptly faster rate
30% Decrease in flow
10 sec in duration
Nothing prominent in respiratory channels to score

Question 26

What are the characteristics of a hypopnea?

Answer 26

Shallow breathing
Occurs while asleep or while awake
Classified as a sleep disorder

Question 27

What causes a hypopnea?

Answer 27

Age, smoking, obesity, nasal septum defect, using sleeping pills, and alcohol