Scoring and Sleep Stages (D-41 - D-48) Flashcards
When should you score a respiratory event as a hypopnea event?
Peak signal excursions drop by 30% or greater of pre-event baseline using nasal pressure, PAP device flow, or an alternative hypopnea sensor.
Must last for 10 seconds.
O2sat must drop by 3% and an arousal occurs
How long does a hypopnea event have to last to score it?
10 seconds
To score a hypopnea event, the O2sat must drop by ___% with an arousal or ___% without an arousal.
3% with arousal
4% without an arousal.
When should you score a RERA?
Score a Respiratory Effort Related Arousal if
Increasing resp effort
Flattening of the inspiratory portion of the flow waveform.
…And leads to arousal from sleep
When should you score consecutive Cheyne-Stokes breathing patterns?
How long does it have to last?
An episode of more than 3 consecutive central apneas or central hypopneas with a crescendo-decrescendo breathing pattern.
Must last for greater than 40 seconds.
When should you score non-consecutive Cheyne-Stokes breathing patterns?
How often should these patterns be seen?
There are greater than 5 central apneas or central hypopneas with a crescendo-decrescendo breathing pattern over 2+ hours of monitoring.
When you hear the term “Crescendo” and “Decrescendo”, think of this breathing pattern.
Cheyne-Stokes Breathing
When doing home sleep apnea testing (HSAT), what has to be reported? (x5)
Type of device Type of airflow sensor Type of respiratory effort sensor(s) O2saturation Heart rate
What does HSAT stand for?
Home Sleep Apnea Testing
What TIME data do you have to report in HSAT? (x4)
Recording start time
Recording end time
Total recording time
Monitoring time (Monitoring time is not the same as recording time)
What SLEEP DATA do you have to report in HSAT? (x5)
Heart rate average, highest, and lowest
Number of apneas
Number of hypopneas
What is an REI? How is it calculated?
Respiratory Event Index
Monitoring time = # resp events x 60 divided by TST in minutes
What is an AHI? How is it calculated?
Apnea Hypopnea Index
(# apneas + #hypopneas x 60) divided by TST in minutes.
What is an ODI? How is it calculated?
Oxygen Desaturation Index #O2 desaturations >3-4% x 60) divided by MT in minutes.
If you have to report a measure of O2 saturation, you should report one of three parameters. What are they?
ODI
O2sat, mean value, zenith, and nadir
O2sat, % of the time at or below 88%
When there is an REI or an AHI, what should you report?
Report the interpretation.
If the HSAT study is non-diagnostic, what should you do?
Recommend in-center PSG if clinically indicated.
HSAT equipment recording features must include these features: (x7)
FDA approval of device Unique identifier for each device Minimum definition of CPT codes Must record oxymetry Must record heart rate Display raw data for review/manual scoring Calculate REI & MT.
HSAT must have at least one of these three sensors:
Oronasal thermal airflow sensor
Nasal pressure transducer
Alternative sensor (RIPsum or RIPflow)
What is a PAT?
Peripheral Arterial Tone
What general parameters should be recorded on a PAT? (x5)
Type of device Airflow/Effort Surrogate signals O2sat (Zenith & Nadir) Sleep/Wake and REM time estimates Heart rate
When using a PAT, what TIME recording data should be reported? (x4)
Recording start time
Recording stop time
Duration of recording
Estimated sleep time
When using a PAT, what PHYSIOLOGICAL data should be reported?
Heart rate
Number of sleep-related respiratory events
ODI
What CPT codes govern HSAT equipment?
95800, 95801, and 95806
What CPT codes govern PAT devices?
95800 and 95801
