Scoring Respiratory Events

Question 1

What is the minimum duration for an adult respiratory event?

Answer 1

At least 10 seconds

Question 2

What type of sensor is used for an apnea?

Answer 2

Thermal sensor

It measures the temperature difference between inhalation and exhalation

Question 3

What type of sensor is used for a hypopnea?

Answer 3

Pressure transducer (PTAF)
It measures the pressure difference between inhalation and exhalation

Question 4

What are the adult rules for scoring apnea?

Answer 4

• Greater than or equal to 90% decrease in amplitude (thermal)
• If a portion of the event meets criteria for an apnea that would otherwise be scored as a hypopnea, score as an apnea
• Greater than or equal to 10 seconds
• No desaturation is required
• These rules apply for obstructive, central or mixed apneas

Question 5

What are the adult rules for scoring a hypopnea? (Medicare)

Answer 5

• Greater than or equal to 30% drop in amplitude (nasal)
• Greater than or equal to 90% of the event
• Greater than or equal to 10 seconds
• Greater than or equal to a 4% desaturation from the previous baseline (3% drop or associated with an arousal if not Medicare)

Question 6

What are the adult rules for scoring a hypopnea? (Alternate - Non-Medicare)

Answer 6

• Greater than or equal to a 50% drop in amplitude

- Greater than or equal to 3% saturation

Question 7

What are the adult rules for scoring a respiratory effort related arousal (RERA)?

Answer 7

• Increased respiratory effort or flattening of the nasal pressure waveform
• An arousal
• Sequence of breaths greater than or equal to 10 seconds
• Doesn’t meet criteria for an apnea or hypopnea

Question 8

What is the polysomnogram definition for hypoventilation?

Answer 8

Greater than or equal to a 10 mm Hg increase in PCO2 during sleep compared to awake

Question 9

What is the respiratory disturbance index (RDI)?

Answer 9

AHI + RERA

-Not in the AASM 2007 manual

Question 10

What is the polysomnogram definition of Cheyne-Stokes breathing?

Answer 10

-Greater >= to three consecutive cycles of increased and decreased breathing amplitude cycle length >/= 40 seconds) with central apneas/hypopneas in between each cycle

And

-Greater than or equal to five central apneas or hypopneas per hour with the cyclical increased and decreased change in breathing over the course of two hours