Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pulmonology Board Review > Sleep Disorders > Flashcards

Sleep Disorders Flashcards

1
Q

2 things that differentiate N1 sleep pattern from REM pattern on sleep study

A

Rapid eye movements and flat chin waveform

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
A

Normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
A

N1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
A

N2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
A

N3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

% of sleep that is REM

A

15-20%, stays constant as we age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Change in minute ventilation with sleep

A

Decreases 1-2L/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Stage of sleep where breathing is most stable

A

N3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Sleep stage that lessens as we age

A

N3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Reduction of tidal volume in REM

A

40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

REM sleep occurs in cycles of how many minutes

A

90 minutes or so

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What key feature must occur to classify an event as an obstructive apnea?

A

Must have a continued effort throughout the event

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
A

Obstructive apnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
A

Mixed Apnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
A

Hypopnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

3 Criteria for hypopnea

A
  1. Drop of signal by 30%
  2. Drop lasts for 10 seconds
  3. 3% or more drop in sats or an arousal
    1. Government payers say 4% or more only, no arousal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

4 Criteria for RERA (respiratory effort related arousal)

A
  1. 10 seconds or more
  2. Increased respiratory effort or flattening of inspiration portion
  3. leads to an arousal
  4. Does not meet criteria for apnea or hypopnea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

2 criteria for apnea

A
  1. Decrease in amplitude by 90%
  2. Lasts for 10 seconds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Definition of apnea index

A

of apneas per hour of sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Definition of Apnea/Hypopnea index (AHI)

A

of apneas and hypopneas per hour of sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Definition of respiratory disturbance index (RDI)

A

apneas, hypopneas, and RERAs per hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Definition of respiratory events index (REI)

A

apneas, hypopneas per hour of recorded time (Home studies)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Normal AHI

A

< 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Mild apnea AHI

A

5-14

(CMS also requires a comorbid condition or symptom)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Moderate apnea AHI

A

15-29

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Severe apnea AHI

A

30 or more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

% of those with severe OSA who are not sleepy

A

50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How does severity of PHTN correlate with OSA

A

OSA will cause mild PHTN but not moderate or severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Positive predictive value of snoring and witnessed apneas for OSA

A

64%

30
Q

4 Medical disorders requiring an inlab sleep study

A
  1. CHF
  2. Hypoventilation syndromes
  3. COPD
  4. Stroke
31
Q

3 Sleep disorders that require an inlab sleep study

A
  1. Insomnia
  2. Restless leg syndrome
  3. Narcolepsy
32
Q

2 methods of diagnosing OSA that are NOT recommended

A
  1. Autotitrating CPAP
  2. Overnight pulse ox
33
Q

Why can you not do a home sleep study in pregnancy?

A

No data on home study accuracy in pregnancy

34
Q

How does data on PAP therapy show impact on CV disease?

A

Not a great reduction except HTN and maybe CVA

35
Q

3 things that will improve CPAP adherence

A
  1. Heated humidification
  2. Education
  3. CBT
36
Q

What do patient’s with an oral device for OSA treatment need after the device has been fitted?

A

Repeat sleep study (only about 70% effective)

37
Q

What surgery is not recommended anymore for OSA?

A

Laser assisted uvuloplasty (LAUP)

38
Q

What are the 4 surgical options for OSA treatment?

A

Bariatric surgery

Maxillo-mandibular advancement (MMA)

Hypoglossal nerve stimulator

Adenotonsilectomy for pediatrics

39
Q

Breathing pattern associated with opioid use

A

Ataxic breathing pattern (Biot’s)

40
Q

Rule of 3rds in CHF sleep disorders

A

1/3 will have OSA

1/3 will have CSA

1/3 will have neither

41
Q

WIth central sleep anea and HF, what is a contraindication to adaptive servoventilation

A

EF < 45%

(SERVE-HF trial showed increased mortality)

42
Q

2 criteria for diagnosis of OHS

A
  1. BMI > 30
  2. Awake PCO2 > 45
  3. Must be a diagnosis of exclusion
43
Q

Which drive is the process is the sleep drive

A

Process S

44
Q

Which process is the circadian rhythm drive?

A

Process C

45
Q

Term for sleep diary

A

Actigraphy

46
Q

Questionnaire used in circadian rhythm sleep disorders

A

Owl - Lark Questionnaire

47
Q

Advanced sleep phase syndrome

A

Goes to bed early and gets up early

48
Q

Gene associated with familial form of advanced sleep phase syndrome

A

Per2 gene mutation

49
Q

Treatment for advanced sleep phase syndrome

A

Early evening bright light therapy

50
Q

Delayed sleep phase syndrome

A

Night owls, go to bed late and get up late

51
Q

Free running circadian disorder

A

AKA non-24 hour sleep/wake disorder

Major sleep period “marches” throughout the day

52
Q

Other than melatonin, drug treatment for Non-24 circadian disorder

A

Tasimelteon

53
Q

Irregular sleep wake circadian rhythm disorder

A

NO real circadian rhythm

Variable periods of sleepiness and wakefullness

54
Q

10 D’s of excessive daytime sleepiness

A
  1. Deprivation
  2. Disorders of sleep
  3. Delayed sleep phase disorder (morning sleepiness)
  4. Depression
  5. Disease (liver failure, thyroid disorders)
  6. Dope (Illegal drugs)
  7. Drugs (prescription drugs)
  8. Drinking (ETOH abuse)
  9. Delirium
  10. Drama (malingering)
55
Q

4 clinical characteristics of narcolepsy type 1

A
  1. Excessive sleepiness for at least 3 months
  2. Cataplexy
  3. Mean sleep latency < 8 mins + 2 sleep onset REM periods (SOREMP) OR
  4. CSF hypocretin/orexin level < 110
56
Q

2 differences in Narcolepsy type 2 as compared to type 1

A

CSF Hypocretin/orexin level > 110

NO cataplexy

57
Q

Drug used to treat cataplexy in narcolepsy

A

Sodium oxybate

58
Q

Diagnostic criteria for idiopathic hypersomnia

A

Sleep latency test (MSLT) showing < 8 minutes

< 2 Sleep onset REM periods (SOREMP)

59
Q

Definition of insomnia

A

difficulty falling asleep at least 3 times per week for > 3 months

60
Q

Insomnia drug contraindicated in patients using fluvoxamine or with liver impairment

A

Ramelteon

61
Q

Non-benzodiazepine benzo receptor antagonists

A

Eszopiclone

Zaleplon

Zolpidem

62
Q

Hypocretin/orexin receptor antagonist drug in insomnia. Cateplexy rarely described.

A

Suvorexant

63
Q

Parasomnia associated with lewy body dementia

A

REM sleep behavior disorder

64
Q

3 Parasomnias associated with NREM sleep

A

Confusional arousals

Sleep terrors

Sleepwalking

65
Q

Characteristic REM sleep behavior disorder

A

Violent movements during REM usually associated with unpleasant or action filled dreams

66
Q

Drug used to treat all parasomnias

A

Clonazepam

(Can use melatonin for RBD)

67
Q

URGE mnemonic for RLS

A

Urge to move

Rest induced

Gets better with activity

Evening and night accentuation

68
Q

What lab test should be considered in patients with RLS or periodic limb movements

A

Ferretin

69
Q

Side effect of dopaminergic meds (ropinirole) in RLS treatment

A

Impulse disorders

70
Q

Threshold for periodic limb movements to be abnormal

A

> 15 in adults

71
Q

2 Charateristics that are unfavorable for hypoglossal nerve stimulators

A

Concentric collapse of the pharangeal airway

Large tonsils

72
Q

Drug shown to improve CPAP adherance in short term use

A

Eszopiclone

Pulmonology Board Review (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions