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PRATICE TEST > SLEEP TEST > Flashcards

SLEEP TEST Flashcards

1
Q

WHAT DOES “MSLT” REFER TO?

A

Multiple Sleep Latency Test.

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2
Q

HOW MANY NAPS ARE USUALLY PERFORMED DURING AN MSLT?

A

4-5 Naps throughout the day.

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3
Q

When does the 1st nap begin once an MSLT has started?

A

1.5 – 3 hours after lights on.

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4
Q

After sleep onset occurs, when is the nap terminated?

A

15 minutes from the 1st epoch of sleep.

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5
Q

If there is no sleep noted, when is the nap terminated?

A

20 minutes from the time of lights out.

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6
Q

SLEEP LATENCY IS DEFINED AS;

A

The amount of time elapsed from lights out to the 1st epoch of sleep.

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7
Q

REM LATENCY IS DEFINED AS;

A

The amount of time elapsed from the 1st epoch of sleep to the 1st epoch of REM.

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8
Q

WHAT IS THE PURPOSE OF PERFORMING THE “MSLT”?

A

To assess & diagnose diseases of excessive somnolence to evaluate daytime sleepiness.

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9
Q

DO THE NAPS OCCUR EVERY 2 HOURS FROM THE TIME THE PREVIOUS NAP ENDED OR EVERY 2 HOURS ON THE HOU R OR HALF-HOUR?

A

Every 2 hours on the hour or half hour.

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10
Q

HOW LONG BEFORE A NAP BEGINS SHOULD THE SUBJECT CEASE SMOKING?

A

30 minutes.

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11
Q

WHAT EPOCH SIZE IS BEST FOR RECORDING THE “MSLT”?

A

30 seconds.

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12
Q

A MEAN SLEEP LATENCY OF INDICATES WHAT?

A

Pathological sleepiness.

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13
Q

A normal mean sleep latency is how many minutes?

A

10 – 20 minutes

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14
Q

How many naps must have unequivocal periods of REM to arrive at a Diagnosis of Narcolepsy?

A

2 naps.

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15
Q

What is the Narcoleptic Tetrad?

A

Excessive daytime sleepiness, hypnogognic hallucinations, sleep paralysis, cataplexy.

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16
Q

What montage is generally used for the recording the “MSLT”?

A

4 EEG, 2EOG, EMG (chin), EKG.

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17
Q

How is the mean sleep latency calculated?

A

Sum of all latencies, divided by total# of naps.

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18
Q

How is the median latency calculated?

A

For 5 naps. Align in numerical order, select 3rd.

For 4 naps. Align in order, average 2nd and 3rd.

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19
Q

How is the mean REM latency calculated?

A

Sum of all REM latencies, divided by # of REMs.

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20
Q

How frequent are the naps scheduled during the MSLT?

A

Every 2 hours.

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21
Q

Respiratory Disturbance Index (RDI) is measurement of what?

A

The # of apneas, hypopneas and all reap. disturbances (snore arousals, UARS..) per hour of total sleep time.

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22
Q

Reflux is identified in the distal esophagus by a drop in pH below what?

A

4.0

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23
Q

A pt. can become the pathway of least resistance, and therefore susceptible to shock when what occurs?

A

When not all the equipment attached to the pt. is connected to a common ground.

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24
Q

What are the effects of chronic alcoholism on sleep?

A

Reduction of NREM delta sleep and REM sleep.

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25
Q

A sleep disturbance that last one to several nights in an isolated period and is most often caused by an acute situational stress or travel across multiple time zones.

A

Transient Insomnia.

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26
Q

During REM, inhibition of thermoregulartory mechanisms lead to what state?

A

Poikilothermia.

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27
Q

What equation best expresses time constant?

A

TC= C x R TC=Time Constant
C= Capacitance
R= Resistance

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28
Q

Impedances greater than 10,000 ohms, allows for greater potential of electrode imbalance and the appearance of what in the recorded signal?

A

60 Hz interference.

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29
Q

If the circumference measurement of the head is 60 cm, what is the distance of the T4 from the Fp2?

A

12 cm.

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30
Q

What is the minimum paper speed recommended to allow clear visual resolution of alpha and sleep spindles?

A

10 mm / second.

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31
Q

What sleep stage: low voltage mixed frequency EEG, with a prominence of activity in the 2 - 7 cps range, slow eye movements, tends to be relatively short, ranging from 1 -7 minutes.

A

Stage 1.

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32
Q

The amplitude of this waveform is occasionally as high as 200 uV?

A

Vertex Sharp Wave.

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33
Q

The total duration of this waveform should exceed. 5 sec with a well-delineated negative sharp wave followed by a positive component.

A

K-Complex.

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34
Q

What sleep stage requires at least 20% but no more than 50% of the epoch to consist of wave of 2 cps or slower w/amplitudes greater than 75 uV.

A

Stage 3.

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35
Q

Alpha activity in stage REM sleep is how many cps slower than wakefulness?

A

1 - 2 cps.

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36
Q

How are eye movements recorded?

A

There is a small electropotential difference between the cornea (+) and the retina (-). An electrode closest to the cornea will register a (+) deflection and close to the retina will register a (-) deflection.

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37
Q

List the 4 skull landmarks used in the 10 - 20 system.

A

Nasion, Inion, Right and Left Preauricular.

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38
Q

The degree to which an amplifier will reject a common mode signal is expressed as what?

A

Common Mode Rejection Ration.

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39
Q

This sleep test is used in the assessment and diagnosis of disorders of Excessive somnolence and to evaluate daytime sleepiness in relation to Various therapeutic or experimental manipulations?

A

MSLT.

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40
Q

How many minutes after lights out (with no sleep) is the standard MSLT Terminated?

A

20 minutes.

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41
Q

IN ORDER TO ASSESS THE OCCURRENCE OF REM SLEEP DURING THE MSLT, THE TEST SHOULD CONTINUE FOR HOW LONG AFTER THE FIRST EPOCH OF SLEEP?

A

15 minutes.

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42
Q

HOW MANY SLEEP-ONSET REM EPISODES IN A SERIES OF 5 NAPS ARE DIAGNOSTIC FOR NARCOLEPSY?

A

2

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43
Q

NREM SLEEP IN THE INFANT IS KNOW AS?

A

Quiet Sleep.

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44
Q

REM SLEEP IN THE INFANT IS KNOWN AS?

A

Active Sleep.

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45
Q

OTHER THAN EEG RECORDING, WHAT ELSE IS USED TO DIFFERENTIATE THE SLEEP STAGES IN THE INFANT?

A

Observed behaviors and movement patterns.

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46
Q

AT WHAT AGE DO SLEEP SPINDLES APPEAR IN INFANTS?

A

The appear at 4 weeks of age, develop rapidly through 8 weeks of age, and clearly characterize NREM sleep by 3 months of age.

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47
Q

AN EPOCH THAT DOES NOT MEET THE CRITERIA FOR ACTIVE SLEEP OR QUITE SLEEP IS CALLED WHAT?

A

Intermediate Sleep.

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48
Q

TRACE ALTERNANT PATTERN IS ASSOCIATED WITH WHAT STAGE OF SLEEP IN THE INFANT?

A

Quiet Sleep (NREM Sleep).

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49
Q

INFANT BREATHING PATTERNS THAT ALTERNATES REGULAR BREATHING WITH 5-10 SECONDS OF APNEA?

A

Periodic Breathing.

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50
Q

REM OCCUPIES WHAT PERCENTAGE OF SLEEP IN THE NEONATE AT TERM?

A

50%.

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51
Q

TERM USED FOR A BRIEF SUPERIMPOSITION OF EEG ALPHA ACTIVITY ON SLEEP ACTIVITIES DURING A STAGE OF SLEEP?

A

Alpha Intrusion.

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52
Q

THERMOREGULATORY RESPONSES SUCH AS SWEATING AND PANTING ARE NOTED IN REM, BUT ARE ABSENT IN NREM SLEEP. TRUE OR FALSE

A

False

Sweating and panting are seen in NREM, but absent in REM.

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53
Q

DEFINE APNEA?

A

Cessation of airflow at the nostrils and mouth lasting at least 10 seconds.

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54
Q

A FUNCTION THAT EXPRESSES THE FREQUENCY OF EYE MOVEMENTS PER UNIT TIME DURING SLEEP STAGE REM?

A

REM Density.

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55
Q

THE NUMBER OF APNEAS (Obstructive, Central, Mixed) PLUS HYPOPNEAS PER HOUR OF TOTAL SLEEP TIME AS DETERMINED BY ALL-NIGHT POLYSOMNOGRAPHY?

A

Respiratory Disturbance Index (RDI)

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56
Q

KNOW AS THE PACEMAKER FOR MAMMALIAN CIRCADIAN RHYTHMS?

A

Suprachiasmatic Nuclei (SCN).

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57
Q

A COMPLAINT OF MORNING HEADACHES ASSOCIATED WITH SEVERE SLEEP APNEA IS A RESULT OF WHAT?

A

Severe oxygen desaturation and hypercapnia (Elevated levels of carbon dioxide in the blood).

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58
Q

WHAT INITIAL EFFECT DOES ADMINISTERING SUPPLEMENT OXYGEN HAVE ON THE OSA PATIENT?

A

A significant increase in apnea duration with associated hypercapnia and respiratory acidosis.

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59
Q

WHAT TERM IS LINKED WITH PATIENT EXPERIENCING EVENING AND NOCTURNAL HALLUCINATIONS ASSOCIATED WITH DEMENTIA?

A

Sundowning.

60
Q

JACTATION CAPITIS NOCTURNA?

A

Headbanging.

61
Q

WHAT IS THE RECOMMENDED PROCEDURE FOR ELECTRODE APPLICATION TO RECORD EYE MOVEMENTS?

A

On electrode is 1cm above and slightly lateral the outer can thus, while the other electrode is 1cm below and slightly lateral the outer can thus of the eye.

62
Q

THREE POTENTIAL SOURCES OF STRAY ELECTRICAL CURRENT?

A

Short circuit, Leakage Current, Ground Loop.

63
Q

THE NUMBER OF PEN DEFLECTIONS OR “WAVES” RECORDED WITHIN THE SPAN OF ONE SECOND?

A

Signal Frequency.

64
Q

MEASUREMENT OF FREQUENCY, NUMBER OF CYCLES PER SECOND?

A

Hertz.

65
Q

REFERS TO THE RESPONSE TIME OF THE POLYGRAPH PENS IN RELATION TO HIGH AND LOW FREQUENCY FILTER SETTINGS DURING A CALIBRATION PROCEDURE?

A

Time Constant.

66
Q

REDUCTION IN SIZEOR AMPLITUDE OF A SIGNAL?

A

Attenuation.

67
Q

UNDESIRABLE VARIATION IS BASELINE DURING A RECORDING, USUALLY CAUSED BY SWEAT OR MOVEMENT?

A

Baseline Sway.

68
Q

Voltage originating from living tissues?

A

Bio-electrical Potentials.

69
Q

SIGNALS OBTAINED BY COMPARING VOLTAGES FROM TWO EXPLORING ELECTRODES?

A

Bipolar Derivation.

70
Q

AN AMPLIFIER COMPONENT USED FOR STORING ELECTRICAL CHARGE?

A

CAPACITOR.

71
Q

A GROUND CONNECTION SHARED BY MORE THAN ONE INSTRUMENT OR APPLIANCE?

A

Common Ground.

72
Q

ANY MATERIAL CAPABLE OF TRANSMITTING AND ELECTRICAL CURRENT?

A

Conductor.

73
Q

FLOW OF ELECTRICAL FORCE ALONG A CONDUCTOR?

A

Current.

74
Q

SIGNAL OBTAINED FROM A PAIR OF ELECTRODES OR SENSORS?

A

Derivation.

75
Q

RECORDING OF ELECTRICAL ACTIVITY GENERATED BY THE BRAIN?

A

ELECTROENCEPHALOGRAM (EEG).

76
Q

THE TIME REQUIRED FOR A PEN TO DESCEND TO 37% OF SIGNAL AMPLITUDE WHEN A DC CALIBRATION SIGNAL IS APPLIED TO AN AMPLIFIER?

A

Fall Time Constant.

77
Q

AN ELECTRONIC DEVICE DESIGNED TO REDUCE OR ELIMINATE UNWANTED FREQUENCIES FROM PASSING THROUGH AN AMPLIFIER?

A

Filter.

78
Q

AN UNDESIRABLE ELECTRICAL PATHWAY BETWEEN TWO SEPARATE GROUND CONNECTIONS, RESULTING IN A POSSIBLE HAZARD TO A PATIENT?

A

Ground Loop.

79
Q

A METHOD OF MEASURING CHANGES IN BODY (OR BODY PARTS) CIRCUMFERENCE?

A

Inductance Plethysomography.

80
Q

Stray current generated by the proximity of electrical power cords to
Adjoining cables or the polygraph chassis.

A

Leakage Current

81
Q

Ratio of output voltage to input voltage, amplifier sensitivity.

A

Gain

82
Q

An instrument used for measuring electrical resistance.

A

Ohmmeter

83
Q

Signal obtained by comparing voltages from an exploring electrode to
A relatively inactive location.

A

Referential Derivation

84
Q

Opposition to an electrical current.

A

Resistance

85
Q

A device used to limit the passage of electrical current

A

Resistor

86
Q

The time required for a pen to reach 63% of signal amplitude when a DC
Calibration signal is applied to an amplifier.

A

Rise Time Constant

87
Q

A device containing two dissimilar metals, which generate an electrical
Signal in response to temperature variations.

A

Thermocouple

88
Q

A sequence of tests used to verify and document appropriate amplifier and pen
Responses to various maneuvers performed by the patient prior to sleep study.

A

Bio-Calibrations

89
Q

Sharp negative waves, usually within the theta frequency range-typically appearing
During the latter part of stage 1 sleep.

A

Vertex Waves

90
Q

A sharp negative wave, followed by a slow positive component-seen primarily
In stage 2 sleep.

A

K-Complex

91
Q

Short rhythmic waveform clusters of 12-14 Hz, often showing a waxing and waning
Appearance-a characteristic feature of stage 2 sleep.

A

Sleep Spindles

92
Q

Relatively low amplitude waves, with a notched, sawtooth appearance-a
Common feature of REM sleep.

A

Sawtooth Waves

93
Q

REM sleep is classified into what two categories?

A

Tonic and Phasic

94
Q

Artifact caused by electrodes which momentarily lift away from the skin.

A

Electrode Popping

95
Q

A transient appearance of alpha activity during sleep.

A

Alpha Intrusion

96
Q

A cessation of airflow detection at the nose occurring for 10 seconds or longer.

A

Apnea

97
Q

An interruption of sleep continuity, identified by an abrupt shift in EEG frequency.

A

Arousal

98
Q

A cessation of breathing, characterized by an absence of both airflow and
Respiratory effort.

A

Central Apnea

99
Q

A single page of a polysomnogram, typically representing 30 seconds of data.

A

Epoch

100
Q

Rapid deep breathing, resulting in reduced levels of CO2 in the blood.

A

Hyperventilation

101
Q

Insufficient breathing volumes resulting in increased levels of CO2 in the blood.

A

Hypoventilation

102
Q

Abnormally low blood oxygen saturation levels.

A

Hypoxemia

103
Q

Jaw muscle.

A

Masseter

104
Q

Lower portion of the temporal bone behind the ear.

A

Mastoid

105
Q

A cessation of breathing caused by upper airway obstruction.

A

Obstructive Apnea

106
Q

The progression and distribution of the various sleep stages and their
Quantitative relationship to each other.

A

Sleep Architecture

107
Q

A period of NREM sleep followed by a subsequent REM period.

A

Sleep Cycle (also see Sleep Patterns; Sleep Stages; Cyclic, Alternating Patterns of)

108
Q

A device used to convert non-electrical physiological activity into electrical
Signals.

A

Transducer

109
Q

Maximum amount of air the lungs can contain.

A

Total Lung Capacity

110
Q

An arrangement of electrode derivations.

A

Montage

111
Q

Voltage (E) is equal to Current (I) flowing in the circuit multiplied by
Resistance (R) in the circuit.
E=I x R

A

Ohm’s Law

112
Q

Three grounds found in electronic equipment.

A

Earth (building or power outlet) ground, chassis ground, common connection ground.

113
Q

What consideration should be given to the choice electrodes used for recording
EEG?

A

Choose a material that has minimum drift of electrode potential and a very long time constant.

114
Q

Suggested solution to soak contaminated electrodes.

A

5% Hypochlorite solution (household bleach)

115
Q

Shock that involves large and quite perceptible currents passing from one external
Surface area to another.

A

Macroshock

116
Q

How is the voltage (uV) of an EEG waveform calculated?

A

Multiplying the amplitude (mm) of the waveform by the sensitivity (uV/mm). V=A x S.

117
Q

Distinct EEG activity appearing to be composed of one dominant frequency.

A

Monomorphic

118
Q

EEG activity with a frequency faster than 13 Hz.

A

Beta Activity

119
Q

Morphologically and topographically distinct EEG activity seen in the central
Areas, frequency is about 9 Hz.

A

Mu Rhythm

120
Q

Breathing pattern characterized by rhythmic waxing and waning of depth
Of respiration, with regularly recurring periods of apnea.

A

Cheyne-Stokes Respiration

121
Q

EKG channel shows regular rhythm, rate 60-100 bpm; P waves present and
Upright before each QRS complex. Time interval is same for all beats.

A

Normal Sinus Rhythm

122
Q

EKG channel shows regular rhythm, rate ≥100 bpm (seldom ≥150 bpm);
P waves present and upright before QRS complex. Time interval is same for all
Beats.

A

Sinus Tachycardia

123
Q

EKG channel shows regular rhythm, rate ≤ 60 bpm; P waves present and upright
Before QRS complex. Time interval is same for all beats.

A

Sinus Bradycardia

124
Q

EKG channel shows P waves then QRS complexes with no association
Between the two. The P-R interval is variable and the QRS complexes are the
Same and regular.

A

3rd degree AV block or complete heart block

125
Q

Normal arterial pCO2 value.

A

35-45 mmHg

126
Q

Normal arterial pO2 value.

A

80-100 mmHg

127
Q

When does sleep onset occur when scoring an MSLT?

A

The time from lights out to the first epoch scored as sleep.

128
Q

A patient with “Ondine’s Curse” would be expected to have what type or
Respiratory impairment?

A

Central Alveolar Hypoventilation

129
Q

Which class of drugs is known to aggravate Periodic Limb Movements of Sleep?

A

Tricyclic Antidepressants

130
Q

What is the effect of chronic alcoholism on REM?

A

Decreases REM sleep

131
Q

What does the narcoleptic tetrad consist of?

A

EDS, Cataplexy, Sleep Paralysis, Hypnagogic Hallucinations

132
Q

Define sleep efficiency.

A

The ratio of total sleep timed to total time in bed.

133
Q

In 1953 Aserinsky and Kleitman associated what with dreaming during sleep?

A

Rapid Eye Movements

134
Q

REM sleep is associated with what changes in the autonomic nervous system?

A

Variable heart rate, irregular respiration’s, decrease in tonic muscle activity.

135
Q

The reticular activating system is essential for what part of the sleep/wake cycle?

A

Initiation and Maintenance of Wakefulness

136
Q

Ultradian rhythm refers to a period of what time?

A

Less than 24 hours

137
Q

Are newborns and infants obligatory “nasal breathers” or “mouth breathers”?

A

“Nasal Breathers”

138
Q

Increased resistance of the upper airways secondary to blockage of one nasal
Orifice restricts ventilation more severely in REM or NREM?

A

REM

139
Q

Paradoxical breathing is noted in neonates or infants?

A

Neonates

140
Q

Periodic breathing in the normal infant most commonly occurs in Active
Or Quiet Sleep?

A

Active Sleep

141
Q

The Untradian rhythm of alternating sleep cycles has a period of how many minutes
During infancy?

A

30-70 minutes

142
Q

What is the definition of periodic breathing?

A

Minimum of 3 central events lasting less than 4 seconds within 20 seconds of each other.

143
Q

A person’s maximum breathing ability.

A

Vital Capacity

144
Q

The content of air remaining in the lungs at the end of normal expiration.

A

Functional Residual Capacity

145
Q

Leg muscle used to monitor/record myoclonic movements.

A

Anterior Tibialis

146
Q

Which type of montage is recommended in order to maximize the voltage
Recorded during a ploysomnogram?

A

Referential montage using contralateral ear references.

PRATICE TEST (2 decks)

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