The following symptoms are representative of Insomnia Disorder: correct answers Early
morning awakenings without returning the sleep,
Prolonged resistance to going to bed,
Non-restorative sleep.
When pain is present, it impacts sleep and causes these changes: correct answers hyperalgesia,
Exacerbated pain
The psychiatric impact of insomnia increases the incidence for these disorders: correct answers
Drug and alcohol use,
Major depression.
Sleep aids have a special risks for older adults. Some of these risks are: correct answers
Confusion and memory problems
The effectiveness of CBT-I use in patients with insomnia is characterized by: correct answers
78% of patients successfully discontinued use of sleep medications
When integrating behavioral education, these are the goals that a practitioner seeks to achieve:
correct answers What are the factors that perpetuate the sleep problem?
Are there other co-existing medical conditions that are untreated?
What factors trigger the onset of the symptoms?
CBT-I uses these behavioral and cognitive approaches to reset the mental processes that regulate
sleep: correct answers Sleep scheduling,
Sleep hygiene education,
Stimulus control therapy.
A patient with REM related apnea, snoring on PAP, and increased weight gain is likely related
to: correct answers Inadequate PAP Setting
Respiratory events appearing in clusters and worsening as night progresses are likely caused by:
correct answers REM related apnea
At a community health fair, a concerned patient describes their child's recurring screaming
outbursts. The best next question for the sleep health specialist to ask is: correct answers What
time of the night do the screams occur?
A 43-year-old with a complaint of insomnia, witnessed apneas, increased difficulty falling
asleep, increased awakening after sleep onset, and increased EDS, has ocular nerve damage due
to an explosion in combat. He has a Mallampati of II/IV hottie of 2/5, moderate drinking of 2-3
12 ounce beers nightly, a 15 to 18 pound weight gain in the past five years and twitching of the
lower limbs during the day. The twitching started two years ago. Which tests would best evaluate
the patient? correct answers Full lead EEG during the PSG
, During the sleep study, what tools would you use to communicate with the patient? correct
answers Audiotape of instructions and questionnaires
A 38-year-old female with EDS has witnessed apneas and loud snoring for five years. Her sleep
is fitful. She has gained 25-28 pounds in the past five years and has clinical deafness due to a
degenerative disease. She has a Mallampati III/IV with increased blood pressure and rapid heart
rate. Which is the best test order to monitor this patient? correct answers PSG
What safety concerns need to be addressed? correct answers Risk for falling
What special equipment is required for the sleep study? correct answers Video/audio recording
An 01.40 hrs. the patient awakens and calls out to the tech. He has rapid, irregular HR, the EEG
rhythms are normal, the SaO2 is 97%. Tech enters the room and finds the patient with a severe
headache, nausea and shaky, sweating profusely, and heart is beating fast.
What are the possible causes for the changes in condition? correct answers Withdrawal from
alcohol causing a blood sugar change
The Center's Policy and procedure requires guidelines to protect patients. What are key
guidelines to have in the policy and procedure manual? correct answers Criteria defining when to
contact the Medical Director of the Sleep Center,
Criteria to continue recording the sleep study during the emergency,
The type of observations that required, documentation in the medical record and on the tech
notes.
A 76-year-old is being recorded with a history of disruptive snoring, EDS, increased fatigue,
impaired concentration, poorly controlled hypertension despite medications and adjustments of
these medications. He had a new onset of AFib that was unresponsive to a cardioversion two
months before this time. Recently, the patient lost 10 pounds and discontinued his cardiac
medications. The physical exam shows: Weight: 138 pounds; BP: 190/100; Pulse: 64 with rare
premature contractions. An EKG showed abnormal rhythms: AFib.
What are appropriate responses when recording this patient? correct answers Call the Center's
Medical Director
What concerns for the patient's safety need to be addressed prior to starting the recording?
correct answers Have an understanding of abnormal cardiac rhythms to recognize them on the
sleep study,
Ensure the policy and procedure manual addresses the appropriate response to abnormal cardiac
rhythms.
Ensure the technologist has the phone numbers for the supervisor and Medical Director to call as
needed.
The Center's policy and procedure manual requires guidelines to protect patients. What are key
guidelines to have included in the policy and procedure manual? correct answers Criteria to