Sleep Technician's Flashcards-RPSGT questions correctly answered 2022

Sleep Technician's Flashcards-RPSGT questions correctly answered 2022Requirements for scoring Cheyne-Stokes Breathing Must be at least 3 consecutive cycles of waning-waxing pattern in airflow with a duration of at least 10 seconds each, and at least 5 central apneas or hypopneas per hour of sleep. Primary Central Apnea This is characterized by cessations of airflow and concurrent cessations of respiratory effort. Diagnostic features include an average of 5 of these events per hour. Behavioral Insomnia of Childhood aka 'Limit-Setting Disorder," characterized by a parent promoting poor sleep hygiene techniques in child, such as putting toys in crib or frequently altering feed times. Paradoxical Insomnia aka "Sleep State Misperception," consists of complaint of insomnia without any evidence. Use of a sleep diary or log may be appropriate. Idiopathic Insomnia aka "Lifelong Insomnia." this is identified as at infancy and persists throughout life. Appears to be no external cause for this, and no other sleep disorder exists as a contributing factor. Adjustment Insomnia aka "acute insomnia," this is a short-term insomnia that is associated with a specific stressor. Very common, typically corrects itself when stressor becomes absent. Psychophysiological Insomnia Common type of insomnia that lasts at least one month. NOT caused by a stressor, but rather a learned response to not fall asleep when planned. Falling asleep at normal bedtimes is difficult. Recurrent Isolated Sleep Paralysis This includes episodes of the inability to move during sleep (hypnogogic) or awakening (hypnopompic.) REM Behavior Disorder Consists of physical activities during REM sleep. Normal muscle atonia does not occur in these patients and the patient is likely to remember the dream associated with the events. Catathrenia aka "sleep-related groaning," this consists of groaning during exhalation, mainly during REM sleep. Short Sleeper When a person sleeps <5 hours and is able to maintain normal functionality and wakefulness. This type of individual does not require the normal amount of sleep. Propriospinal Myoclonus of Sleep These events are similar to sleep starts, but mainly involve body movements in the trunk and neck areas. They typically occur at sleep onset or during brief arousals from sleep. Excessive Fragmentary Myoclonus Characterized by frequent small twitches of fingers, toes, or muscles of the mouth during wake or sleep. They are typically benign, occur in NREM sleep, and persist >20 min. Sleep Starts (Hypnic Jerks) Sudden muscle jerks or movements at sleep onset, often accompanied by feelings of surprise or fear. Hypnogogic Foot Termor (HFT) and Alternating Leg Muscle Activation (ALMA) Rhythmic leg or foot movements at sleep onset. The latter is characterized by movement in one leg followed by movement in another leg. They are typically benign but can cause brief arousals. Describe the types of PVCS Unifocal: Same origins, look the same Multifocal: Different origins Bigeminy: PVC in every other beat Trigeminy: PVC in every third beat Couplet: 2 PVCs in a row VTACH: Three or more PVCs in a row What cardiac activity does the P wave represent? Contraction of the atria. What ECG wave is representative of ventricular repolarization? T Wave What are the normal ranges for the PR interval? .12-.20 seconds What cardiac activity does the QRS complex represent? Contraction of the ventricles. Effect of Barbituates on sleep Decreased N3, REM, and leg movements, Increased N2. Effect of Benzodiazepines on sleep Decreased REM and N3, increased latency to REM and N3. Effect of alcohol on sleep Suppresses REM, increases stage N3 and apneas. Increases sleep fragmentation. Effect of amphetamines on sleep Suppresses REM, delays REM onset. Effect of THC on sleep Suppresses REM, increases drowsiness and N3. Effect of morphine on sleep Decreases REM and leg movements, increases N1 and apnea. Effect of heroin on sleep Decreases REM, N1, and limb movements, increases apneas. Effect of depressants on sleep Decrease REM and N3, increase latency to these stages. High Altitude Periodic Breathing This disorder is characterized by central apneas and hypopneas occurring during a recent ascent to at least 12,000 feet. These events occur at least 5 times per hour of sleep. Adult OSA This includes repeated apneas and hypopneas with continued respiratory effort. Diagnostic criteria include an RDI of >5 with complaints of EDS, choking, gasping, or snoring, or an RDI of >15 without these complaints. Pediatric OSA Diagnostic criteria for this disorder include at least 1 obstructive apnea or hypopnea per hour of sleep. It may sometimes be associated with sudden infant death syndrome (SIDS) Narcolepsy Type I Characterized by EDS and cataplexy, and often includes sleep paralysis and hypnagogic hallucinations. Diagnostic criteria include a mean sleep latency of <8 minutes and 2 REM onsets in an MSLT. Recurrent Hypersomnia This is a rare disorder that is usually a case of Klein-Levin syndrome and includes repeating episodes of hypersomnia. Patients may sleep 16-18 hours a day during these periods, which may last as long as 4 weeks. Sleep-Related Hypoventilation Due to Lower Airway Obstructions This refers to obstructions in the airway below the laryngeal apparatus. This obstruction is determined by a PFT showing a vital capacity ratio of <70%. Sleep-Related Hypoventilation due to Neuromuscular and Chest Wall Disorders. This refers to patients who have difficulty breathing as a result of a chest wall or neuromuscular disorder such as muscular dystrophy or Eaton-Lambert syndrome. AV Node The point of the heart that is responsible for the conduction of the electrical impulses from the atria to the ventricles. Attenuation A marked decreased in the amplitude of a wave Additional channels typically used during a REM Behavior Study? Arm EMG to detect arm movements, additional EEG channels to rule out seizure activity. What filter directly impacts Fall Time? The Low Frequency Filter. Increasing the sensitivity from 10uV/mm to 20uV/mm with do what to the appearance of the wave? It will cut the height of the wave in half. The EEG and EOG channels present an intermittent single fast wave approximately every second. What is the most appropriate course of action? Take steps to correct EKG artifact starting with moving M1 and M2 to the earlobes.