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What is it called when a person goes to bed early in the evening and wakes early in the morning?
- ANSWER Advanced sleep phase syndrome What is the minimum recording time for a study?.
- ANSWER 6 hrs How many naps does an MSLT consist of?
- ANSWER 4- 5 In an ECG the T wave represents ____________________.
- ANSWER Ventricular repolarization Antidepressants suppress which stage of sleep? – ANSWER REM A mixed apnea __________________.
- ANSWER starts with a central component that has become obstructive. The technician should log which patient information into the computer before the study?
- ANSWER Study ID #
Sweat artifact looks like________________
- ANSWER Slow wave sleep Nocturnal paroxysmal dystonia is characterized by________________
- ANSWER Sudden, random, violent movements during NREM sleep. BiPAP S/T stands for________________
- ANSWER Bilevel positive airway pressure spontaneous/timed When a signal starts blocking and squaring off at the top it is caused by________________ - ANSWER The gain (sensitivity) being set too high Theta waves are primarily associated with________________
- ANSWER Stage 1 sleep K-complexes are often seen________________ ANSWER Stage 2 sleep Bright light therapy is used to treat________________
- ANSWER Circadian rhythm disorders, insomnia and depression. What is the clinical term for talking in sleep?
- ANSWER Somniloquy Which of the following medications is used to treat narcolepsy?
- ANSWER Dextroamphetamine
Narcolepsy first manifests itself in _______________________.
- ANSWER Adolescence and young adults What is the difference between fatigue and sleepiness?. ANSWER Fatigue deals with a lack of energy whereas sleepiness is the inability to stay awake. Amplifier calibrations________________
- ANSWER Ensure that the channels are set correctly. Obstructive sleep apnea is normally at its worst when the patient is________________ - ANSWER In REM and on his back. What is hypnagogic jerk?
- ANSWER a muscle spasm during the transition from wakefulness to sleep In children, most common parasomnias such as night terrors and sleepwalking present in what stage of sleep?
- ANSWER Stage 3 How much sleep time must be between 2 apnea events?
- ANSWER There is no sleep time requirement. How can alcohol affect sleep?
- ANSWER Increase OSA An oral device treats sleep apnea by________________
- ANSWER Pulling the patient's lower jaw forward thereby opening the airway.
What are some medications used to treat PLMS?
- ANSWER Benzodiazepines, anticonvulsant agents and dopaminergic agents The leg EMG lead should be placed________________
- ANSWER Anterior tibialis/ on the outside of chins Which is best for cleaning leads?
- ANSWER Bleach The technician's duties include all of the following except_______________ A. Providing a safe environment for the patient. B. Giving an interpretation of the study to the patient. C. Making sure the study is accurate. D. None of the above.
- ANSWER B. Giving an interpretation of the study to the patient. Delta waves are mostly found in ________________.
- ANSWER Stage 3 sleep What is the minimum amount of recording time a study may last?.
- ANSWER 6 hrs ASV stands for ____________________.
- ANSWER Adaptive servo-ventilation
The best way to eliminate artifact is by________________ - ANSWER Going to the problem source and replacing and reapplying the affected leads For Americans the most common sleep disorder is________________. - ANSWER Insomnia If a slow-wave artifact appears in two channels that share the same reference, what is the best solution to correct it? - ANSWER Re-reference both leads to a reference point that doesn't have the artifact. If the exploring and reference electrodes are close to one another, the amplitude will be________________ - ANSWER Low Compared to the EEG, the LFF on an EMG is usually set________________ - ANSWER Higher Alpha-wave intrusion in sleep is indicative of ____________________ - ANSWER Chronic pain REM behavior disorder is most often seen in ________________________. - ANSWER Males over the age of 60. What is the term for breath-holding followed by an expiratory groan? - ANSWER Catathrenia Bio-calibrations are performed to ______________________. - ANSWER Set a baseline for scoring. In which study does a patient try to stay awake in a darkened room? - ANSWER MWT What is the clinical term for bedwetting? - ANSWER Enuresis Which filter would be used to adjust the rise time of a signal? - ANSWER The HFF
What are some possible causes for secondary PLMS? - ANSWER Blood iron deficiency NPSG stands for_________________________. - ANSWER Nocturnal polysomnogram. Sleepwalking and night terrors are common in the ages of ______________. - ANSWER 3-12 yrs old A ________ study is used to look for seizure activity during sleep. - ANSWER Nocturnal seizure The 60-Hz notch filter is used to eliminate _______________________. - ANSWER Artifact generated from electrical devices On an EKG, the QRS complex represents ___________. - ANSWER ventricular depolorization (contraction) A premature P wave in the EKG is referred to as a ___________________ - ANSWER PAC During bilevel titration, the ________ is sometimes used to treat central apneas. - ANSWER Backup rate CHF - ANSWER congestive heart failure Research has shown that patients with narcolepsy with cataplexy have a deficiency of: - ANSWER Hypocretin The measure taken during MSLT with the best sensitivity and specificity for narcolepsy is: - ANSWER 2 or more episodes of stage R sleep The narcolepsy tetrad includes - ANSWER Excessive daytime sleepiness, sleep paralysis, hypnagogic hallucinations, and cataplexy
If a single spindle or K complex is recorded during an epoch where the chin EMG is at REM level and the preceding and succeeding epochs are REM and contain no sleep spindles, the epoch is scored what stage? - ANSWER REM Sensitivity effects what? - ANSWER Amplitude-height Frequency - ANSWER width What physiological parameters will be most affected by a 60 Hz notch filter? - ANSWER EMG The number of intervals in a period of time defines which of the following? - ANSWER Sampling Rate A 30 second epoch, sleep spindles occur at the 8th and 17th seconds. The preceding and succeeding epochs were REM. This epoch is scored as: - ANSWER REM What are the stages for scoring sleep in infants? - ANSWER Quiet sleep, indeterminate sleep, active sleep, and wake During a sleep study rhythmic EMG artifact in the EEG with associated chin EMG bursts is noted. The episodes meet the definition of: - ANSWER Bruxism During the first REM period, significant eye movements are noted along with a lack of atonia in the chin EMG, and the patient is yelling and waving his arms. The activity meets the criteria for which of the following? - ANSWER REM behavior disorder Which is the most dangerous rhythm? - ANSWER Ventricular Fibrillation The input voltage is 500uv and the pen deflection is 3.33mm the sensitivity would be? - ANSWER 150 500/3.
Time in bed for a polysomnogram is 480 minutes. The latency to sleep onset is 3 minutes. The patient is asleep at the end of the test. The wake after sleep onset is 21 minutes. Total sleep time for this polysomnogram is how many minutes? - ANSWER 480-3=477-21= Gastro-esophageal reflux is identified in the distal esophagus by a drop in the pH below what? - ANSWER 4. Actigraphy is used to monitor what? - ANSWER Gross body movement All of the following procedures are required for proper physiologic calibration during a routine polysomnogram: - ANSWER Eyes open/close, Limb flexing, Teeth grinding, etc. The apnea/hypopnea index is reported as what? - ANSWER The average number of apneas and hypopneas seen per hour of sleep. If a calibration signal on an EEG recording channel decays to the baseline faster than expected during montage calibrations, the: - ANSWER LFF is set to high Electrode impedances above what amount is considered to high? - ANSWER 5000-10000 ohms While scoring a PSG study, a technologists notes a 30-second apneic event accompanied by a 3- second burst of four abnormally wide QRS complexes on the EKG channel. What action should be taken by the scoring technologist? - ANSWER Provide documentation on the record and in the report. Sleep initiation in newborns usually begins with: - ANSWER Active Sleep The PRIMARY function of EPAP is to: - ANSWER Prevent the upper airway from being occluded
What is the MOST appropriate way to sterilize virus-contaminated electrodes? - ANSWER Bleach and Water What sleep disorder is associated with intermittent interruptions of REM sleep related atonia, and intense dream mention? - ANSWER REM behavior disorder Nocturnal paroxysmal dystonia - ANSWER Rare and NREM Nocturnal myoclonus - ANSWER repetitive jerks of lower limbs What is the predominant frequency range expected in the EEG channels during physiological calibrations of an adult patient who is awake with eyes closed? - ANSWER 8-13.5 Hz A 60-year-old patient with a history of chronic alcohol use for the past thirty years states that he has very recently quit drinking. What should the technologist most likely see during his PSG? - ANSWER Increased REM sleep Regular, repetitive stereotypical extremity muscle activity during sleep MOST LIKELY indicates: - ANSWER Periodic Limb Movement The technologist observes a sudden onset of sinus arrhythmia. The MOST appropriate course of action is to: - ANSWER Continue to monitor The EKG showed multi-focal PVC's and asystole during the first part of the PSG study. The MOST appropriate course of action would be: - ANSWER Activate Emergency Response During a PSG study, all physiological signals are simultaneously replaced by flat lines. What is MOST LIKELY the cause? - ANSWER Disconnected electrode input box
What is the least appropriate to document? - ANSWER The technologist's description of the patient's medical history During setup for a PAP titration study, a patient states that he has restless leg syndrome. The technologist should expect that the patient will have: - ANSWER Difficulty initiating sleep The distance from pre-auricular crease to pre-auricular crease is 35 cm. What is the distance in cm between C3 and CZ? - ANSWER 3. According to the recommended guidelines, unattended portable monitoring devices must include: - ANSWER What is an example of an electrical artifact? - ANSWER pulse* Which arrhythmia would require activation of the Emergency Response System? - ANSWER Ventricular Fibrillation * Kcomplexes and sleep spindles are most prevalent in what stage of sleep? - ANSWER N2 * What is the minimum duration in seconds of an apnea/hyponea? - ANSWER 10 seconds hyp. down 30% for 10 seconds According to recommended titration guidelines, CPAP should be increa sed after observing at least: - ANSWER Which PAP interface is the best option for a patient with a nasal obstruction? - ANSWER a-fib - ANSWER atrial fibrillation
EDS - ANSWER excessive daytime sleepiness EMG - ANSWER electromyogram EOG - ANSWER electrooculogram; measures eye movement EPAP - ANSWER expiratory positive airway pressure EtCO2 - ANSWER end-tidal carbon dioxide FIO2 - ANSWER fractional inspired oxygen GERD - ANSWER gastroesophageal reflux disorder HFF - ANSWER High Frequency Filter Hz - ANSWER Hertz IPAP - ANSWER Inspiratory Positive Airway Pressure LFF - ANSWER Low Frequency Filter MSLT - ANSWER multiple sleep latency test mV - ANSWER millivolt
mV/cm - ANSWER Millivolts per centimeter MWT - ANSWER Maintenance of Wakefulness Test uV - ANSWER microvolt uV/mm - ANSWER Microvolts per Millimeter NPPV - ANSWER noninvasive positive pressure ventilation NREM - ANSWER non rapid eye movement OSA - ANSWER obstructive sleep apnea OSAS - ANSWER obstructive sleep apnea syndrome O2 - ANSWER Oxygen PAC - ANSWER premature atrial contraction PAP - ANSWER positive airway pressure PCO2 - ANSWER partial pressure of carbon dioxide PaCO2 - ANSWER partial pressure of CO2 in arterial blood PLM - ANSWER periodic limb movement
SOB - ANSWER shortness of breath SOREM - ANSWER sleep onset REM SOREMP - ANSWER Sleep onset REM period SpO2 - ANSWER oxyhemoglobin saturation TC - ANSWER time constant TST - ANSWER total sleep time UARS - ANSWER Upper Airway Resistance Syndrome V tach - ANSWER ventricular tachycardia WASO - ANSWER Wake After Sleep Onset During the PSG, if a patient ask the technologist whether he has obstructive sleep apnea, the technologist should: - ANSWER Suggest to the patient that this information should be provided by the physician. A patient who has been compliant with PAP therapy for 9 months stops by the lab during the day complaining of a minor skin irritation around his nose, the technologist should: - ANSWER Check mask size During an MSLT the patient should be instructed that the following MUST be avoided between nap trails: - ANSWER Caffeine, Napping, Smoking 30 minutes prior to test
The most important reason more monitoring limb movements from both the left and right leg anterior tibialis muscles is that the movements: - ANSWER Can occur in only one leg or can switch from one leg to the other throughtout the night. AIMS A patient comes in with an open cut, sore, or ulcer located on the patients right anterior tibialis. Where should the technologist place the leg EMG electrode? - ANSWER Move the electrode to another part of that muscle. amputees All is true about the EMG electrodes EXCEPT: The electrodes must be placed 2-4 cm apart. Can detect muscle activity by placing the electrodes on the masseter and submentalis. Can detect muscle activity from the anterior tibialis Can detect muscle activity from the mastoid. - ANSWER Can detect muscle activity from the mastoid. The standard minimum duration for scoring an apnea/hypopnea in a child: - ANSWER 6 A patient with low-amplitude submentalis chin EMG and low-voltage, mixed frequency, mixed frequency EEG activity would MOST LIKELY be in what stage of sleep? - ANSWER REM Sleep efficiency is defined as: - ANSWER Total sleep time relative to total recording time The minimum voltage of a K-complex is 75uv peak to peak. The amplitude requirements needed to identify it as a K-complex would be: - ANSWER There is no criteria The scoring criteria for stage 1 sleep includes all of the following accept:
