Deck 18: Sleep Disordered Breathing

Question 1

What is the treatment of choice for the patient with moderate to severe obstructive sleep apnea?

A)CPAP
B)Oral appliances
C)Surgery
D)Medications

Answer 1

A

Question 2

After falling asleep,how much time usually passes before the healthy sleeper experiences a REM episode?

A)20 minutes
B)40 minutes
C)90 minutes
D)120 minutes

Answer 2

C

Question 3

What is the reported compliance rate with sleep apnea patients using CPAP?

A)About 50%
B)About 75%
C)About 95%
D)None of the above

Answer 3

B

Question 4

All the following are monitored during a sleep study except:

A)EEG
B)ECG
C)Venous oxygen saturations
D)Pulse oximetry

Question 5

Which of the following problems is NOT associated with obstructive sleep apnea?

A)Poor memory
B)Impotence
C)Morning headaches
D)Joint pain

Question 6

Which of the following problems suggests that a sleep study should be done on a patient despite a lack of the obvious signs of sleep apnea?

A)Poorly controlled hypertension
B)Secondary polycythemia
C)Pulmonary hypertension
D)All the above

Question 7

What is the most common cause of obstructive sleep apnea?

A)Small lower jaw
B)Large tonsils
C)Large tongue
D)Obesity

Question 8

What disorder is suggested when the patient has a multiple sleep latency test and demonstrates REM sleep during at least two of the five naps?

A)Hypothyroidism
B)Narcolepsy
C)Encephalitis
D)Overdose with sedatives

Question 9

What medical condition(s)is/are associated with causing central sleep apnea?

A)Congestive heart failure
B)Extreme obesity
C)Neurologic injuries
D)All the above

Question 10

The Epworth sleepiness scale is used to measure the degree of daytime sleepiness.What score suggests excessive daytime sleepiness?

A)11
B)15
C)20
D)All the above

Question 11

Your patient has an apnea/hypopnea index of 36.How severe is the problem in this case?

A)Mild
B)Moderate
C)Severe
D)Very severe

Question 12

Your patient has obstructive sleep apnea due to obesity.What initial recommendations would you make to the patient?

A)Weight loss
B)Changing sleep position
C)Avoid sleeping pills
D)All the above

Question 13

Contraindications for using CPAP to treat obstructive sleep apnea include all the following except:

A)Uncontrolled emesis
B)Hypotension with hypovolemia
C)Pneumothorax
D)Left heart failure

Question 14

Why do people with central sleep apnea stop breathing periodically during sleep?

A)Their chronic CO₂ retention blunts their drive to breathe during sleep
B)Their pons and medulla are atrophied compared to normal
C)They often have hypothyroidism
D)The cause is unknown

Question 15

In some cases of obstructive sleep apnea an automatic in-home CPAP titrating device may be useful.What does this machine do that others cannot?

A)Measures the amount of sleep the patient is getting
B)Adjusts the CPAP level as needed by the patient during the night
C)Adjusts the inspiratory time as needed
D)Sends signals to the sleep lab when apnea worsens

Question 16

During the sleep study your patient moves air during sleep but the amount is below what is needed to maintain homeostasis.What term is applied to this type of breathing problem during sleep?

A)Apnea
B)Eupnea
C)Hypopnea
D)Platypnea

Question 17

How would you describe the normal changes in breathing and breathing patterns during the deeper stages of NREM sleep?

A)Increased and regular
B)Decreased and regular
C)Increased and irregular
D)Decreased and irregular

Question 18

What percentage of adult males ages 30-60 years are believed to have obstructive sleep apnea/hypopnea syndrome?

A)0.5%
B)4%
C)8%
D)12%

Question 19

What term is also used to describe stage III and IV NREM sleep?

A)Slow-wave sleep
B)K-wave sleep
C)Low-voltage sleep
D)Beta sleep

Question 20

Why do patients with obstructive sleep apnea complain of excessive daytime sleepiness?

A)CO₂ build up during sleep makes the brain abnormal
B)Sleep is normal,but patient perception is not
C)Sleep is very fragmented
D)Nobody knows

Question 21

Which of the following has been used to treat central sleep apnea due to Cheyne-Stokes breathing?

A)CPAP
B)Nocturnal oxygen therapy
C)Bilevel noninvasive positive pressure
D)All the above

Question 22

What is the goal of surgery in patients with obstructive sleep apnea?

A)Bypass the obstruction
B)Widen the airway
C)Increase the upper airway muscle tone
D)A and B only