what is the minimum number of diagnostic and therapeutic in a split study?
2 diagnostic 3 therapeutic
what is the most stable stage of sleep
... [Show More] respiratory wise?
N3 (NREM is more stable and REM is irregular)
What does common mode rejection do?
It is a process that takes input signals and eliminates identical voltages from two different sources (records dissimilar voltages)
(higher the CMMR, the more efficient the amplifier)
what should the low pass filter for an EEG be if seizures are expected?
70 Hz (usually 35 Hz)
What happens to a waveform is sensitivity is increased?
The vertical size of the wave decreases
what is the difference in gain and sensitivity?
Increasing gain increases amplitude and increasing sensitivity decreases the amplitude
What is the shortest sleep latency for a MSLT nap?
15 minutes (longest its 35 minutes)
What is HST?
Home sleep test
How do you clean ECG electrodes?
Wipe with cleaning agent that is non-corrosive to plastic, air dry, gas sterilization as needed
What are the NREM parasomnias?
Confusional arousals, sleepwalking, sleep terror, SRED
What are the REM parasomnias?
Nightmares, RBD, sleep paralysis
How long does a "short sleeper" sleep?
<6 hours (long: >10)
What stage of sleep is CSA more common?
NREM
What are SOREMPS?
Occurrence of REM sleep within 15 minutes of sleep onset (<2 = hypersomnia, >2 narcolepsy)
What type of narcolepsy is cataplexy present?
Type 1
When is narcolepsy onset age usually?
10-20
What is the effect of light therapy on circadian rhythms?
Light therapy in the morning, after core body temperature minimum, advances the circadian rhythm (go to bed early, wake up early)
What gender does SRED happen in more?
Females
What gender does RBD happen more in?
Males (>50)
When do disorders of arousal usually disappear?
onset puberty
What is another name for "hypnic jerk"?
Sleep start
What is cataythrenia?
Sleep related groaning in REM sleep usually
What is expected with sleep-related seizures?
Episodes usually last <1 minute, can have multiple episodes, more common in first part of the night, complex behaviors are uncommon
What drugs suppress REM?
SSRI
TCA
Propranolol
Benzodiazepines
Barbiturates
MOA Inhibitors
What drugs decrease N3?
Clozapine
Olanzapine
Fluoxetine
Paroxetine
What drugs increase N3?
Cimetidine
Gamma hydroxybutyrate
TCA
Trazadone
Gabapentin
Pregabalin
What way do the EOGs behave?
If looking left, REOG has upward deflection and LEOG has downward deflection
if looking right, REOG has downward deflection and LEOG has upward deflection
What is needed to score REM Without Atonia (RWA)?
Excessive sustained muscle activity in REM and cEMG
Excessive TMA in REM and chin or limb EMG
50% of mini epochs contain any chin or limb activity
What is a normal PR interval?
0.20 seconds
What is the Respiratory Event Index equation?
REI= (# of apneas + hypopneas) x 60 / monitoring time
When active equipment is close to patient what kind of artifact occurs?
60 Hz artifact
(can also occur from poor electrode contact, defective wires, inadequate grounding, and it's see in EEG/ECG/EOG/EMG)
(fix by fixing electrode and turning off unnecessary electronic equipment)
How do you correct ECG artifact seen on other channels?
Reposition electrodes higher on chest, reposition reference leads (M1 and M2), Link M1 and M2, re-reference, use QRS filter
How do you fix artifact that is "swaying"?
Wipe away sweat, decrease room temperature, turn on fan and remove blankets, (last resort) increase LFF (can dampen the slow waves)
How is OPTIMAL CPAP titration defined?
RDI <5, supine REM with no arousals
How is GOOD CPAP titration defined?
RDI <10 (or reduction of 50% when RDI baseline is <15), supine REM with no arousals
How is ADEQUATE CPAP titration defined?
RDI >10 (but reduction of >75% from baseline RDI)
When do you increase your CPAP?
Increase by z1 if:
z OA, z3 hypopneas, z5 RERAs, z3 minutes of loud snoring
(and then wait another 5 minutes before another increase)
When do you increase IPAP and EPAP?
z2 OA
When do you increase only IPAP?
z3 hypopneas, OR z5 RERAs, OR z3 minutes of loud snoring
If your patient doesn't have teeth, what mask interface is best for them?
Nasal pillows (Nasal and oral mask require structural teeth support in placement)
What is indicated to increase NPPV pressure support by 1-2?
Every 5 minutes of TV is low (6-8ml/kg)
Every 5 minutes is O2 sat <90% for z5 minutes and total volume is low [Show Less]