Positive Airway Pressure Therapy & Treatment Modalities Flashcards

What is the primary difference between standard BiPAP and BiPAP-ST (Spontaneous-Timed) mode?

Answer: BiPAP-ST includes a backup respiratory rate to ensure a minimum breathing frequency

BiPAP-ST adds a timed backup rate that delivers a breath if the patient does not initiate one within a set time interval, making it suitable for patients with central hypoventilation.

During PAP titration, when the technologist observes persistent large mask leak, what is the most appropriate first response?

Answer: Refit or readjust the mask to achieve a proper seal

Mask leak reduces effective therapy pressure delivery and must be corrected by adjusting mask fit, tightening headgear, or selecting a different mask size or style before escalating pressure.

What is the AASM-recommended residual AHI goal that defines a successful CPAP titration?

Answer: Less than 5 events per hour

Per AASM guidelines, an optimal titration result is a residual AHI of less than 5 events per hour with resolution of snoring and oxygen desaturations throughout all sleep stages and positions.

Heated humidification added to PAP therapy primarily benefits patients by:

Answer: Decreasing nasal dryness and congestion to improve comfort and adherence

Heated humidification adds warmth and moisture to the airstream, reducing nasal dryness, irritation, and congestion — side effects that are among the most common reasons patients discontinue PAP therapy.

Which condition may paradoxically emerge or worsen when a patient with OSA is treated with CPAP, resulting in new or persistent central apneas?

Answer: Complex (treatment-emergent) sleep apnea syndrome

Complex sleep apnea syndrome (also called treatment-emergent central sleep apnea) occurs when CPAP successfully eliminates obstructive events but unmasks or provokes central apneas that were not apparent during the diagnostic study.

In APAP devices, which combination of detected events typically triggers a pressure increase algorithm?

Answer: Apneas, hypopneas, snoring, and flow limitation

APAP algorithms monitor for the full spectrum of sleep-disordered breathing — apneas, hypopneas, snoring, and subtle flow limitation — and increase pressure in response to any detected event.

What is the purpose of 'expiratory pressure relief' technology (marketed as EPR, C-Flex, or A-Flex) on PAP devices?

Answer: To lower pressure transiently during exhalation, improving comfort without compromising therapy

Expiratory pressure relief briefly reduces delivered pressure during the exhalation phase, making it easier to exhale against PAP and improving patient comfort, particularly at higher treatment pressures.