Free BRPT AASM Scoring of Respiratory and Cardiac Events Questions and Answers — Questions and Answers
Question 1: An obstructive apnea is scored when there is a drop in the peak signal excursion of airflow by at least 90% for a duration of at least 10 seconds, and which other condition is met?
- There is an absence of inspiratory effort.
- There is continued or increased inspiratory effort. (Correct answer)
- The event is associated with a 4% oxygen desaturation.
- The patient is in REM sleep.
Correct answer: There is continued or increased inspiratory effort.
The key feature distinguishing an obstructive apnea from a central apnea is the presence of respiratory effort. Despite the near-complete cessation of airflow, the patient's chest and/or abdomen continue to move, indicating an effort to breathe against a blocked airway.
Question 2: According to the AASM Recommended hypopnea rule (1A), a hypopnea is scored when there is a drop in airflow of at least 30% for 10 seconds or more, associated with what?
- A ≥3% oxygen desaturation or an arousal. (Correct answer)
- Only a ≥4% oxygen desaturation.
- Only an arousal.
- An increase in heart rate of 10 bpm.
Correct answer: A ≥3% oxygen desaturation or an arousal.
The recommended AASM scoring rule for a hypopnea requires both a significant reduction in airflow (≥30% for ≥10 seconds) and a clear physiological consequence. This consequence is defined as either an oxygen desaturation of at least 3% or an arousal from sleep.
Question 3: A central sleep apnea event is characterized by a cessation of airflow for at least 10 seconds and what defining feature?
- Continued paradoxical respiratory effort.
- A concurrent 3% oxygen desaturation.
- Absence of inspiratory effort. (Correct answer)
- Loud snoring preceding the event.
Correct answer: Absence of inspiratory effort.
Unlike an obstructive apnea where effort continues, a central apnea is defined by the absence of inspiratory effort throughout the entire period of airflow cessation. This indicates that the brain did not send the signal to breathe.
Question 4: Which of the following best describes the pattern of Cheyne-Stokes Respiration (CSR)?
- A sudden, brief cessation of airflow with continued effort.
- A crescendo-decrescendo pattern of breathing with central apneas. (Correct answer)
- Consistently shallow breathing throughout the night.
- Periods of rapid, deep breathing followed by an obstructive apnea.
Correct answer: A crescendo-decrescendo pattern of breathing with central apneas.
Cheyne-Stokes Respiration is a specific pattern of central sleep apnea most often seen in patients with congestive heart failure. It is characterized by a cyclical, waxing and waning (crescendo-decrescendo) pattern of breathing effort and airflow, interspersed with central apneas or hypopneas.
Question 5: A Respiratory Effort-Related Arousal (RERA) is a sequence of breaths lasting at least 10 seconds that is characterized by increasing respiratory effort and that leads to what?
- A 4% oxygen desaturation.
- A central apnea.
- An arousal from sleep. (Correct answer)
- A significant bradycardia.
Correct answer: An arousal from sleep.
A RERA is an event that does not meet the criteria for an apnea or hypopnea but still disrupts sleep. It is defined by a period of increasing respiratory effort (e.g., flattening of the nasal pressure waveform) that culminates in an arousal from sleep.
Question 6: Sinus bradycardia during sleep is typically scored if the heart rate drops below what threshold for adults?
- 60 bpm
- 50 bpm
- 40 bpm (Correct answer)
- 30 bpm
Correct answer: 40 bpm
While heart rate naturally slows during sleep, a sustained drop below 40 beats per minute (bpm) for at least 30 seconds is considered clinically significant bradycardia in adults and should be scored. This is a common parameter monitored for cardiac abnormalities during a polysomnogram.
Free BRPT AASM Scoring of Respiratory and Cardiac Events Questions and Answers
An obstructive apnea is scored when there is a drop in the peak signal excursion of airflow by at least 90% for a duration of at least 10 seconds, and which other condition is met?