FREE RST Therapeutic Interventions and Titration Questions and Answers

Question 1

A patient on CPAP at 15 cm H2O continues to have obstructive hypopneas and reports significant discomfort exhaling against the pressure.
According to AASM guidelines, which of the following is the most appropriate next step?

Accepted Answer

Switch to bilevel PAP with an IPAP of at least 15 cm H2O and an EPAP of 11 cm H2O.

Answer

Increase CPAP to 16 cm H2O and reassess after 15 minutes.

Answer

Add supplemental oxygen at 1 L/min.

Answer

Switch to bilevel PAP with an initial IPAP of 12 cm H2O and EPAP of 8 cm H2O.

Question 2

During a PAP titration, a patient begins to exhibit frequent central apneas after obstructive events have been eliminated at a CPAP pressure of 10 cm H2O. This phenomenon is best described as:

Accepted Answer

Treatment-Emergent Central Sleep Apnea

Answer

Obesity Hypoventilation Syndrome

Answer

Cheyne-Stokes Respiration

Answer

High-Altitude Periodic Breathing

Question 3

According to the AASM Manual, which of the following criteria defines an OPTIMAL PAP titration?

Accepted Answer

The RDI is <5/hour for at least a 15-minute duration, including supine REM sleep, with SpO2 >90%.

Answer

The RDI is reduced by at least 75% from baseline, and SpO2 remains above 88%.

Answer

The RDI is <10/hour for at least 30 minutes, including some supine sleep.

Answer

All apneas and hypopneas are eliminated, but snoring and RERAs persist at an acceptable level.

Question 4

A patient is being titrated on bilevel PAP for hypoventilation. The technologist has increased the IPAP to augment ventilation, but the SpO2 remains at 87% for over 5 minutes despite the absence of discrete apneas or hypopneas. What is the recommended intervention?

Accepted Answer

Add supplemental oxygen, starting at 1 L/min.

Answer

Increase the EPAP to improve oxygenation.

Answer

Switch the patient to ASV mode immediately.

Answer

Decrease the pressure support (IPAP-EPAP difference).

Question 5

Adaptive Servo-Ventilation (ASV) is a therapeutic option for specific types of sleep-disordered breathing. However, its use is contraindicated in which of the following patient populations due to increased mortality risk?

Accepted Answer

Patients with heart failure and a left ventricular ejection fraction (LVEF) of ≤ 45%.

Answer

Patients with treatment-emergent central sleep apnea.

Answer

Patients with idiopathic Cheyne-Stokes respiration.

Answer

Patients with central sleep apnea due to long-term opioid use without alveolar hypoventilation.

Question 6

During a split-night study, what is the minimum duration of PAP titration recommended by the AASM to consider the study adequate for determining a therapeutic pressure?

Accepted Answer

At least 3 hours of titration time.

Answer

At least 1 hour of titration time.

Answer

At least 2 hours of titration time.

Answer

At least 4 hours of titration time.

A patient on CPAP at 15 cm H2O continues to have obstructive hypopneas and reports significant discomfort exhaling against the pressure.According to AASM guidelines, which of the following is the most appropriate next step?

A patient on CPAP at 15 cm H2O continues to have obstructive hypopneas and reports significant discomfort exhaling against the pressure.
According to AASM guidelines, which of the following is the most appropriate next step?