Mixed Deck — All RPSGT Topics Flashcards

Adaptive servo-ventilation (ASV) is contraindicated in which specific patient population, based on the findings of the SERVE-HF clinical trial?

Answer: Patients with heart failure with reduced ejection fraction (EF < 45%) and predominant central sleep apnea

The SERVE-HF trial (2015) demonstrated significantly increased cardiovascular mortality with ASV in patients with heart failure with reduced ejection fraction (LVEF < 45%) who had predominant central sleep apnea. ASV is therefore contraindicated in this population. This is a critical safety contraindication that all sleep technologists must know.

Which of the following correctly states the amplitude criterion for slow wave activity in N3 scoring?

Answer: Peak-to-peak >75 µV in frontal leads

AASM requires slow waves to have peak-to-peak amplitude >75 µV measured over the frontal derivations.

A sleep lab team is preparing for AASM accreditation. In a team leadership context, which action most demonstrates shared governance?

Answer: Staff technologists are included in developing policies and quality improvement plans

Shared governance involves frontline staff in decision-making processes, which improves buy-in and the quality of policies and procedures.

Stage N3 sleep is defined by what minimum percentage of slow-wave activity (SWA) per epoch?

Answer: 20%

AASM criteria require at least 20% of the epoch to consist of slow-wave (delta) activity to score N3.

A sleep technologist witnesses a patient have a generalized tonic-clonic seizure during a study. After calling for help, which action is the NEXT priority?

Answer: Position the patient on their side to protect the airway

Positioning the patient laterally (recovery position) protects the airway from aspiration and is the primary safety intervention during a seizure.

Which of the following scenarios represents a HIPAA breach?

Answer: Emailing unencrypted patient records to an unauthorized third party

Sending unencrypted PHI to an unauthorized recipient is a HIPAA breach regardless of intent.

What is the minimum preceding sleep duration required before an EEG frequency shift can be scored as an arousal per AASM rules?

Answer: 10 seconds

AASM requires at least 10 seconds of stable sleep preceding the EEG frequency shift for it to qualify as a scoreable arousal.

What is the purpose of a technology needs assessment?

Answer: To identify gaps between current capabilities and desired outcomes

A technology needs assessment systematically identifies gaps between current technological capabilities and desired outcomes, guiding informed technology investment decisions.

Which metric is MOST useful for tracking the percentage of studies that meet AASM minimum technical standards?

Answer: Study adequacy rate

Study adequacy rate directly measures the proportion of studies meeting minimum technical criteria, making it the primary QA metric for technical quality.

Body position during a PSG is most commonly recorded using:

Answer: A position sensor whose data is embedded as a channel in the EDF/PSG file

A body position sensor channel synchronized with the recording allows precise correlation of position with respiratory events and sleep stages.

A sleep lab team is transitioning to a new electronic health record (EHR) system. Which change management approach is most effective?

Answer: Involve staff in the planning process and provide adequate training before go-live

Involving staff in planning and providing training reduces resistance and increases successful adoption of new systems.

Which EEG frequency band is characterized by 8–13 Hz activity and is most prominent in quiet wakefulness with eyes closed?

Answer: Alpha

Alpha waves (8–13 Hz) are the hallmark of relaxed wakefulness with eyes closed.

During a split-night study, what minimum criteria must typically be met before transitioning from the diagnostic to the CPAP titration portion, per AASM guidelines?

Answer: At least 2 hours of diagnostic recording with an AHI ≥ 40 events/hour

AASM guidelines specify that a split-night study requires at least 2 hours of diagnostic sleep and an AHI ≥ 40 events/hour (or AHI 20-40 with clinical justification such as severe hypoxemia) before proceeding to CPAP titration in the same night.

A final PSG report shows sleep onset latency of 45 minutes. How should this be interpreted?

Answer: Mildly prolonged

Normal sleep onset latency is ≤20 minutes; 45 minutes is mildly to moderately prolonged but not at the severely delayed threshold.

What is the consequence of non-compliance with mandatory regulations?

Answer: Penalties including fines, license revocation, and potential legal action

Non-compliance with mandatory regulations can result in serious consequences including financial penalties, loss of licensure, and legal proceedings.

What distinguishes a mixed apnea from other apnea types?

Answer: It begins with absent respiratory effort and ends with resumed but obstructed effort

A mixed apnea begins with the absent effort of a central apnea and transitions to obstructive respiratory effort before airflow resumes.

Which of the following best describes the 'two-process model' of sleep regulation?

Answer: Sleep is regulated by the interaction of circadian rhythms (Process C) and homeostatic sleep drive (Process S)

The two-process model (Borbély) describes sleep as regulated by the circadian clock (Process C) and homeostatic sleep pressure that builds during wakefulness (Process S).

What should be the first action when a new regulation is enacted that affects your practice?

Answer: Review the regulation, assess its impact, and develop an implementation plan

When new regulations are enacted, professionals should promptly review them, assess their impact on current practices, and develop a structured implementation plan.

Which filter setting in PSG is specifically used to reduce slow-moving artifacts such as sweat and movement?

Answer: Low-frequency filter (LFF) / High-pass filter

The low-frequency filter (high-pass filter) attenuates very slow frequencies, reducing sweat and movement artifacts that appear as slow undulations.

In polysomnography, what does the term 'montage' refer to?

Answer: The specific combination and arrangement of recording channels

A montage is the defined set of channels and their derivations used during a PSG recording.