RPSGT RPSGT Sleep Disorders & Pathophysiology 2 — Questions and Answers
Question 1: Which sleep-related breathing disorder involves cessation of both airflow and respiratory effort?
- Obstructive sleep apnea
- Mixed apnea
- Central sleep apnea (Correct answer)
- Upper airway resistance syndrome
Correct answer: Central sleep apnea
Central sleep apnea is defined by cessation of both airflow and respiratory effort, as the brain fails to send signals to the breathing muscles.
Question 2: Kleine-Levin syndrome is best described as:
- A chronic insomnia disorder
- A recurrent hypersomnia with behavioral changes (Correct answer)
- A form of narcolepsy with cataplexy
- A circadian rhythm sleep-wake disorder
Correct answer: A recurrent hypersomnia with behavioral changes
Kleine-Levin syndrome is a rare disorder characterized by recurrent episodes of hypersomnia accompanied by cognitive, behavioral, and autonomic disturbances.
Question 3: The Multiple Sleep Latency Test (MSLT) is primarily used to diagnose:
- Obstructive sleep apnea
- Periodic limb movement disorder
- Narcolepsy and idiopathic hypersomnia (Correct answer)
- Circadian rhythm disorders
Correct answer: Narcolepsy and idiopathic hypersomnia
The MSLT objectively measures daytime sleepiness and detects sleep-onset REM periods (SOREMPs), which are diagnostic criteria for narcolepsy.
Question 4: Confusional arousals, sleepwalking, and sleep terrors are all classified as:
- REM parasomnias
- NREM parasomnias (Correct answer)
- Circadian rhythm disorders
- Hypersomnias
Correct answer: NREM parasomnias
These are all disorders of arousal from NREM sleep, classified as NREM parasomnias, and typically arise from slow-wave sleep in the first third of the night.
Question 5: Which finding is required to score a hypopnea per AASM recommended (not acceptable) criteria?
- ≥30% reduction in airflow with ≥3% oxygen desaturation or arousal (Correct answer)
- Complete cessation of airflow for ≥10 seconds
- ≥50% reduction in airflow with ≥4% oxygen desaturation
- ≥20% reduction in thoracic effort with arousal
Correct answer: ≥30% reduction in airflow with ≥3% oxygen desaturation or arousal
The AASM recommended hypopnea rule requires ≥30% airflow reduction for ≥10 seconds with ≥3% oxygen desaturation or EEG arousal.
Question 6: Advanced sleep-wake phase disorder (ASWPD) is characterized by:
- Inability to fall asleep before 2 AM
- Persistently early sleep onset and early morning awakening (Correct answer)
- Irregular sleep-wake patterns without a circadian rhythm
- Non-24-hour sleep-wake cycles
Correct answer: Persistently early sleep onset and early morning awakening
ASWPD is a circadian rhythm disorder where the sleep period is phase-advanced, causing early evening sleep onset and very early morning awakening.
RPSGT RPSGT Sleep Disorders & Pathophysiology 2
Which sleep-related breathing disorder involves cessation of both airflow and respiratory effort?