Egan’s Chapter 30 Practice Questions:

1. Available evidence has shown that bilevel pressure is associated with better patient compliance than the conventional CPAP (T,F).: false

2. Central sleep apnea occurs more often than obstructive sleep apnea. (T,F).: false

3. The definition of sleep apnea uses what criteria for defining an episode of apnea?: 10 seconds

4. How does CPAP improve breathing in the patient with OSA?: pneumatic splinting of the upper airway

5. In what way do BiPAP units differ from CPAP units?: BiPAP applies different pressure levels on inspiration and exhalation

6. Medications have proved ineffective for most patients with sleep apnea (T,F).: true

7. Oral devices may prove useful for cases of mild OSA (T,F).: true

8. Patients with more severe levels of OSA usually need higher levels of CPAP to eliminate the apnea episodes (T,F).: false

9. Uvulopalatopharyngoplasty has a success rate of less than 50% (T,F).: true

10. What are the criteria to define hypopnea?: 30% decrease in airflow and 4% oxygen desaturation

11. What is believed to be the cause of systemic hypertension in patients with sleep apnea?: increased sympathetic tone

12. What is considered to be the major problem with the use of CPAP in patients with obstructive sleep apnea?: patient compliance

13. What is the amount of CPAP that is typically required to abolish upper airway obstruction in patients with OSA?: 7.5 to 12.5 cm H2O

14. What is the name of the respiratory pattern where a crescendo-decrescendo pattern of hypernea alternates with periods of apnea?: Cheyne-Stokes

15. What is the primary cause of obstructive sleep apnea?: small or unstable pharyngeal airway

16. What percent of the adult population is believed to have obstructive sleep apnea?: 2% to 4%

17. What term is used to describe a significant decrease in airflow during sleep but not a complete cessation of breathing?: hypopnea

18. What term is used to describe CPAP units that use a computer to adjust CPAP levels as needed by the patient during sleep?: auto-CPAP

19. What value for the apnea-hypopnea index (AHI) is consistent with moderate obstructive sleep apnea?: 15 to 30

20. Which of the following behavioral interventions is least useful for the treatment of sleep apnea?: avoidance of daytime naps

21. Which of the following characteristics is not typically associated with sleep apnea?: excessive daytime sleepiness

22. Which of the following characteristics is not typically associated with sleep apnea?: hypotensive

23. Which of the following conditions are associated with central apnea?: congestive heart failure, primary central nervous system lesions, high-altitude hypoxemia

24. Which of the following conditions is NOT associated with untreated obstructive sleep apnea?: heart failure

25. Which of the following factors has been shown to positively correlate with obstructive sleep apnea?: obesity of the upper body

26. Which of the following is NOT a common side effect of positive-pressure therapy?: headache

27. Which of the following is NOT a parameter used to confirm the metabolic syndrome associated with obstructive sleep apnea?: low triglycerides

28. Which of the following medical therapies is considered first-line treatment for obstructive sleep apnea (OSA)?: continuous positive airway pressure (CPAP)

29. Which of the following parameters is NOT typically monitored with a polysomnogram?: exhaled PCO2

30. Which of the following physical exam findings is associated with obstructive sleep apnea?: large tonsils

31. Why should the patient with obstructive sleep apnea not use alcohol?: alcohol decreases the arousal threshold