CPAP
Medical therapy choice for sleep apnea
CPAP
Range of mild OSA
5-15
What surgical treatment can eliminate OSA?
Tracheostomy
DME supplier needs this to issue equipment to patients
Prescription/Physician Order
Organization accredits DME Supplier
AASM
This sleep test is ordered for narcoleptic patients
MSLT
What extra parameter would you add to a PSG for a suspected parasomnia?
Arm leads
Close video observation
Hours of sleep needed for an adequate titration after split
3 or more hours
Stage of sleep and body position for optimal CPAP pressure.
REM, Supine
Maximum pressure support for NPPV
20 cm H20
What setting on BIPAP would you change to reduce snoring/hypopneas?
Increase IPAP
Normal range of ETC02
35-45 mmHG
This sleep test is performed on a patient with a sleep related breathing disorder
PSG/Diagnostic Study
First described pap and the year
Sullivan, 1981
What are 3 different modes of pap?
CPAP
BIPAP
APAP
What are goals of a CPAP Titration?
RDI<5
SP02>90%
Snoring Eliminated
EEG Arousals/RERA'S <5 hr
A method/type of capnography
End-tidal C02
Transcutaneous C02
Minimum & Maximum gap between IPAP and EPAP
4-10
15-30
What sleep test will best diagnosis a patient with insomnia?
Wrist Actigraphy
What neck size and BMI are indicators of OSA?
16-17 inches
BMI >30
Standard device used to verify CPAP pressure?
Water Column Manometer
Increase IPAP for how many hypopneas and minutes of snoring?
3
Behavioral strategy option for OSA treatment
Weight Loss=BMI of 25/less
Exercise
Positional Therapy
Avoidance of alcohol/sedatives before bed
What are 2 different modes of BIPAP?
S=Spontaneous
ST=Spontaneous Time
What is a contraindication of supplemental 02?
Hypercapnia
02 can prolong apneas & worsen hypercapnia in patients w/ comorbid respiratory disease
Sleep test for suspected circadian rhythm sleep disorder
Actigraphy w/ sleep diary.
Complex sleep apnea
The amount of air a patient breaths in on a pap machine
Tidal Volume
An intentional leak is:
Expected leak at the exhalation port to release C02
What three things do portable monitors observe?
Airflow
Respiratory Effort
Blood oxygenation
Target ventilation for ASV is ____ of patient average ventilation
90%
Name one of the potential applications of auto-titrating PAP
APAP Diagnosis (not recommended)
APAP Titration
Sleep test performed on a patient suspected of hypersomnia
PSG followed by MSLT
2 reasons to decrease CPAP pressure
Patient tolerance
Central apneas