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Poor sleep, hazardous breathing: An overview of obstructive sleep apnea

doi: 10.1097/01.NPR.0000427942.27410.64
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INSTRUCTIONS Poor sleep, hazardous breathing: An overview of obstructive sleep apnea


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Poor sleep, hazardous breathing: An overview of obstructive sleep apnea

General Purpose: To provide information on the diagnosis and treatment of OSA. Learning Objectives: After reading the article and taking this test, you should be able to: 1. Identify the risk factors for and signs and symptoms, pathophysiology, and potential consequences of OSA. 2. Discuss the diagnosis and treatment of OSA.

  1. Which statement is true regarding OSA?
    1. OSA is characterized by repeated episodes of lower airway obstruction during sleep.
    2. Oxygen saturation levels remain stable during periods of apnea in OSA.
    3. Sleep arousals often last 15 minutes or longer before sleep is resumed.
    4. Persons with OSA usually are unaware that their sleep has been disrupted.
  2. Risk factors for OSA include
    1. female gender.
    2. older age.
    3. hyperthyroidism.
    4. microglossia.
  3. Which risk factor makes a person nearly three times more likely to have OSA than persons without it?
    1. growth hormone deficiency
    2. lower airway soft-tissue abnormalities
    3. male gender
    4. current smoker
  4. Airway obstruction causing disrupted breathing leads to
    1. hypercapnia.
    2. decreased breathing effort.
    3. alkalosis.
    4. decreased pharyngeal muscle activity.
  5. In severe cases each episode of apnea typically lasts
    1. 5 to 10 seconds.
    2. 12 to 18 seconds.
    3. 20 to 40 seconds.
    4. 45 to 60 seconds.
  6. The negative intrathoracic pressure that results from OSA causes
    1. increased ventricular afterload.
    2. increased left ventricular compliance.
    3. decreased myocardial oxygen demand.
    4. decreased pulmonary artery pressures.
  7. In cases without typical symptoms, OSA is clinically defined by an AHI of
    1. 1.
    2. 5.
    3. 10 or greater.
    4. 15 or greater.
  8. The most frequent symptom of OSA is
    1. nocturia.
    2. snoring.
    3. nocturnal gasping.
    4. headache.
  9. Comorbid conditions increasing risk of OSA include all except
    1. hypertension.
    2. metabolic syndrome.
    3. irritable bowel syndrome.
    4. diabetes.
  10. The most common craniofacial and soft-tissue abnormality in OSA is
    1. a nonspecific narrowing of the oropharyngeal airway.
    2. retrognathia.
    3. macroglossia.
    4. tonsillar hypertrophy.
  11. Home-based sleep studies are a reasonable option for patients with
    1. major comorbid conditions.
    2. an intermediate index of suspicion for OSA.
    3. atypical symptoms.
    4. a high likelihood of moderate-to-severe OSA.
  12. During home-based sleep studies, the authors recommend documenting
    1. an ECG.
    2. a chin electromyogram.
    3. airflow.
    4. an electrooculogram.
  13. The treatment of choice for OSA is
    1. CPAP during sleep.
    2. medication and supplemental oxygen.
    3. upper airway surgery.
    4. an adjustable OA during sleep.
  14. The preferred method for delivering CPAP for mouth breathers is via a
    1. non-rebreathing face mask.
    2. nasal mask.
    3. nasal pillow.
    4. full-face mask.
  15. Which of the following is true about CPAP?
    1. Asthma is an absolute contraindication to CPAP.
    2. Adverse effects of CPAP can include pulmonary hypertension.
    3. Adding humidification may lessen some adverse effects of CPAP.
    4. Nasal saline sprays must be avoided when using CPAP.
  16. OAs for the treatment of OSA
    1. serve as a splint for the pharyngeal soft tissues.
    2. advance the mandible and tongue relative to the maxilla.
    3. are used to prevent teeth grinding during sleep.
    4. are as effective as CPAP.
  17. Which of the following is generally used as part of primary OSA treatment?
    1. eszopiclone
    2. bariatric surgery
    3. positional therapy
    4. supplemental oxygen
  18. Patient adherence to CPAP therapy is most often determined in about
    1. 1 week.
    2. 2 weeks.
    3. 3 weeks.
    4. 6 weeks.


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