In the Philippine Licensure Examination for Respiratory Therapists, the Diagnostic section includes Sleep Studies (Polysomnography) as a critical area of assessment. Polysomnography is a comprehensive sleep test used to diagnose sleep disorders by monitoring brain waves, oxygen levels, heart rate, breathing, and body movements during sleep.
Evaluation of Sleep Disorders
The exam often includes topics on diagnosing sleep-related breathing disorders, particularly:
- Obstructive Sleep Apnea (OSA) – A condition where airway obstruction causes repeated pauses in breathing, leading to fragmented sleep and oxygen desaturation.
- Central Sleep Apnea (CSA) – A disorder characterized by a lack of respiratory effort due to brainstem dysfunction, resulting in irregular breathing patterns.
A test-taker must understand how to interpret polysomnographic findings, differentiate between OSA and CSA, and recognize their impact on overall health.
Analysis of Sleep Stages and Respiratory Events
Sleep is divided into Non-Rapid Eye Movement (NREM) and Rapid Eye Movement (REM) stages. The exam may include questions on how respiratory patterns change across these sleep stages and how abnormalities indicate underlying disorders. Respiratory therapists must also identify apnea-hypopnea index (AHI) values, oxygen desaturation levels, and arousal patterns from sleep study reports.
Welcome to our Respiratory Therapist Reviewer. In this session, you'll have the opportunity to test your understanding of key concepts in Sleep Studies (Polysomnography). The quiz consists of multiple-choice questions covering various topics. Pay close attention to each question and select the best answer. After completing the exam, check the video or the answer key and explanations at the last part.
Basic Concepts of Polysomnography
1. What is the primary diagnostic tool used to evaluate
sleep disorders?
A. Pulse oximetry
B. Polysomnography (PSG)
C. Arterial blood gas (ABG) analysis
D. Capnography
2. Which of the following is NOT a standard parameter
measured during polysomnography?
A. Electroencephalogram (EEG)
B. Electromyogram (EMG)
C. Forced expiratory volume (FEV1)
D. Electrooculogram (EOG)
3. Which sleep disorder is characterized by repeated
episodes of upper airway obstruction during sleep?
A. Narcolepsy
B. Obstructive sleep apnea (OSA)
C. Central sleep apnea (CSA)
D. Restless leg syndrome
4. Which sleep stage is characterized by rapid eye
movement (REM), vivid dreams, and muscle atonia?
A. Stage 1
B. Stage 2
C. Stage 3
D. REM sleep
5. Which brain activity pattern is most dominant during
deep (slow-wave) sleep?
A. Alpha waves
B. Beta waves
C. Delta waves
D. Theta waves
Sleep Apnea and Respiratory Events
6. What is the apnea-hypopnea index (AHI) used for?
A. To assess lung volumes
B. To measure oxygen saturation levels
C. To determine sleep disorder severity
D. To monitor CO2 retention
7. What AHI value is considered diagnostic of moderate
obstructive sleep apnea (OSA)?
A. 5-14 events/hour
B. 15-29 events/hour
C. 30-49 events/hour
D. >50 events/hour
8. Which event is defined as a complete cessation of
airflow for at least 10 seconds?
A. Hypopnea
B. Apnea
C. RERA (Respiratory Effort-Related Arousal)
D. Snoring
9. Which of the following is a characteristic feature of
central sleep apnea (CSA)?
A. Airflow cessation with persistent respiratory effort
B. Absence of both airflow and respiratory effort
C. Airflow cessation due to airway obstruction
D. Increased snoring
10. What is the main physiological consequence of
untreated obstructive sleep apnea (OSA)?
A. Increased tidal volume
B. Chronic hypoxemia and cardiovascular disease
C. Decreased respiratory rate
D. Hyperventilation
Polysomnography Interpretation and Therapy
11. What device is commonly used to treat obstructive
sleep apnea (OSA)?
A. Nasal cannula
B. Incentive spirometer
C. Nebulizer
D. CPAP (Continuous Positive Airway Pressure)
12. Which component of a polysomnogram detects airflow?
A. Thermistor or nasal pressure transducer
B. Electroencephalogram (EEG)
C. Pulse oximeter
D. Electrocardiogram (ECG)
13. Which of the following is NOT a common symptom of
sleep apnea?
A. Loud snoring
B. Daytime sleepiness
C. Morning headaches
D. Hyperactivity
14. Which oxygen desaturation level is commonly used to
define a hypopnea event?
A. ≥2% decrease
B. ≥3% decrease
C. ≥4% decrease
D. ≥5% decrease
15. What term describes the transition from wakefulness
to sleep?
A. Sleep inertia
B. Sleep onset
C. REM rebound
D. Sleep fragmentation
16. Which of the following conditions is associated with
REM sleep behavior disorder?
A. Uncontrolled limb movements during REM sleep
B. Excessive daytime sleepiness
C. Sleepwalking
D. Narcolepsy
17. A patient with obesity, excessive daytime sleepiness,
and chronic hypoventilation may have:
A. Narcolepsy
B. Obesity hypoventilation syndrome (OHS)
C. Central sleep apnea
D. Restless leg syndrome
Advanced Concepts in Sleep Studies
18. Which sleep disorder is characterized by excessive
daytime sleepiness and sudden muscle weakness triggered by emotions?
A. Obstructive sleep apnea (OSA)
B. Insomnia
C. Central sleep apnea (CSA)
D. Narcolepsy with cataplexy
19. What is the gold standard method for diagnosing
narcolepsy?
A. Overnight polysomnography (PSG)
B. Multiple Sleep Latency Test (MSLT)
C. Actigraphy
D. Home sleep apnea test (HSAT)
20. Which sleep-related breathing disorder is most
commonly associated with obesity?
A. Obesity hypoventilation syndrome (OHS)
B. Narcolepsy
C. Restless legs syndrome (RLS)
D. Periodic limb movement disorder (PLMD)
21. What condition is characterized by uncontrollable leg
movements at rest, often worsening at night?
A. Central sleep apnea
B. REM sleep behavior disorder
C. Restless legs syndrome (RLS)
D. Sleepwalking
22. Which test is used to assess circadian rhythm
disorders?
A. Multiple Sleep Latency Test (MSLT)
B. Home sleep apnea test (HSAT)
C. Actigraphy
D. Epworth Sleepiness Scale (ESS)
23. Which of the following is a key finding in REM sleep
behavior disorder (RBD)?
A. Excessive daytime sleepiness
B. Sleep paralysis
C. Lack of muscle atonia in REM sleep
D. Frequent awakenings during Stage 3 sleep
24. Which type of apnea occurs due to a lack of
respiratory effort from the brainstem?
A. Obstructive sleep apnea
B. Central sleep apnea
C. Complex sleep apnea
D. Cheyne-Stokes respiration
25. What is the most common first-line treatment for
central sleep apnea?
A. CPAP therapy
B. Tracheostomy
C. Oxygen therapy
D. Bilevel Positive Airway Pressure (BiPAP) therapy
26. What is the role of the Epworth Sleepiness Scale
(ESS) in sleep studies?
A. To measure oxygen desaturation
B. To quantify excessive daytime sleepiness
C. To diagnose sleep apnea severity
D. To assess leg movements during sleep
27. What is the term for brief, partial awakenings caused
by increased respiratory effort during sleep?
A. Apnea
B. Hypopnea
C. Respiratory Effort-Related Arousals (RERA)
D. Cataplexy
28. Which imaging modality is most useful for diagnosing upper airway structural abnormalities in sleep apnea?
A. Chest X-ray
B. MRI
C. CT scan
D. Lateral neck X-ray
29. What is the most common cause of
non-respiratory-related insomnia?
A. Depression and anxiety
B. Obstructive sleep apnea
C. Periodic limb movement disorder
D. Narcolepsy
30. Which statement best describes Cheyne-Stokes
respiration in sleep disorders?
A. It is a continuous, rapid breathing pattern.
B. It involves gradual rises and falls in breathing effort.
C. It is caused by airway collapse.
D. It only occurs in REM sleep.
ANSWER KEY HERE