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New RPSGT Exam - Study Guide and Practice test with Answers (999 Solved Questions)

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    NEW RPSGT EXAM - Study Gui de and Practice Test Latest Update Graded A+ The purpose of an intentional mask leak is to... ✔✔ Wash out CO2 and prevent rebreathing Recommended guidelines state that HSV can be considered when.... ✔✔ Cheyne Stokes and central Apn eas have not been eliminated. What is aerophagia? ✔✔ The swallowing of air What is maxillomandibular advancement? ✔✔ Treatment that involves cutting and advancing the upper and lower jaw bones; enlarging and stabilizing the posterior airway. What is the PRIMARY function of the EPAP setting? ✔✔ To eliminate desaturations and arousals. According to guidelines, how many Hypopneas need to occur in peds pts prior to increasing pressure? ✔✔ 1 What are the AASM guidelines for supplemental O2 during PAP studie s? ✔✔ 1lmp during PAP titration when SPO2 is less than or equal to 88% for 5 or more minutes and in the absence of obstructive events. If a pts Apneas are fixed at 10cm, but Hypopneas and snoring still occur at 16cm, what levels of BiLevel should be used? ✔✔ IPAP: 14 EPAP: 10 Which of the following can reduce the effectiveness of CPAP and why: Nasal spray, Alcohol, Anti depressants. ✔✔ Alcohol: impairs arousal response which can lead to longer than normal events and severe desats. Inhibits upper airway ac tivity What syndrome would a pt with COPD and OSA have? ✔✔ Overlap syndrome What are hypoxemia and hypercapnia? ✔✔ Hypoxemia: very low 02 in the blood Hypercapnia: very high CO2 in the blood. What would a patient with both hypoxemia and hypercapnia most likely be diagnosed with? ✔✔ Hypoventilation What is an MWT's MOST important use? ✔✔ Measure patients ability to resist the urge to fall asleep

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    Tricyclic antidepressants, large amounts of caffeine and large amounts of chocolate have been known to trigge r what? ✔✔ REM sleep behavior disorder Recommended impedance for eeg and eog ✔✔ 5k ohms The amount of space needed to archive digitized data is MOST impacted by? ✔✔ Sampling rate Cortical activity is best described as ✔✔ Spontaneous arousal Calculate t he AHI based on the following data 25 obstructive apneas 5 central apneas 23 mixed apneas 15 hypopneas 48 RERAS 65 arousals 360 min of sleep ✔✔ 11 According to RECOMMENDED guidelines, the minimum duration of a significant leg movement is ✔✔ .5 According to RECOMMENDED guidelines, an optional parameter to include in the report for an adult polysomnogram is ✔✔ Occurrence of hypoventilation during the diagnostic study in adult The respiratory event that requires oxygen desaturation and/ or an arousal as par t of the scoring criteria is ✔✔ Obstructive hypopnea An ECG arrhythmia commonly seen when recording PSG's, particularly in patients that have obstructive sleep apnea and cardiac disease. It can be identified by the morphology of an irregularly irregular v entricular rhythm associated with replacement of consistent P waves by rapid oscillations that vary in size, shape, and timing ✔✔ Atrial fibrillation The stage that is the greatest portion of the epoch ✔✔ The stage that is the greatest portion of the epoc h What is the best response when a patient asks the technologist if they have sleep apnea and will need to wear a CPAP mask? ✔✔ Provide the patient with educational material about sleep apnea Which of the following is the MOST LIKELY cause of a 35 minute REM latency ✔✔ Untreated depression

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    A breathing pattern characterized by at least three cycles of crescendo breathing with duration of at least 10 minutes is ✔✔ Cheyne Stokes respiration An important responsibility of the scoring tech is to ✔✔ Confirm a ccuracy of report components Which type of calibration is based on a series of patient instructions intended to verify the signal response and quality ✔✔ Physiological The most important reason for performing a MWT is to ✔✔ Measure the patient's ability to resist the urge to fall asleep The importance of selecting sampling rates according to RECOMMENDED guidelines is to ✔✔ Minimize aliasing effect The syndrome characterized by prolonged episodes of severe hypoxemia and associated PaCO2 elevation that wo rsens during sleep is ✔✔ Obesity hypoventilation The patient's medical history indicates the patient has been taking tricyclic antidepressants for the past 5 years. The technologist should anticipate that the patient may have an increased likelihood of ✔✔ REM Sleep Behavior Disorder According to RECOMMENDED guidelines, the sampling rate to provide the optimal resolution for recording EEG in a patient with suspected nocturnal seizure is ✔✔ 500Hz The electrode located 30% above the left pre - a crease i s ✔✔ C3 According to RECOMMENDED guidelines, four nap opportunities on a MSLT would be acceptable when the patient ✔✔ Had REM on at least two nap opportunities A patient's history indicates a diagnosis of overlap syndrome. The tech can anticipate that the pat ient has ✔✔ COPD AND OSA according to recommended guidelines, which of the following should be included when recording pediatric patients ✔✔ end - tidal co2 the ability to remontage while recording on digital equipment is the result of ✔✔ system referencin g when reviewing a patient's history in preparation for a polysomnogram, physiologic findings suggestive of hypoventilation include ✔✔ hypoxemia and hypercapnia

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    when the amplitude of a signal exceeds the physical limitations of a channel the most importa nt adjustment the tech can make to optimize waveform display is to ✔✔ decrease sensitivity when intermittent 60 hz activity occurs in the f4 - m1 electrodes during rem sleep the best immediate action would be to ✔✔ rely on f3 - m2 a patient with mild dementi a becomes more confused and/or agitated in the early evening. the patient is most likely experiencing ✔✔ sundowning the most common method to monitor blood oxygen saturation during polysomnography is ✔✔ pulse oximetry the most appropriate action a techno logist would take when there is confirmed ventricular tachycardia greater than 30 seconds is ✔✔ initiate emergency response system a patient's chart indicates that they use 30 l/min of oxygen at home. the tech notes that the physician's orders for the psg specifies the study without supplemental oxygen and to add 1.0 l/min oxygen if the saturation is less than 89%. the best action for the tech is to ✔✔ call the physician for confirmation which of the following is the most likely effect of zolpidem and zal eplon on sleep architecture ✔✔ increased sleep latency which of the following best describes a referential montage ✔✔ there is potential for electrode contamination according to recommended guidelines, the device that should be used to monitor airflow an d detect apnea during a diagnostic study is ✔✔ oronasal thermal sensor which process would be an adequate routine for disinfecting cup electrodes after removing adhesive residue, gel and organic material, and washing in warm water and mild detergent ✔✔ so aking in 1: 10 bleach and water for 10 min. which of the following would be most important to document during a polysomnogram ✔✔ position changes the electrode array used for recording physiologic activity is referred to as ✔✔ montage according to recom mended guidelines, the maximum electrode impedance for eeg and eog recording is ✔✔ 5000 ohms

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    according to recommended guidelines, unattended portable monitoring can be used as an alternative to in lab testing when ✔✔ there is a high probability of moderat e to severe osa without comorbid conditions a self reporting tool used to evaluate subjective sleep quality and disturbance over the previous month is ✔✔ pittsburgh sleep quality index the most appropriate setting a technologist would use to control the frequency band of waveforms on a recording is the ✔✔ (low filter (high pass filter) which of the following can negatively impact all bioelectric channels ✔✔ contaminated m1 which of the following substances can reduce the effectiveness of pap therapy ✔✔ alcoholic beverages a patient that intentionally engages in behavioral patterns that are inconsistent with sleeping well is demonstrating ✔✔ inadequate sleep hygiene what is the best tool that a physician could use to more clearly explain the results of the sleep study and the importance of therapy to a patient ✔✔ histogram real time access to pap compliance data is an example of ✔✔ efficacy monitoring a process to decrease fear of artificial circumstances by repeated and controlled exposure to a feared situation is ✔✔ desensitization what has the largest impact on adherence to pap therapy ✔✔ patient education which statement is true regarding cpap ✔✔ there is one level of pressure for inspiration and expiration sleep debt can best be described as the ✔✔ cumulative effect of insufficient sleep according to recommended guidelines for pediatric cpap titration, how many hypopneas must occur prior to increasing pressure ✔✔ one excessive warming and humidification will cause ✔✔ water to pool in the cpap t ubing maxillomandibular advancement treats osa by ✔✔ enlarging and stabilizing the upper airway in patients with severe sleep - disordered breathing the most commonly seen response resulting from successful pap titration is ✔✔ rem and slow wave rebound

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    wh ich of the following is most likely to occur due to an improperly fitting pap interface? ✔✔ conjunctivitis when a patient complains of claustrophobia, is unable to tolerate pap and requests to end the psg, the next best step is to ✔✔ schedule desensitizat ion a patient reports a complete nasal obstruction prior to pap titration. the tech should ✔✔ use a oro - nasal interface the best candidate for oral appliance would have ✔✔ mild osa during stage n2 sleep, the patient changes position and the tech notes i ncreased snoring and an increasing leak. the tech should ✔✔ reposition and adjust pap interface according to recommended guidelines, cpap should be increased at an interval no less than ✔✔ 5 minutes the primary function of epap is to ✔✔ maintain upper ai rway patency through inspiration based on the psg results below, what would be the best recommendation for a patient that is non - compliant and refuses to continue with cpap therapy overall ahi 8 overall rem ahi 38 supine rem ahi 28 supine nrem ahi 21 late ral nrem ahi 1 lateral rem 3 ✔✔ position therapy the best method for detecting apneas and hypopneas during pap titration is to use a/an ✔✔ airflow signal generated by the pap delivery device the primary benefit of heated humidification is to ✔✔ help reduce nasal congestion a side e ffect of cpap is ✔✔ aerophagia the most common reason for changing the pap interface during a titration is ✔✔ unacceptable leak value what is the recommended starting pressure for pediatric and adult cpap titration ✔✔ 4 cmh2o the purpose of intentional leak is to ✔✔ wash out co2 and prevent rebreathing

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    during cpap titration at 10 cm h2o, spo2, values range between 80 and 85% for 10 min despite absence of respiratory events. what is the best action for the tech to take ✔✔ follow protocol for supplemental oxygen according to recommended guidelines, adaptive servo ventilation can be considered during a titration study when a down titration ✔✔ has not eliminated cheyne stokes respiration or central emergent apneas during a titration study the patients apne as are eliminated at 10 cm h2o but hypopneas and snoring continue at 16 cm h20. according to recommended guidelines, the appropriate pressures to begin a bilevel titration are ✔✔ ipap 10 epap 14 during a cpap titration at 15 cm h20, the patient is restles s and continues to have frequent obstructive respiratory events. the best action is to ✔✔ change to bi level dc channel ✔✔ psg channel derived from an external piece of equipment such as a pap device or oximeter. stray capacitance ✔✔ when electrical sign als from external sources interfere w/ signals derived from the pt. amperes are measured in what units? ✔✔ coulombs/second time axis ✔✔ horizontal positioning of the pen. common mode rejection ✔✔ the process by which a differential amplifier rejects ide ntical inputs (unwanted signals). mechanical baseline ✔✔ pen's vertical position when the power to the psg is turned off. electrical baseline ✔✔ the vertical positioning of the pen w/ power of psg turned on. capnometer ✔✔ a device used to measure the le vel of co2 in a sample of air. frequency ✔✔ measured in hertz(hz) or cycles/second. paper speed for psg ✔✔ 10 mm/sec when a pt. looks towards an eog electrode it causes what? ✔✔ a positive charge, or downward deflection. rise time ✔✔ amount of time it takes for a wave to reach 63% of its peak.

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    sensitivity setting for eeg channel ✔✔ 7uv/mm or 70uv/cm *in pt.'s w/ low amplitude eegs, the sensitivity can be adjusted to 5uv/mm or 50uv/cm filter settings for respiratory effort & airflow ✔✔ lff= 0.1hz hff= 15hz filter settings for eog ✔✔ lff= 0.3hz hff= 35hz high level disinfection ✔✔ used for items that come into contact w/ non - intact skin, blood, and mucous membranes. do the naps occur every 2 hours from the time the previous nap ended or every 2 hours on the hou r or half - hour? ✔✔ every 2 hours on the hour or half hour. how long before a nap begins should the subject cease smoking? ✔✔ 30 minutes what epoch size is best for recording the "mslt"? ✔✔ 30 seconds. a mean sleep latency of indicates what? ✔ ✔ Pathological sleepiness. A normal mean sleep latency is how many minutes? ✔✔ 10 - 20 minutes How many naps must have unequivocal periods of REM to arrive at a Diagnosis of Narcolepsy? ✔✔ 2 naps. What is the Narcoleptic Tetrad? ✔✔ Excessive daytime sle epiness, hypnagogic hallucinations, sleep paralysis, cataplexy. How is the mean sleep latency calculated? ✔✔ Sum of all latencies, divided by total# of naps. During REM, inhibition of thermoregulatory mechanisms lead to what state? ✔✔ Poikilothermia. Wh at equation best expresses time constant? ✔✔ TC= C x R TC=Time Constant C= Capacitance R= Resistance What sleep stage requires at least 20% but no more than 50% of the epoch to consist of wave of 2 cps or slower w/amplitudes greater than 75 uV. ✔✔ Stage 3. an epoch that does not meet the criteria for active sleep or quite sleep is called what? ✔✔ intermediate sleep

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    trace alternant pattern is associated with what stage of sleep in the infant? ✔✔ quiet sleep (nrem sleep) infant breathin g patterns that alternates regular breathing with 5 - 10 seconds of apnea? ✔✔ periodic breathing. rem occupies what percentage of sleep in the neonate at term? ✔✔ 50%. a function that expresses the frequency of eye movements per unit time during sleep stage re m? ✔✔ rem density. know as the pacemaker for mammalian circadian rhythms? ✔✔ suprachiasmatic nucleus (scn). a complaint of morning headaches associated with severe sleep apnea is a result of what? ✔✔ Severe oxygen desaturation and hypercapnia (Elevated levels of carb on dioxide in the blood). Pre - Sleep Interviews ✔✔ conducted by sleep technicians who ask questions to clarify information and make careful observations of the patient such as, willingness to learn, mental age, physical limitations, etc. Sleep Diary ✔✔ Pa tient keeps a record of sleep habits for 2 weeks preceding the test. The sleep diary generally has two components: Before Sleep and After Sleep. Pre - sleep Questionnaire ✔✔ standardized form that reviews issues related to sleep, but tech asks additional qu estions for clarification, as needed. The questionnaire determines if the patient's preceding 24 hrs was normal for that individual. Bed - Partner Questionnaires ✔✔ Filled out by the patient's bed partner (or roommate or parent in some cases) with the patie nt's permission. The partner typically is aware of snoring or periods of apnea even though the patient may not be aware. Morning Questionnaire ✔✔ Takes place in the morning after PSG; May come in the form of a checklist, or the tech may ask specific quest ions regarding sleep quality,onset to sleep time,number of arousals,TST,Differences between sleeping at home and in lab, and Sleepiness upon awakening. - If pt reports sleep was very different from home, repeat PSG may be warranted. Morning/Evening Question naires ✔✔ asks 19 questionnaires about time preferences to determine if patient is a morning,evening, or neutral person.

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    Excessive Daytime Sleepiness ✔✔ increasing societal problem related to lack of adequate sleep, causing the patient to feel sleepy during the waking hours to the point that the patient may fall asleep or feel the need to nap. Fatigue ✔✔ General feeling of tiredness, weakness, or lack of energy and may be related to physical or emotional problems. "Do you feel the need to sleep during the dayti me?" "Do you feel drowsy?" --- are questions a tech should ask to determine if they are experiencing EDS or Fatigue? ✔✔ EDS "Do you feel as though you have no energy?" "Do you feel weary or weak?" --- are questions a tech should ask to determine if they are e xperiencing EDS or Fatigue? ✔✔ Fatigue Stanford Sleepiness Scale ✔✔ brief assessment used a number of different times a day to determine if people have excessive daytime sleepiness (EDS). Epworth Sleepiness Scale ✔✔ evaluates how likely a person is to fa ll asleep during a number of different activities. The person rates each situation on a scale of 0 - 3 corresponding to the chance of falling asleep (none, slight, moderate, or high). Sleep - Wake Activity Inventory (SWAI) ✔✔ Measures a number of different as pects of sleep disorders:excessive daytime sleepiness, nocturnal sleep,relaxing ability,energy, etc. - asks patient to score 9 different statements about sleepiness on a 1 - 9 scale. (A score of 50 or more is normal, 40 - 50 suggests EDS, 40 or less indicated ED S. Fatigue Severity Scale ✔✔ list of nine descriptions related to fatigue; patient scores each statement on a 1 - 7 scale (strongly disagree to strongly agree). Scores of 9 - 35=normal; scores above 35 suggest high degree of fatigue. Multiple Sleep Latency Tests (MSLT's) ✔✔ measure sl eepiness during waking hours and the tendency of a person to fall asleep. - may diagnose narcolepsy and idiopathic hypersomnia. MSLT includes how many nap periods with first within 3 hours of nocturnal PSG, and then spaced at 2 hours after preceding nap. ✔✔ 5 No smoking is allowed within _____ minutes of starting MSLT nap and no strenuous activity within ____ minutes of a nap. ✔✔ 30;15 Maintenance of Wakefulness Test ✔✔ determines patient's ability to stay awake in the daytime.

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    During MWT, patient is plac ed at rest, sitting in bed with low lights for ___ 40 minute periods spaced at 2 hours. ✔✔ 4 Tracheostomy ✔✔ An opening directly into the trachea bypasses the obstruction and opens the airway, but it is invasive and can result in many complications, so it is rarely done. - can be blocked during waking hours and opened during sleep. - usued as last resort usually in elderly or morbidly obese, facial abnormalities etc Higher Sampling Rates are needed to detect seizure activity in infant and child PSG'S. What sa mpling Rates for EOG AND EMG recordings during psg for seizure acivity? ✔✔ greater than or equal to 500 Hz for EOG and greater than or equal to 200 Hz for EMG recording. Initiate Low - Flow Supplemental Oxygen at how many liters per minute when SpO2 falls below 85% on ambient room air. ✔✔ 1 liter per minute Monitor SpO2 carefu lly to ensure it increases to at least __% ✔✔ 90% Titrate oxygen by slowly increasing the flow rate by _._ liters per minute at a time until the SpO2 is 90% or more, but do not exceed 4 liters/min. without a physicians order. ✔✔ 0.5 l/min. Obesity Hypove ntilation Syndrome occurs when the body mass index is __kg/m2 or more, resulting in impaired respirations,hypoxia, and hypercapnia during sleep. The obesity results in impairment of muscles of muscles of inspiration, restricting the thorax and causing hypo ventilation, leading to hypercapnia. ✔✔ 30 You should begin CPAP when the patient is ready for sleep and start it at the lowest setting, usually _ cm H20 and maintain the low pressure until the patient falls asleep. ✔✔ 5 Increase Positive Airway Pressure during CPAP titration by _ cm h20 at a time, usually at 15 minute intervals, and observe effects, including changes in oxygen saturation, EEG,EMG, and ECG. ✔✔ 1 Ensure that the patient is in what body position during titration for part of the titration period? ✔✔ supine Respiratory Effort Related Arousal (RERA) ✔✔ Occurs when the airway narrows during sleep, usually indicated by snoring. Although the constricted airway does not result in apnea or hypopnea, it does cause a brief arousal. For scoring of a RERA, there should be a sequence of respirations indicating increased respiratory effort or flattening of nasal pressure waveforms with a duration of ___ seconds or more. ✔✔ 10

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    Hypoventilation ✔✔ based on PaCO2 scores on awakening and not on persistent desaturation. - the use of other sensors is not considered adequate to determine this. To score Hypoventilation, the PaCO2 level (immediately upon awakening) increases __mm Hg or more as compared to the baseline awake/supine value. ✔✔ 10 Bruxism ✔✔ teeth grinding Stages of sleep should be rep orted in minutes, minutes of latencies, and percentage of ✔✔ TST ________ should be reported as a total number, index number, numbers occurring in REM sleep and in non - REM sleep for all different types and associations. ✔✔ Arousals Sinus Bradycardia ✔✔ i s caused by a decreased rate of impulses from the sinus node. The pulse and ECG usually appear normal except for at a slower rate. (Less than 50 - 60 beats per minute). Sinus Bradycardia is scored during sleep with a sustained heart rate of less than __ bea ts/min for patients 6 years of age or more. ✔✔ 40 Alternating Leg Muscle Activation (ALMA) ✔✔ Occurs with a rapid alternating activation of EMG's in the lower extremities. - may be associated with PLM'S. Usually considered benign, do not require treatment, and are unrelated to sleep disorders. An ALMA Series requires at least _ Alma's at a minimum frequency of 0.5 Hz and a maximum frequency of 3.0 Hz. ✔✔ 4 Hypnagogic Foot Tremors ✔✔ tremors that occur during sleep onset in one or both feet that are most common in stage wake but may continue into s tages 1 and 2. Hypnagogic Foot Tremors are scored with a minimum of _ EMG bursts in the frequency range of 0.3 - 4.0 Hz. ✔✔ 4 Hypnagogic Foot Tremors have a frequency of _._ - _._ Hz. ✔✔ 0.3 - 4.0 Cheyne - Stokes Respirations ✔✔ periodic breathing characterized by periods of apnea, alternating with rapid respirations that increase in intensity and then decrease in a crescendo - decrescendo pattern. What respirations are common before death or can occur with central nervous system damage (ex: brain tumor), hyperve ntilation, and heart failure. ✔✔ Cheyne - Stokes

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    Criteria for scoring Cheyne - Stokes respirations includes _ or more consecutive cycles of crescendo - decrescendo pattern and one of the following: 1. Cycles that persist for 10 or more consecutive minutes 2. Five central apneas or central hypopneas PER HOUR of sleep. ✔✔ 3 Rhythmic Movement Disorder ✔✔ very common in infants; beginning at about 6 months of age continuing until 2 - 3 years of age. - incidence after age 5 is rare unless pt has injury to the central nervous system. often include s: 1. Rocking 2.Head Banging 3.Head Rolling 4.Leg Banging 5.Body Rolling - These Movements may be accompanied by humming. Rhythmic Movement Disorder - scoring ✔✔ - often occurs in stage wake when the pt is very drowsy or during stage 1. - clusters of 4 or more rhythmic movements. - amplitude of each burst is double background EMG activity. - minimum frequency of 0.5 Hz and maximum frequency of 2.0 Hz. (Video Synchronized with PSG required for diagnosis). Stage 3 non - REM Sleep ✔✔ - also referred to as Slow Wave Sl eep (SWS) or Delta Sleep. - Adolescents have higher percentage of this stage as it is the stage the growth hormone is produced. - pt is easily aroused by external stimuli Stage 3 ✔✔ 20% of TST; Delta activity of 0.5 - 2 Hz; stage where parasomnias such as, s leep walking, enuresis, and night terrors occur. This is an example of Cheyne - Stokes Respiration ✔✔ Example of Central Apnea ✔✔ Example of Hypopnea ✔✔ Example of Obstructive Apnea ✔✔ Pediatric RERAs must be scored with adequate ______ or nasal pre ssure signals. ✔✔ esophageal

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    REM Sleep Behavior Disorder (RBD) ✔✔ Requires a PSG and a video, audio, or clinical history of REM occuring without atonia or with excessive muscle activity. - chin and leg EMG may have slightly higher frequency than usual for REM. Score RBD if REM Epoch has __% or more increased cEMG activity and __% or more of excessive transient movement for 10 mini - epochs. - bursts of activity are usually 0.1 - 5.0 seconds in duration ✔✔ 50 To score an apnea, it must last __ seconds or more and the thermal sensor must drop at least 90% or more below baseline. ✔✔ 10 Obstructive ✔✔ Inspiratory effort continues or increases throughout the apneic period. Central ✔✔ Inspiratory effort is absent during apneic period. Mixed ✔✔ Inspiratory effort is absent for the initial apneic period but resumes during the second half of the apneic period. Example of Mixed Apnea ✔✔ How many stages does the normal conduction of the heart have? ✔✔ 4 SA Node ✔✔ primary pacemaker Purkinje Fibers ✔✔ stimulate the myocardial cells to contract the ventricles Pediatric Sleep scoring rules apply to children _ months post term or older. ✔✔ 2 Sleep Spindles occur at _ - _ months or older ✔✔ 2 - 3 K complexes and slow - wave activity occur at _ - _ months or older ✔✔ 4 - 6 Sta ges 1, 2, and 3 can be scored in most infants at _ - _ months or older. ✔✔ 5 - 6 REM Sleep ✔✔ occupies about 25% of TST for adults. Dreaming as well as sexual arousal (penile/clitoral erection) most often occurs in what stage of sleep? ✔✔ REM Non - REM and RE M cycles occur about every _._ - _hours. ✔✔ 1.5 - 2 What sleep stage are sawtooth theta waves most likely to be present? ✔✔ REM

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    How many seconds of chin activity in REM for it to be scored as an arousal? ✔✔ 1 Excessive Fragmentary Myoclonus (EFM) ✔✔ Twitchi ng movements of the fingers, toes, and mouth that may occur in any stage, including wake. To score EFM, activity needs to continue for at least __ minutes of Non - REM sleep with at least 5 EMG potentials per minute. ✔✔ 20 Pediatric Scoring of Wake uses th e __________ _________ _________ rather than the term 'alpha rhythm.' ✔✔ Dominant Posterior Rhythm (DPR) If there is no reactive alpha waves or age - appropriate DPR, score wake with _________ _____________. ✔✔ Eye Movements What is the recommended square feet for patient rooms? ✔✔ 140 Electroencephalogram (EEG) ✔✔ Measure the electrical activity within the brain through the scalp electrodes to rule out seizure disorders and to determine characteristics of the sleep - wake state. Alpha wave frequency ✔✔ 8 - 1 3 Hz Beta wave frequency ✔✔ 13 - 30 Hz Delta wave frequency ✔✔ < 0.5 - 4Hz Theta wave frequency ✔✔ > 4 - 7 Hz How many leads are typically used for the EEG channels during a nocturnal PSG? - although more may be applied to diagnose seizure disorders ✔✔ 6 Elec trocardiogram (ECG) ✔✔ Record and display electrical activity of the heart through a number of different wave - forms, complexes, and intervals. P wave ✔✔ wave in ECG that represents the beginning of electrical impulses in the Sinus Node, which spread throu gh the atria (muscle depolarization). QRS Complex ✔✔ wave in ECG that represents ventricular muscle depolarization and atrial repolarization. T wave ✔✔ wave in ECG that represents ventricular muscle repolarization (resting state) as cells regain negative charge. U wave ✔✔ wave that represents repolarization of the Purkinje Fibers

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