Sleep Medicine Board Review Exam
SLEEP MEDICINE BOARD REVIEW EXAM WITH COMPLETE QUESTIONS
AND CORRECT ANSWERS| BRAND NEW VERSION!
Identifying an apnea
Use an oronasal thermal airflow sensor to monitor airfow
What is the prevalence of Narcolepsy? Gender predominance?
M=F
0.03-0.07%
Low education and socioeconomic status are more/less likely to report insomnia
symptoms?
More
What is the dorsal respiratory group? Where is it located?
mainly inspiratory neurons
located in medulla
What are the typical filter settings for EEG channels?
LFF 0.3 Hz, HFF 35 Hz
Remember the low frequency filter=high pass filter
high frequency filter=low pass filter
When do narcolepsy symptoms typically occur?
1|Page
, Sleep Medicine Board Review Exam
10-19 yo (highest 15-19)
typically not diagnosed until 20s or 30s
There is a bimodal age of onset at 14.7 years and 35 years
What is the ventral respiratory group? Where is it located?
both inspiratory and expiratory neurons.
- drives spinal respiratory neurons and auxiliary muscles of respiration
- pre-Botzinger complex: essential for generation of respiratory rhythm
Located in medulla
What % of patients have comorbid insomnia?
70-90%
Alternate ways to identify an apnea
Nasal pressure transducer, RIPsum, RIPflow, PVDFsum
What is the association of insomnia with Major depressive disorder?
Young adults who reported insomnia were 4x more likely to develop MDD than
those without insomnia
- sleep disturbance has been shown to precede recurrence of MDD- if sleep
doesn't improve, your chance of recurrence is higher
What are the typical filter settings for EOG channels?
LFF 0.3 Hz, HFF 35 Hz
What is the healthy sleep duration for toddlers (1-2 years)?
11-14 hours
2|Page
, Sleep Medicine Board Review Exam
What is the healthy sleep duration for preschoolers (3-5 years)?
10-13 hours
What are the typical filter settings for EMG channels?
LFF 10 Hz, HFF 100 Hz
What is the association of circadian rhythms and depression?
Associated with phase delay
Identifying a hypopnea
Use a nasal pressure transducer to monitor airflow
What are the characteristics of cataplexy?
recurrent, brief episodes of muscle weakness triggered by emotions
- patients are medically stable, conscious with eye movements intact
- duration <2 minutes
- areflexia during event in involved limbs
What is the healthy sleep duration for infants (4-12 months)?
12-16 hours
What is the diagnostic criteria for alternating leg muscle activation?
>= 4 EMG bursts, 0.5-3 Hz in frequency
alternating between legs with usual duration of .1-.5s
What is the diagnostic criteria for bruxism?
3|Page
, Sleep Medicine Board Review Exam
- either brief (Rhythmic masticatory muscle activity) or sustained elevations in
chin EMG at least 2x amplitude of background EMG
- 0.25-2s in duration and if at least 3 elevations occur in regular sequence
- sustained elevations in EMG are scored as bruxism if duration is >2s
- a period of stable background chin EMG must occur before a new episode can be
scored
- can be scored reliably if at least 2 audible tooth grinding episodes are heard in
the absence of epilepsy
What is the diagnostic criteria for rhythmic movement disorder?
- 0.5-2 Hz
- >=4 individual movements
- >= 2 x background EMG tone
What is the diagnostic criteria for Excessive Fragmentary Myoclonus?
- usual max EMG burst duration is 150 msec
- At least 20 min of NREM sleep with EFM must be recorded
- at least 5 EMG potentials per min
What are PSG changes seen in depression?
prolonged sleep latency
increased percent REM
increased REM density
decreased sleep efficiency
decreased REM latency
decreased SWS
What is the diagnostic criteria for hypnagogic foot tremor?
4|Page
SLEEP MEDICINE BOARD REVIEW EXAM WITH COMPLETE QUESTIONS
AND CORRECT ANSWERS| BRAND NEW VERSION!
Identifying an apnea
Use an oronasal thermal airflow sensor to monitor airfow
What is the prevalence of Narcolepsy? Gender predominance?
M=F
0.03-0.07%
Low education and socioeconomic status are more/less likely to report insomnia
symptoms?
More
What is the dorsal respiratory group? Where is it located?
mainly inspiratory neurons
located in medulla
What are the typical filter settings for EEG channels?
LFF 0.3 Hz, HFF 35 Hz
Remember the low frequency filter=high pass filter
high frequency filter=low pass filter
When do narcolepsy symptoms typically occur?
1|Page
, Sleep Medicine Board Review Exam
10-19 yo (highest 15-19)
typically not diagnosed until 20s or 30s
There is a bimodal age of onset at 14.7 years and 35 years
What is the ventral respiratory group? Where is it located?
both inspiratory and expiratory neurons.
- drives spinal respiratory neurons and auxiliary muscles of respiration
- pre-Botzinger complex: essential for generation of respiratory rhythm
Located in medulla
What % of patients have comorbid insomnia?
70-90%
Alternate ways to identify an apnea
Nasal pressure transducer, RIPsum, RIPflow, PVDFsum
What is the association of insomnia with Major depressive disorder?
Young adults who reported insomnia were 4x more likely to develop MDD than
those without insomnia
- sleep disturbance has been shown to precede recurrence of MDD- if sleep
doesn't improve, your chance of recurrence is higher
What are the typical filter settings for EOG channels?
LFF 0.3 Hz, HFF 35 Hz
What is the healthy sleep duration for toddlers (1-2 years)?
11-14 hours
2|Page
, Sleep Medicine Board Review Exam
What is the healthy sleep duration for preschoolers (3-5 years)?
10-13 hours
What are the typical filter settings for EMG channels?
LFF 10 Hz, HFF 100 Hz
What is the association of circadian rhythms and depression?
Associated with phase delay
Identifying a hypopnea
Use a nasal pressure transducer to monitor airflow
What are the characteristics of cataplexy?
recurrent, brief episodes of muscle weakness triggered by emotions
- patients are medically stable, conscious with eye movements intact
- duration <2 minutes
- areflexia during event in involved limbs
What is the healthy sleep duration for infants (4-12 months)?
12-16 hours
What is the diagnostic criteria for alternating leg muscle activation?
>= 4 EMG bursts, 0.5-3 Hz in frequency
alternating between legs with usual duration of .1-.5s
What is the diagnostic criteria for bruxism?
3|Page
, Sleep Medicine Board Review Exam
- either brief (Rhythmic masticatory muscle activity) or sustained elevations in
chin EMG at least 2x amplitude of background EMG
- 0.25-2s in duration and if at least 3 elevations occur in regular sequence
- sustained elevations in EMG are scored as bruxism if duration is >2s
- a period of stable background chin EMG must occur before a new episode can be
scored
- can be scored reliably if at least 2 audible tooth grinding episodes are heard in
the absence of epilepsy
What is the diagnostic criteria for rhythmic movement disorder?
- 0.5-2 Hz
- >=4 individual movements
- >= 2 x background EMG tone
What is the diagnostic criteria for Excessive Fragmentary Myoclonus?
- usual max EMG burst duration is 150 msec
- At least 20 min of NREM sleep with EFM must be recorded
- at least 5 EMG potentials per min
What are PSG changes seen in depression?
prolonged sleep latency
increased percent REM
increased REM density
decreased sleep efficiency
decreased REM latency
decreased SWS
What is the diagnostic criteria for hypnagogic foot tremor?
4|Page
