Kacmarek: Egan's Fundamentals of Respiratory Care, 10th 

Edition ​Chapter 30: Disorders of Sleep  

Test Bank  

MULTIPLE CHOICE  

1. What percent of the adult population is believed to have obstructive sleep apnea? 
a. <1%  
b. 2% to 4%  
c. 5% to 10%  
d. unknown  
2. The definition of sleep apnea uses what criteria for defining an episode of apnea? 
a. 5 seconds  
b. 10 seconds  
c. 15 seconds  
d. 20 seconds  

3. Which of the following conditions are associated with central apnea? 

1. congestive heart failure  
2. primary central nervous system lesions  
3. high-altitude hypoxemia  
4. obesity  
a. 1 and 4  
b. 2 and 3  
c. 1, 2, and 3  
d. 1, 2, 3, and 4  
 
4. Central sleep apnea occurs more often than obstructive sleep apnea.  
a. True  
b. False  

5. What term is used to describe a significant decrease in airflow during sleep but not a complete 
cessation of breathing?  
a. apnea  
b. minor apnea  
c. hypopnea  
d. dyspnea  
6. What are the criteria to define hypopnea?  
a. 20% decrease in airflow and 4% oxygen desaturation  
b. 20% decrease in airflow and 2% oxygen desaturation  
c. 30% decrease in airflow and 4% oxygen desaturation  
d. 30% decrease in airflow and 2% oxygen desaturation  

 
7. What is the primary cause of obstructive sleep apnea?  
a. small or unstable pharyngeal airway  
b. deviated septum  
c. unstable larynx  
d. large tongue  
8. All of the following conditions are associated with untreated obstructive sleep apnea, except: 
a. systemic hypotension 
b. pulmonary hypertension  
c. heart failure  
d. myocardial infarction  

9. What is believed to be the cause of systemic hypertension in patients with sleep apnea? 
a. hypervolemia  
b. increased sympathetic tone  
c. elevated CO​2  
d. tachycardia  

10. Which of the following factors has been shown to positively correlate with obstructive sleep 
apnea?  
a. age  
b. height  
c. obesity of the upper body  
d. blood pressure at rest  
11. What is the name of the respiratory pattern where a crescendo-decrescendo pattern of 
hyperpnea alternates with periods of apnea?  
a. Cheyne-Stokes  
b. Kussmaul  
c. agonal  
d. Biot’s  

12. All of the following characteristics are typically associated with sleep apnea, except: 
a. male patient  
b. over the age of 40 years  
c. hypotensive  
d. loud snoring during sleep  

13. Which of the following complaints is frequently seen in a patient with obstructive sleep 
apnea?  
a. dizziness  
b. chest pain  
c. shortness of breath with exertion  
d. excessive daytime sleepiness  

14. Which of the following physical exam findings is associated with obstructive sleep apnea? 
a. large tonsils  
b. microcephaly  
c. macroglossia  
d. deviated nasal septum  
15. All of the following are parameters used to confirm the metabolic syndrome associated with 
obstructive sleep apnea, except:  
a. low triglycerides  
b. insulin resistance  
c. hypertension  
d. impaired glucose intolerance 

16. All of the following parameters are typically monitored with a polysomnogram, except: 
a. SaO​2  
b. electroencephalogram (EEG)  
c. breathing effort  
d. exhaled PCO​2  

17. What value for the apnea–hypopnea index (AHI) is consistent with moderate obstructive sleep 
apnea?  
a. 5 to 15  
b. 15 to 30  
c. above 30  
d. below 5  

18. Which of the following behavioral interventions is least useful for the treatment of sleep 
apnea?  
a. weight loss  
b. avoidance of alcohol  
c. avoidance of sedatives  
d. avoidance of daytime naps  

19. Why should the patient with obstructive sleep apnea not use alcohol?  
a. Alcohol decreases the arousal threshold.  
b. Alcohol increases upper airway muscle tone.  
c. Alcohol increases the arousal threshold.  
d. Alcohol reduces the cardiovascular compensatory mechanisms.  

20. Which of the following medical therapies is considered first-line treatment for obstructive 
sleep apnea (OSA)?  
a. continuous positive airway pressure (CPAP)  
b. surgery  
c. oxygen therapy  
d. antibiotics  

21. What is the amount of CPAP that is typically required to abolish upper airway obstruction in 
patients with OSA?  
a. 3 to 5 cm H​2​O  
b. 10 to 20 cm H​2​O  
c. 2.5 to 7.5 cm H​2​O  
d. 7.5 to 12.5 cm H​2​O  

 
22. How does CPAP improve breathing in the patient with OSA?  
a. stimulation of the phrenic nerve  
b. pneumatic splinting of the upper airway 
c. stimulation of upper airway muscles  
d. repositioning of the epiglottis  

23. When diffentiating between central and obstructive sleep apnea, which of the following 
“channels” or parameters would reflect vastly different results during an apneic episode or 
event?  
a. SPO2  
b. heart rate  
c. chest wall and abdominal effort  
d. nasal airflow  

24. What is considered to be the major problem with the use of CPAP in patients with obstructive 
sleep apnea?  
a. patient compliance  
b. frequent pneumothorax  
c. cardiovascular complications  
d. expense  

25. Available evidence has shown that bilevel pressure is associated with better patient 
compliance than the conventional CPAP.  
a. True  
b. False  

26. In what way do BiPAP units differ from CPAP units?  

a. BiPAP applies different pressure levels on inspiration and exhalation.  
b. BiPAP units cost significantly more that CPAP units.  
c. BiPAP operates on electricity.  
d. BiPAP simulates spontaneous breathing.  

27. What term is used to describe CPAP units that use a computer to adjust CPAP levels as 
needed by the patient during sleep?  
a. min-CPAP  
b. max-CPAP  
c. retro-CPAP  
d. auto-CPAP  

28. All of the following are common side effects of positive-pressure therapy, except: 
a. dry nasal mucosa  
b. claustrophobia  
c. skin irritation  
d. headache  

 
29. Oral devices may prove useful for cases of mild OSA.  
a. True  
b. False  

30. Medications have proved ineffective for most patients with sleep apnea. 
a. True  
b. False  

31. Uvulopalatopharyngoplasty has a success rate of less than 50%.  

a. True  
b. False  

32. Which of the following are TRUE about obstructive sleep apnea (OSA)?  

A. It is overdiagnosed in the United States.  

B. It has an equivalent prevalence to asthma in the general population.  
C. It has an equivalent prevalence to diabetes in the general population.  
D. The spectrum of the disease includes sleep disruption related to increased airway 
resistance.  
a. 1 and 2 only  
b. 2 and 3 only  
c. 1, 2 and 4 only  
d. 2, 3 and 4 only  

33. All of the following are interventions used in the management of obstructive sleep apnea, 
except:  
a. group therapy 
b. behavioral  
c. medical  
d. surgical