Free RST Scoring, Documentation & Reporting Questions and Answers — Questions and Answers
Question 1: According to AASM scoring rules, what is the minimum duration required to score an apnea event?
- 5 seconds
- 10 seconds (Correct answer)
- 15 seconds
- 30 seconds
Correct answer: 10 seconds
According to the American Academy of Sleep Medicine (AASM) scoring rules, an apnea event in adults is defined as a complete cessation or near-complete cessation of airflow for a minimum duration of 10 seconds. This standardized duration ensures consistency and accuracy in diagnosing sleep-disordered breathing events. It helps distinguish significant breathing pauses from normal respiratory variations.
Question 2: Which of the following is required to score a hypopnea in an adult patient?
- ≥50% airflow reduction with EEG arousal
- ≥30% airflow reduction with ≥3% desaturation or arousal (Correct answer)
- Any airflow reduction with snoring
- ≥10% airflow reduction with respiratory effort
Correct answer: ≥30% airflow reduction with ≥3% desaturation or arousal
According to AASM scoring criteria for adults, a hypopnea is scored when there is a discernible reduction in airflow of at least 30% from baseline, lasting for at least 10 seconds. This reduction must also be accompanied by either an oxygen desaturation of 3% or greater, or an associated arousal from sleep. Both criteria (airflow reduction and physiological impact) must be met.
Question 3: How is the Apnea-Hypopnea Index (AHI) calculated?
- Number of events per hour of recording time
- Number of events per hour of sleep (Correct answer)
- Number of events during REM sleep only
- Number of oxygen desaturations per hour
Correct answer: Number of events per hour of sleep
The Apnea-Hypopnea Index (AHI) is a key metric used to quantify the severity of sleep-disordered breathing. It is calculated by dividing the total number of apneas and hypopneas recorded during the study by the total sleep time, expressed in hours. This provides a standardized measure of how many breathing disturbances occur per hour of actual sleep, directly reflecting the impact on sleep quality.
Question 4: Which EEG finding is required to score a sleep spindle?
- Delta waves (0.5-2 Hz)
- 11-16 Hz activity lasting ≥0.5 seconds (Correct answer)
- Sharply contoured theta waves
- K-complexes with alpha intrusion
Correct answer: 11-16 Hz activity lasting ≥0.5 seconds
Spindles are 11-16 Hz waveforms lasting ≥0.5 seconds, characteristic of N2 sleep.
Question 5: What is the minimum duration of elevated chin EMG activity required to score an arousal during REM sleep?
- ≥0.5 seconds (Correct answer)
- ≥1 second
- ≥2 seconds
- Any visible increase
Correct answer: ≥0.5 seconds
Transient muscle activity (TMA) in REM must last <0.5 seconds to avoid being scored as REM without atonia.
Question 6: Which of the following must be included in a standard PSG report?
- Patient's home address
- Sleep stage percentages and AHI (Correct answer)
- Technologist's work schedule
- Raw EEG calibration data
Correct answer: Sleep stage percentages and AHI
Reports require sleep architecture percentages, respiratory indices, and clinical correlation.
Question 7: How are periodic limb movements (PLMs) scored?
- Any leg movement during sleep
- ≥4 movements lasting 0.5-5 seconds, 5-90 seconds apart (Correct answer)
- Only movements associated with arousals
- Movements occurring exclusively in N3 sleep
Correct answer: ≥4 movements lasting 0.5-5 seconds, 5-90 seconds apart
PLMs are scored when ≥4 movements occur sequentially (5-90 sec apart) with EMG increases ≥8μV.
Question 8: What defines a 'major body movement' in sleep staging?
- Any epoch with EMG artifact
- Movement artifact obscuring EEG for ≥50% of epoch (Correct answer)
- Limb movements lasting >10 seconds
- Sleep stage transitions
Correct answer: Movement artifact obscuring EEG for ≥50% of epoch
MBMs obscure EEG for ≥50% of the epoch, requiring special staging rules.
Question 9: Which parameter is critical for scoring Cheyne-Stokes respiration?
- Oxygen desaturation <70%
- Cyclic crescendo-decrescendo breathing ≥3 cycles (Correct answer)
- Exclusive occurrence during REM sleep
- Associated snoring
Correct answer: Cyclic crescendo-decrescendo breathing ≥3 cycles
CSR requires a crescendo-decrescendo pattern with central apneas/hypopneas.
Free RST Scoring, Documentation & Reporting Questions and Answers
According to AASM scoring rules, what is the minimum duration required to score an apnea event?