Sleep disorders including sleep apnea and insomnia management as tested on USMLE Step 2 CK.
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- What AHI (apnea-hypopnea index) threshold defines obstructive sleep apnea in a patient WITH symptoms like daytime sleepiness?
- AHI of 5 or more events per hour
- What AHI threshold defines obstructive sleep apnea even in an ASYMPTOMATIC patient?
- AHI of 15 or more events per hour
- What does the apnea-hypopnea index (AHI) measure?
- The average number of apneas and hypopneas per hour of sleep
- The gold-standard test for diagnosing obstructive sleep apnea is ____.
- polysomnography
- What is the first-line treatment for moderate-to-severe obstructive sleep apnea?
- Continuous positive airway pressure (CPAP)
- What is the STOP-BANG questionnaire used for?
- Screening for risk of obstructive sleep apnea
- What does the Epworth Sleepiness Scale assess?
- A patient's subjective level of daytime sleepiness
- Central sleep apnea with a Cheyne-Stokes breathing pattern is most commonly caused by what condition?
- Congestive heart failure
- What is obesity hypoventilation syndrome (Pickwickian syndrome)?
- Obesity plus chronic daytime hypercapnia not explained by another cause
- What is the single most important modifiable risk factor for obstructive sleep apnea?
- Obesity
- What cardiopulmonary complication can result from long-standing untreated severe OSA?
- Pulmonary hypertension and cor pulmonale
- What is the first-line treatment for chronic insomnia disorder?
- Cognitive behavioral therapy for insomnia (CBT-I)
- How long must sleep difficulty persist, occurring at least 3 nights per week, to meet criteria for insomnia disorder?
- At least 3 months
- What class of medication is preferred for short-term pharmacologic treatment of insomnia?
- Nonbenzodiazepine benzodiazepine receptor agonists (Z-drugs, e.g., zolpidem)
- What is cataplexy and what typically triggers it?
- Sudden, brief loss of muscle tone triggered by strong emotion (e.g., laughter)