Apnea - Literally means "no breath";
the cessation of airflow at the nostrils and mouth for at least
10 seconds.
Apnea index (AI) - A measure of the severity
of sleep apnea; the number of apnea events per hour.
Apnea/Hypopnea index (AHI) - The number of
apneas and hypopneas per hour. 5 - 20 = mild, 21 - 50 = moderate above, 51 = severe
Arousal - Abrupt change from sleep to wakefulness,
or from a "deeper" stage of non-REM sleep to a "lighter"
stage.
Basic Sleep Cycle - Progression through orderly
succession of sleep states and stages. For the healthy adult,
the first cycle begins by going from wakefulness to non-REM sleep.
The first REM period follows the first period of non-REM sleep,
and the two sleep states continue to alternate throughout the
night with an average period of about 90 minutes. A night of normal
human sleep usually consists of 4-6 non-REM/REM sleep cycles.
Bi-Level (BiPAP) - Bi-level pressure device
used to treat sleep apnea. The "bi" refers to two pressures:
a lower pressure for exhalation and a higher pressure for inhalation.
Bi-Level machines are more expensive than a standard CPAP, but
some patients tolerate it better because they can exhale comfortably
against the constant inhalation pressure. (Sometimes called
Bi-PAP, but that is a trademark name of one system)
Central apnea - Absence of airflow and inspiratory
effort; apnea caused by irregularity in the brain's control of
breathing.
Circadian rhythm - Innate, daily, fluctuation
of behavioral and physiological functions, including sleep waking,
generally tied to the 24 hour day-night cycle but sometimes to
a different (e.g., 23 or 25 hour) periodicity when light/dark
and other time cues are removed.
Compliance - Adhering to or conforming with
a regimen of treatment such as CPAP.
CPAP - Continuous Positive Airway Pressure;
the device used to treat sleep apnea by sending positive airway
pressure at a constant, continuous pressure to help keep an open
airway, allowing the patient to breathe normally through his/her
nose and airway.
Deep Sleep - Refers to combined non-REM sleep
stages 3 and 4 in sleep studies.
DME - Durable Medical Equipment. Equipment
such as wheelchairs and walkers which are prescribed for use by
or on the order of a physician, also includes CPAP and BI-Level
machines.
Epworth Sleepiness Scale - Index of sleep propensity
during the day as perceived by patients, and derived from the
answers to 8 questions.
Excessive daytime sleepiness or somnolence (EDS)
- Subjective report of difficulty in staying awake, accompanied
by a ready entrance into sleep when the individual is sedentary.
Humidification - Moisture is added to the airflow
as an adjunct to CPAP (Continuous Positive
Airway Pressure) therapy in treating obstructive
sleep apnea (OSA). Humidification can be added
to the CPAP by diverting the airflow over or through a cool or
heated water reservoir (humidifier) to prevent the upper
airway from drying out.
Hypopnea - Shallow breathing in which the air
flow in and out of the airway is less than half of normal - usually
associated with oxygen desaturations.
Hypoxia - Deficiency of oxygen reaching the
tissues of the body.
Jet Lag - Disturbance induced by a major rapid
shift in environmental time during travel to a new time zone.
Insomnia - Complaint describing difficulty in
sleeping.
Letter of Medical Necessity (LMN) - Certification
by a physician that the prescribed item(s) is/are medically indicated,
reasonable and necessary with reference to the standards of medical
practice and treatment of a patient's condition.
Light Sleep - Term used to describe non-REM
sleep stage 1, and sometimes, stage 2.
Mixed (sleep) apnea - Interruption
in breathing during sleep beginning as a central apnea then becoming
an obstructive apnea.
Multiple sleep latency test (MSLT) - A series
“nap tests” utilized in the assessment of excessive
daytime sleepiness.
Narcolepsy - Sleep disorder characterized by
excessive sleepiness, cataplexy, sleep paralysis, hypnogogic hallucinations,
and an abnormal tendency to pass directly from wakefulness into
REM sleep.
Nightmare - Unpleasant and/or frightening dream
occurring in REM sleep. (Different from a night terror)
Obstructive apnea - Cessation of airflow (at
least 10 seconds) in the presence of continued inspiratory
effort; cessation of breathing during sleep, due to a mechanical
obstruction, such as a semi-collapsed trachea, tongue relaxed
to back of the throat, or a large amount of tissue in the uvula
area.
Oxygen Saturation - Measure of oxygen carried
by hemoglobin in the blood. Normal values 90% - 100%.
Polysomnogram (PSG) - Continuous and simultaneous
recording of physiological variables during sleep, i.e., EEG,
EOG, EMG (the three basic stage scoring parameters),
EKG, respiratory air flow, respiratory excursion, lower limb movement,
and other electrophysiological variables.
Polysomnographic Technologist - Health care
professional trained in performing diagnostic sleep studies and
has achieved a passing grade on the RPSGT board exam.
RDI - Respiratory Disturbance Index - includes
all respiratory events per hour.
REM rebound or recovery - Lengthening and increase
in frequency and density of REM periods, which results in an increase
in REM percent above base line. REM rebound follows REM deprivation
once the inhibitory influence is removed.
Sleep Apnea - Cessation of breathing for 10
or more seconds during sleep.
Sleep architecture - NREM/REM stage and cycle
infrastructure of sleep understood from the vantage point of the
quantitative relationship of these components to each other.
Sleep Debt - Result of recurrent sleep deprivation
which occurs over time when an individual does not experience
a sufficient amount of the restorative daily sleep that is required
to maintain a sense of feeling rested and refreshed.
Sleep Disorders - Broad range of illnesses arising
from many causes, including, dysfunctional sleep mechanisms, and
abnormalities in physiological functions during sleep, abnormalities
of the biological clock, and sleep disturbances that are induced
by factors extrinsic to the sleep process.
Sleep efficiency (SE) - Proportion of sleep
in the period potentially filled by sleep - ratio of total sleep
time to time in bed.
Sleep Fragmentation - Brief arousals occurring
throughout the night, reducing the total amount of time spent
in the deeper levels of sleep.
Sleep hygiene - Conditions and practices that
promote continuous and effective sleep, including regularity of
bedtime and arise time; conforming time spent in bed to the time
necessary for sustained and individually adequate sleep (i.e.,
the total sleep time sufficient to avoid sleepiness when awake);
restriction of alcohol and caffeine beverages in the period prior
to bedtime; employment of exercise, nutrition, and environmental
factors so that they enhance, not disturb, restful sleep.
Sleepiness (somnolence, drowsiness)
- Difficulty in maintaining the wakeful state so that the individual
falls asleep if not actively kept aroused; not simply a feeling
of physical tiredness or listlessness.
Smart PAP (Smart CPAP) - (Smart [Continuous]
Positive Airway Pressure) Medical device used in the treatment
of obstructive sleep apnea providing preset levels of continuous
airflow, and automatically adjusting to keep the breathing passages
open by sensing changes in airway integrity. The air flows from
the device through a tube that connects to a nose or face mask.
Somnolence - Prolonged drowsiness or sleepiness.
Titration - Progressive, stepwise increase in
CPAP pressure applied during a polysomnogram to establish the
optimal treatment pressure.
Upper Airway Resistance Syndrome (UARS) - Part
of the spectrum of obstructive sleep-related breathing disorders
in which repetitive increases in resistance to airflow in the
upper airway lead to brief arousals and daytime fatigue. Apneas
and hypopneas (see RDI) may be totally
absent. Blood oxygen levels can be in the normal range.