CCSH flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Process S (homeostatic sleep drive)

The homeostatic component of sleep regulation: sleep pressure that accumulates with wakefulness, is linked to adenosine, and dissipates during sleep.

REM sleep latency

Time from sleep onset to the first REM epoch; typically about 90 minutes in healthy adults and shortened in narcolepsy and depression.

K-complex

A negative sharp wave followed by a positive component lasting at least 0.5 seconds; a defining feature of stage N2 sleep.

AHI severity cutoffs

Apnea-hypopnea index ranges: 5 to <15 mild, 15 to 30 moderate, and >30 severe obstructive sleep apnea per hour of sleep.

Hypopnea scoring rule

A ≥30% reduction in airflow lasting ≥10 seconds accompanied by a ≥3% oxygen desaturation or an arousal (AASM recommended rule).

Narcolepsy type 1 marker

Hypocretin (orexin) deficiency in cerebrospinal fluid, usually with cataplexy; the MSLT shows short sleep latency and multiple SOREMPs.

Epworth Sleepiness Scale

Eight everyday situations rated 0–3 for chance of dozing; total ranges 0–24, with scores above 10 suggesting excessive daytime sleepiness.

STOP-BANG

Eight-item OSA risk screen: snoring, tiredness, observed apnea, pressure, BMI, age, neck circumference, gender; ≥5 indicates high risk.

Insomnia Severity Index

A seven-item self-report scored 0–28; 15 or higher indicates clinically significant insomnia, and repeat scores track treatment response.

Mallampati classification

A visual airway grading from I to IV based on oropharyngeal structures visible with the mouth open and tongue protruded; higher grades suggest a crowded airway.

Neck circumference risk

A measurement greater than 17 inches in men or 16 inches in women is associated with increased risk of obstructive sleep apnea.

SOREMP

Sleep-onset REM period: REM sleep within 15 minutes of sleep onset during an MSLT nap; two or more support a narcolepsy diagnosis.

Oxygen desaturation index

The number of ≥3% oxygen desaturations per hour of sleep; it correlates with but does not equal the apnea-hypopnea index.

Central sleep apnea

Absence of airflow for at least 10 seconds with absent respiratory effort, reflecting failure of ventilatory drive rather than airway obstruction.

Cheyne-Stokes respiration

Periodic breathing with crescendo-decrescendo airflow and central apneas, commonly seen in heart failure and after stroke.

Multiple Sleep Latency Test

Four or five 20-minute nap opportunities scheduled at 2-hour intervals; a mean sleep latency of 8 minutes or less is abnormal.

HSAT limitation

Home sleep apnea testing uses fewer channels, can underestimate the AHI, and is not appropriate when central apnea or hypoventilation is suspected.

PAP adherence threshold

Commonly defined as at least 4 hours of use per night on at least 70% of nights, a threshold many payers require for continued coverage.

CBT-I components

Stimulus control, sleep restriction, cognitive restructuring, relaxation training, and sleep hygiene education; first-line treatment for chronic insomnia disorder.

Sleep restriction therapy

Time in bed is set near the patient's average total sleep time (not below about 5 hours) and extended 15–30 minutes weekly as sleep efficiency improves.

Stimulus control rule

The bed is reserved for sleep and intimacy; patients leave the bedroom if awake more than about 20 minutes and return only when sleepy.

Mandibular advancement device

An oral appliance that advances the lower jaw to enlarge the upper airway; an option for mild-to-moderate OSA or CPAP intolerance.

Hypoglossal nerve stimulation

An implanted device that stimulates the hypoglossal nerve during inspiration; candidates have CPAP intolerance, BMI ≤32, and AHI 15–65.

Teach-back method

The clinician asks the patient to restate the care plan in their own words, confirming comprehension and revealing misunderstandings to correct.

OARS

Motivational interviewing skills: Open-ended questions, Affirmations, Reflections, and Summaries, used to build rapport and elicit change talk.

Sleep efficiency formula

Total sleep time divided by time in bed, multiplied by 100; a value of 85–90% or higher is the target for extending time in bed.

Aerophagia

Swallowing air during PAP therapy, causing bloating and burping; managed by adjusting pressure, improving mask fit, or switching to bilevel therapy.

Caffeine timing guidance

Caffeine has a half-life of roughly 5 hours; avoiding it about 6 hours before bedtime reduces disruption of sleep onset.

CCSH scope of practice

Screening, patient education, and adherence support; clinical sleep health educators do not diagnose sleep disorders or prescribe therapy.

Protected Health Information

Individually identifiable health data governed by HIPAA that requires safeguards, minimum-necessary use, and authorized disclosure.

Informed consent

A documented discussion of purpose, risks, benefits, and alternatives that occurs before sleep testing or treatment begins.

CPT 95810

The billing code for an attended in-laboratory polysomnogram with sleep staging, used to support reimbursement and documentation requirements.