RT-21 · Initiation & Modification

Sleep-Disordered Breathing & Titration

Obstructive versus central events, AHI severity, and how a CPAP or bilevel titration is actually driven overnight.

~18 min read3 concept sections·2 questions with rationale

What you'll be able to do

  • Differentiate obstructive, central, and mixed events
  • Grade severity using the apnea-hypopnea index
  • Apply titration rules for CPAP and bilevel therapy
  • Troubleshoot adherence and mask problems
Concept breakdown
01

Naming the event

Effort is the discriminator: obstructive events have effort against a closed airway, central events have none.

  • Apnea: airflow drops at least 90% for 10 seconds or more. Hypopnea: airflow drops at least 30% for 10 seconds with a desaturation or arousal.
  • Obstructive apnea shows continued or paradoxical chest and abdominal effort; central apnea shows a flat effort channel.
  • Mixed apnea begins central and finishes obstructive.
  • Cheyne-Stokes respiration is a crescendo-decrescendo central pattern seen in heart failure and stroke.
At the bedside

Loud snoring with witnessed pauses and daytime sleepiness in an obese, hypertensive, thick-necked patient is the exam's OSA profile.

Practice quiz

Check yourself before you read the rationale.

Question 1 of 1

During a titration, the technologist sees repeated 15-second airflow cessations with continued paradoxical chest and abdominal movement. The correct response is:

Practice questions

Answer first, then read why the distractors fail.

Question 1

During a titration, the technologist sees repeated 15-second airflow cessations with continued paradoxical chest and abdominal movement. The correct response is:

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2 more concept sections, 1 more question, and the exam-day playbook for this module.

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