TheorySleep Tech RPSGT
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30 free Sleep Tech RPSGT questions
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Sleep Disorders
Obstructive sleep apnea (OSA) is defined by repeated episodes of upper airway collapse during sleep. Which structure most commonly collapses to cause OSA?
Correct — C. In OSA, the pharyngeal soft tissues—particularly the soft palate, uvula, and posterior tongue base—collapse against the posterior pharyngeal wall, obstructing airflow. The trachea and hard palate are rigid and do not collapse. -
Sleep Disorders
According to the AASM criteria, an apnea is scored when airflow drops by at least what percentage from baseline for ≥10 seconds?
Correct — A. An apnea requires a ≥90% drop in airflow from baseline lasting ≥10 seconds. A 30% drop defines a hypopnea, and 50% is not the threshold for either criterion. -
Sleep Disorders
The Apnea-Hypopnea Index (AHI) is calculated as the total number of apneas and hypopneas divided by:
Correct — B. AHI = (total apneas + hypopneas) / total sleep time (hours). Using total recording time would underestimate severity because awake time is excluded. -
Sleep Disorders
An adult patient has an AHI of 22 events/hour with an oxygen desaturation nadir of 82%. How would this be classified by AASM severity criteria?
Correct — D. AHI 15–29.9 events/hour defines moderate OSA. Mild OSA is 5–14.9, and severe OSA is ≥30 events/hour. The oxygen nadir does not alter the AHI-based severity classification. -
Sleep Disorders
On a PSG, an obstructive apnea differs from a central apnea primarily because:
Correct — A. Obstructive apneas show persistent respiratory effort (paradoxical rib-cage/abdominal movement visible on effort belts) despite absent airflow, indicating airway obstruction. Central apneas lack both airflow and effort. -
Sleep Disorders
Which of the following is the first-line recommended treatment for moderate-to-severe obstructive sleep apnea?
Correct — C. CPAP is the gold-standard first-line treatment for moderate-to-severe OSA, effectively splinting the airway open pneumatically. Oral appliances are an alternative for mild-to-moderate OSA or CPAP-intolerant patients. -
Sleep Disorders
Central sleep apnea (CSA) is characterized by the absence of:
Correct — B. In CSA, the brain fails to send respiratory drive signals, resulting in loss of both airflow and thoracoabdominal effort simultaneously. This distinguishes it from obstructive apnea, where effort persists. -
Sleep Disorders
Cheyne-Stokes respiration (CSR) is most commonly associated with which underlying condition?
Correct — D. CSR—a crescendo-decrescendo breathing pattern with central apneas—is strongly associated with congestive heart failure due to prolonged circulatory time and hypersensitive chemoreceptor feedback loops. -
Sleep Disorders
Treatment-emergent central sleep apnea (TECSA) most commonly occurs after initiating therapy for which condition?
Correct — A. TECSA (also called complex sleep apnea) is the appearance of central apneas after OSA is treated with CPAP. The prevailing theory involves CO2 below the apnea threshold once upper airway obstruction is eliminated. -
Sleep Disorders
High-altitude periodic breathing is a form of central sleep apnea driven primarily by:
Correct — C. At altitude, hypoxia triggers hyperventilation, lowering PaCO2 below the apneic threshold and causing central apneas. The respiratory control loop becomes unstable because CO2 is the main chemoreflex driver. -
Sleep Disorders
Per AASM 2012 recommended criteria, a hypopnea requires a ≥30% drop in airflow for ≥10 seconds associated with:
Correct — B. The AASM recommended rule (Rule 1B) requires ≥30% airflow reduction + ≥3% desaturation or an arousal. The alternative acceptable rule (1A) requires ≥4% desaturation; 1B is recommended for clinical labs. -
Sleep Disorders
A Respiratory Effort-Related Arousal (RERA) is a sequence of breaths lasting ≥10 seconds characterized by increasing respiratory effort leading to an arousal, but the event does NOT meet criteria for:
Correct — A. RERAs are sub-threshold respiratory events that cause arousals but lack the airflow reduction required for apnea or hypopnea scoring. They contribute to the Respiratory Disturbance Index (RDI) but not the AHI. -
Sleep Disorders
Obesity Hypoventilation Syndrome (OHS) is defined as daytime hypercapnia (PaCO2 >45 mmHg) in an obese patient (BMI ≥30) after excluding other causes. Which PSG finding most distinguishes OHS from simple OSA?
Correct — D. OHS features prolonged nocturnal hypoventilation—particularly sustained oxyhemoglobin desaturation during NREM sleep—not just discrete events. Simple OSA without daytime CO2 retention does not show this sustained low SpO2 pattern. -
Sleep Disorders
In Obesity Hypoventilation Syndrome, the preferred PAP modality when OSA co-exists and CPAP alone fails to resolve hypoventilation is:
Correct — B. BiPAP-ST provides backup-rate ventilation to correct alveolar hypoventilation in OHS. ASV is contraindicated in patients with predominant central hypoventilation or reduced ejection fraction; CPAP alone may not adequately treat hypoventilation. -
Sleep Disorders
The classic tetrad of narcolepsy includes excessive daytime sleepiness, sleep paralysis, hypnagogic hallucinations, and:
Correct — C. Cataplexy—sudden bilateral loss of muscle tone triggered by strong emotion—is the pathognomonic feature that, together with EDS, sleep paralysis, and hypnagogic/hypnopompic hallucinations, forms the narcolepsy tetrad. -
Sleep Disorders
The MSLT diagnosis of narcolepsy type 1 requires a mean sleep latency of ≤8 minutes AND at least how many sleep-onset REM periods (SOREMPs)?
Correct — A. AASM criteria require MSL ≤8 min AND ≥2 SOREMPs; a SOREMP on the preceding night PSG (REM within 15 min of sleep onset) counts as one of the two, reducing the MSLT SOREMP requirement to ≥1. -
Sleep Disorders
Narcolepsy type 1 is primarily caused by the loss of which hypothalamic neuropeptide?
Correct — D. Narcolepsy type 1 results from autoimmune destruction of hypocretin-producing neurons in the lateral hypothalamus, causing CSF hypocretin-1 levels to fall to ≤110 pg/mL (or <1/3 of normal mean). -
Sleep Disorders
A patient with narcolepsy has a CSF hypocretin-1 level of 85 pg/mL. Which classification applies?
Correct — B. CSF hypocretin-1 ≤110 pg/mL confirms narcolepsy type 1, regardless of whether cataplexy is present. Narcolepsy type 2 has normal hypocretin levels and requires MSLT confirmation. -
Sleep Disorders
Idiopathic hypersomnia (IH) differs from narcolepsy type 2 primarily in that IH patients:
Correct — C. IH is characterized by EDS with normal or near-normal MSLT results (fewer than 2 SOREMPs) and prolonged, unrefreshing sleep with significant sleep inertia ('sleep drunkenness'). Nocturnal sleep is usually long and consolidated. -
Sleep Disorders
Kleine-Levin Syndrome (KLS) is best described as:
Correct — A. KLS causes episodic hypersomnia (sleeping 16–20 h/day for days-weeks) with cognitive changes, hyperphagia, and hypersexuality, followed by full recovery between episodes. It primarily affects adolescent males and is self-limiting. -
Sleep Disorders
Delayed Sleep-Wake Phase Disorder (DSWPD) is characterized by a persistent delay in the major sleep period relative to the desired sleep time, resulting in difficulty:
Correct — B. In DSWPD the circadian phase is delayed (e.g., preferred sleep 3 AM–11 AM), making it hard to fall asleep at a socially normal bedtime or wake at a required early hour. Nocturnal sleep quality is normal once sleep onset occurs. -
Sleep Disorders
Advanced Sleep-Wake Phase Disorder (ASWPD) most commonly affects which population?
Correct — D. ASWPD—characterized by early evening sleepiness and early morning awakening—is most prevalent in the elderly, partly due to age-related shortening of the intrinsic circadian period and reduced amplitude of the circadian signal. -
Sleep Disorders
Free-Running (Non-24-Hour Sleep-Wake Rhythm) Disorder most commonly affects:
Correct — A. In people without light perception, the SCN cannot entrain to the 24-hour light-dark cycle, so the circadian clock drifts at its intrinsic period (~24.2 h), causing progressive daily delay of the sleep phase (non-24 disorder). -
Sleep Disorders
A nurse working a permanent night shift (11 PM–7 AM) for 5 years complains of chronic insomnia and EDS only on days off. The most appropriate diagnosis is:
Correct — C. Shift work disorder is defined by insomnia or EDS causally linked to a work schedule that overlaps the habitual sleep period. Symptoms typically resolve on days off when the patient can sleep at their natural circadian time. -
Sleep Disorders
According to the ICSD-3, chronic insomnia disorder requires sleep difficulties occurring at least how many nights per week for ≥3 months?
Correct — B. Chronic insomnia disorder is diagnosed when sleep difficulty (plus daytime impairment) occurs ≥3 nights/week for ≥3 months and cannot be explained by inadequate sleep opportunity or another disorder. -
Sleep Disorders
The first-line treatment recommended for chronic insomnia disorder by the AASM is:
Correct — D. AASM and most sleep medicine guidelines recommend CBT-I as first-line treatment for chronic insomnia due to its durable efficacy and lack of side effects. Pharmacotherapy is considered adjunctive or second-line. -
Sleep Disorders
Which PSG finding is most characteristic of primary (psychophysiological) insomnia?
Correct — C. Psychophysiological insomnia typically shows prolonged sleep onset latency and increased WASO reflecting conditioned arousal, but sleep architecture (stage distribution) is often relatively normal once sleep is established. -
Sleep Disorders
Sleep state misperception (paradoxical insomnia) is distinguished from psychophysiological insomnia by the finding that:
Correct — A. In paradoxical insomnia, objective PSG recordings are largely normal (adequate total sleep, normal latency) while the patient subjectively reports significant sleep loss. This mismatch between perception and measurement is the defining feature. -
Sleep Disorders
The four essential diagnostic criteria for Restless Legs Syndrome (RLS) include an urge to move the legs, worsening at rest, relief with movement, and:
Correct — B. The four IRLSSG essential criteria are: (1) urge to move legs, (2) worsened by rest, (3) partially/totally relieved by movement, and (4) worse in the evening or night than during the day. All four must be present. -
Sleep Disorders
Augmentation in RLS pharmacotherapy is characterized by symptoms that:
Correct — A. Augmentation is a paradoxical worsening induced by dopaminergic therapy: symptoms advance earlier in the day, increase in severity, may spread to arms/trunk, and worsen with dose escalation. Switching to an alpha-2-delta ligand (gabapentin/pregabalin) is a management strategy.
Sleep Tech RPSGT sample questions
Tap any question below to reveal the answer and a plain-English explanation.
Sleep Disorders Periodic Limb Movements during Sleep (PLMS) are scored when there is a series of at least 4 movements, each lasting 0.5–10 seconds, with an inter-movement interval of:
A. 2–20 seconds
B. 5–30 seconds
C. 5–90 seconds ✓
D. 10–120 seconds
Correct — C. AASM scoring criteria define a PLMS series as ≥4 consecutive limb movements each lasting 0.5–10 s, separated by 5–90 s (inter-movement interval measured onset to onset). Movements outside this range are not counted.
EEG/EOG/EMG According to the 10-20 International System, where is electrode C3 located?
A. Left central region, 30% of the nasion-to-inion distance from the midline ✓
B. Right central region, 20% of the nasion-to-inion distance from the midline
C. Left central region, 20% of the left-to-right distance from the midline
D. Right frontal region, 30% of the nasion-to-inion distance
Correct — A. In the 10-20 system, odd numbers denote left hemisphere electrodes. C3 is in the central (C) area on the left side, placed at 30% intervals from anatomical landmarks. The percentages '10' and '20' refer to the electrode spacing as proportions of skull measurements.
Instrumentation & Calibration According to the AASM scoring manual, which electrode placement system is used for EEG derivations in polysomnography?
A. International 10-20 system ✓
B. International 10-10 system
C. Bipolar montage only
D. Common average reference
Correct — A. The AASM scoring manual specifies the International 10-20 electrode placement system for EEG channel positioning in PSG. The 10-20 refers to 10% and 20% intervals measured between standard skull landmarks.
Patient Care When performing a pre-study patient assessment, which vital sign should be recorded before beginning a polysomnogram?
A. Blood pressure ✓
B. Pupillary response
C. Grip strength
D. Visual acuity
Correct — A. Blood pressure is a standard vital sign documented during pre-study assessment. It establishes a baseline and may reveal contraindications or health risks relevant to the overnight study.
Respiratory Events According to AASM scoring rules, an obstructive apnea is scored when airflow drops by at least what percentage from baseline?
A. 90% ✓
B. 50%
C. 30%
D. 70%
Correct — A. An apnea requires a ≥90% drop in the peak signal excursion of an oro-nasal thermal sensor lasting ≥10 seconds. A ≥50% drop defines a hypopnea, not an apnea.
Safety What is the maximum allowable leakage current for a patient-connected medical device according to AAMI standards?
A. 10 microamps ✓
B. 100 microamps
C. 500 microamps
D. 1 milliamp
Correct — A. AAMI ES1 standards limit patient-lead leakage current to 10 µA (microamps) under normal conditions to prevent microshock hazards. Higher leakage currents pose serious risk to patients with direct cardiac access.
Sleep Stage Scoring According to AASM scoring rules, Stage N1 sleep is characterized by which EEG feature replacing alpha activity?
A. Low-amplitude mixed-frequency activity (LAMF) ✓
B. Sleep spindles and K-complexes
C. High-amplitude delta waves (>75 µV)
D. Saw-tooth waves
Correct — A. N1 is defined by replacement of alpha rhythm with low-amplitude mixed-frequency (LAMF) EEG activity predominantly in the 4–7 Hz range. Sleep spindles and K-complexes define N2; high-amplitude delta defines N3; saw-tooth waves appear in REM.
PAP Titration CPAP delivers pressure that is:
A. Fixed at a single set pressure throughout the night ✓
B. Automatically adjusted based on resistance changes
C. Bilevel, with higher pressure on inhalation
D. Pressure-relief only during peak flow
Correct — A. CPAP (Continuous Positive Airway Pressure) maintains one constant pressure throughout the entire breathing cycle, unlike APAP or bilevel modes.
About the Sleep Tech RPSGT test
Pass your Sleep Exam with confidence. Sleep Tech RPSGT Prep gives you 750+ realistic practice questions with clear, detailed explanations for every answer.
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Sleep Stage Scoring, EEG/EOG/EMG, Respiratory Events, PAP Titration, Instrumentation & Calibration, Sleep Disorders — and more.
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You will be tested on
- Safe and effective care environment
- Health promotion and maintenance
- Psychosocial and physiological integrity
- Pharmacology, infection control and patient safety
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Topics in this question bank
Safe and effective care environment
Health promotion and maintenance
Psychosocial and physiological integrity
Pharmacology, infection control and patient safety
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