Sleep Tech RPSGT Exam Questions & Answers 2026 (11–20)

Question 1

Per AASM 2012 recommended criteria, a hypopnea requires a ≥30% drop in airflow for ≥10 seconds associated with:

TheoryPractice · Accepted Answer

A ≥3% oxygen desaturation OR an arousal. 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.

Question 2

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:

TheoryPractice · Accepted Answer

An apnea or hypopnea. 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.

Question 3

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?

TheoryPractice · Accepted Answer

Sustained hypoventilation with SpO2 <90% for >5 min during NREM sleep. 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.

Question 4

In Obesity Hypoventilation Syndrome, the preferred PAP modality when OSA co-exists and CPAP alone fails to resolve hypoventilation is:

TheoryPractice · Accepted Answer

Bilevel PAP in spontaneous-timed (ST) mode. 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.

Question 5

The classic tetrad of narcolepsy includes excessive daytime sleepiness, sleep paralysis, hypnagogic hallucinations, and:

TheoryPractice · Accepted Answer

Cataplexy. 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.

Question 6

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)?

TheoryPractice · Accepted Answer

2 SOREMPs (including any from the prior night PSG). 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.

Question 7

Narcolepsy type 1 is primarily caused by the loss of which hypothalamic neuropeptide?

TheoryPractice · Accepted Answer

Hypocretin (orexin). 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).

Question 8

A patient with narcolepsy has a CSF hypocretin-1 level of 85 pg/mL. Which classification applies?

TheoryPractice · Accepted Answer

Narcolepsy type 1. 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.

Question 9

Idiopathic hypersomnia (IH) differs from narcolepsy type 2 primarily in that IH patients:

TheoryPractice · Accepted Answer

Typically do NOT have ≥2 SOREMPs and sleep inertia is prominent. 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.

Question 10

Kleine-Levin Syndrome (KLS) is best described as:

TheoryPractice · Accepted Answer

Recurrent episodes of hypersomnia lasting days to weeks, with cognitive impairment and hyperphagia, separated by normal periods. 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 Tech RPSGT Exam Questions & Answers 2026 (11–20)

More Sleep Tech RPSGT practice questions

Free practice here. Timed mocks when you are ready.