RPSGT Exam Patient Assessment & Pre-Study Evaluation

Question 1

A patient scores 18 on the Epworth Sleepiness Scale (ESS) before their overnight PSG. How should this score be interpreted?

Accepted Answer

Severe excessive daytime sleepiness warranting urgent clinical evaluation

Answer

The ESS ranges from 0 to 24. Scores of 0-10 are normal; 11-12 indicate mild sleepiness; 13-15 moderate sleepiness; and 16-24 indicate severe excessive daytime sleepiness. A score of 18 falls in the severe range and warrants urgent clinical attention, as it suggests significant impairment of waking function.

Question 2

The STOP-BANG questionnaire is used in sleep medicine primarily to screen for which condition?

Accepted Answer

Obstructive sleep apnea risk stratification

Answer

STOP-BANG assesses eight risk factors (Snoring, Tired, Observed apneas, high blood Pressure, BMI >35, Age >50, Neck >40 cm, Gender male). A score ≥ 3 indicates high risk for OSA. It is widely used in preoperative and sleep clinic settings to triage patients for PSG.

Question 3

A patient scheduled for an overnight PSG reports taking a nightly benzodiazepine for anxiety. How should the sleep technologist anticipate this medication will affect the study?

Accepted Answer

It will suppress N3 (slow-wave) sleep and alter overall sleep architecture

Answer

Benzodiazepines enhance GABA activity and significantly suppress slow-wave (N3) sleep while often increasing N2 sleep spindles. They also reduce REM sleep, particularly in the first half of the night. This must be noted on the PSG report as it confounds interpretation of sleep architecture.

Question 4

A patient arrives for an overnight PSG having consumed three alcoholic beverages 2 hours earlier. What sleep architecture effect should the technologist anticipate?

Accepted Answer

Decreased sleep onset latency and REM suppression in the first half of the night, with REM rebound in the second half

Answer

Alcohol is a CNS depressant that shortens sleep onset latency and suppresses REM sleep early in the night as it is metabolized. As blood alcohol level drops in the second half of the night, a REM rebound occurs, often accompanied by more vivid dreams and lighter, fragmented sleep.

Question 5

Before scheduling a Multiple Sleep Latency Test (MSLT) to evaluate for narcolepsy, what minimum overnight sleep requirement must be met on the prior night's PSG per AASM protocol?

Accepted Answer

At least 6 hours of total sleep time

Answer

AASM MSLT protocol requires that the patient obtain at least 6 hours of sleep on the prior night's PSG to ensure the MSLT results are valid. Insufficient overnight sleep can produce false-positive sleep-onset REM periods (SOREMPs) and spuriously shortened sleep latencies, mimicking narcolepsy.

RPSGT Exam Practice Test

RPSGT Exam Practice Test

RPSGT Exam Patient Assessment & Pre-Study Evaluation