RPSGT Documentation & Record Keeping 5 — Questions and Answers
Question 1: The term 'total recording time' (TRT) in PSG documentation is defined as:
- The interval from lights off to lights on (Correct answer)
- The total minutes of actual sleep scored
- The time from first electrode application to last electrode removal
- The interval from study start to the first arousal
Correct answer: The interval from lights off to lights on
TRT is the entire lights-off to lights-on period and serves as the denominator for calculating sleep efficiency.
Question 2: A scored epoch is classified as Wake (W) when alpha or other waking EEG activity occupies more than what fraction of the epoch per AASM rules?
- 50% (Correct answer)
- 20%
- 75%
- 10%
Correct answer: 50%
Per AASM scoring rules, an epoch is scored Wake when more than 50% contains alpha or low-amplitude mixed-frequency activity characteristic of wakefulness.
Question 3: During a home sleep apnea test (HSAT), the patient log completed by the patient serves primarily to:
- Document lights off/on times and any interruptions not captured by the device (Correct answer)
- Replace the need for a technician-scored report
- Provide insurance authorization data
- Record the patient's subjective AHI estimate
Correct answer: Document lights off/on times and any interruptions not captured by the device
Because no technician is present, the patient log captures key timestamps and events (getting up, equipment problems) needed to interpret device data accurately.
Question 4: When an AASM-required 10-minute inter-scorer reliability check is performed, the acceptable minimum agreement for sleep staging is:
- 80% epoch-by-epoch agreement (Correct answer)
- 60%
- 95%
- 70%
Correct answer: 80% epoch-by-epoch agreement
AASM accreditation standards require a minimum of 80% epoch-by-epoch agreement between scorers on sleep staging during inter-scorer reliability assessments.
Question 5: A CAP (cyclic alternating pattern) notation in technician comments indicates documentation of:
- A periodic EEG pattern of NREM instability with alternating A (activation) and B (background) phases (Correct answer)
- A cardiac arrhythmia captured during sleep
- A continuous positive airway pressure titration event
- A calibration artifact pattern
Correct answer: A periodic EEG pattern of NREM instability with alternating A (activation) and B (background) phases
CAP is an NREM sleep EEG marker of sleep instability, with phase A (phasic activation bursts) alternating with phase B (background), relevant to sleep fragmentation analysis.
Question 6: If a fire evacuation occurs mid-study, which documentation action is most critical immediately after the emergency?
- Record the exact time the study was interrupted, events that occurred, and the patient's status (Correct answer)
- Re-start the study from scratch without noting the interruption
- Document only in an incident report and exclude from the PSG record
- Wait until the interpreting physician requests the information
Correct answer: Record the exact time the study was interrupted, events that occurred, and the patient's status
Any study interruption must be immediately logged in the PSG record with timestamp and patient status to ensure data integrity and patient safety documentation.
Question 7: Which statement about documenting periodic limb movements (PLMs) is correct per AASM rules?
- PLMs are scored in series of ≥4 consecutive movements with inter-movement intervals of 5–90 seconds (Correct answer)
- Any limb movement longer than 2 seconds qualifies as a PLM series
- PLMs require associated arousals to be counted
- PLMs are only scored during REM sleep
Correct answer: PLMs are scored in series of ≥4 consecutive movements with inter-movement intervals of 5–90 seconds
A PLM series requires ≥4 movements, each lasting 0.5–10 seconds, separated by intervals of 5–90 seconds, and can occur in any sleep stage.
RPSGT Documentation & Record Keeping 5
The term 'total recording time' (TRT) in PSG documentation is defined as: