Free Certified Polysomnographic Technician (CPSGT) Examination Practice Questions

Sample Practice Questions

Try these 10 sample questions from the Certified Polysomnographic Technician (CPSGT) Examination practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1A technician reviews an order for home sleep apnea testing in an adult with suspected obstructive sleep apnea. Which item in the patient's history most warrants clarification with the ordering clinician before the home test proceeds?

   1. A. Long-term opioid medication use
   2. B. Treated systemic hypertension
   3. C. Excessive daytime sleepiness
   4. D. Habitual loud snoring

   Answer: A

   Explanation: The AASM recommends polysomnography rather than home sleep apnea testing for patients with "chronic opioid medication use, history of stroke or severe insomnia." Long-term opioid use is therefore the history item that conflicts with the planned home test and should be brought to the ordering clinician; the technician does not change the order independently.

   Reference: Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea — Recommendation 4, Diagnosis of OSA in Patients with Comorbid Conditions

2. 2An adult diagnostic PSG shows a 12-second reduction of 92% in oronasal thermal airflow from baseline. Which respiratory event type should the scorer assign on that signal?

   1. A. Apnea
   2. B. Hypopnea
   3. C. Respiratory effort-related arousal
   4. D. Cheyne-Stokes breathing

   Answer: A

   Explanation: The AASM adult apnea rule requires a signal drop "by ≥ 90%" for "≥ 10 seconds." This event meets both conditions, so apnea takes precedence over a less severe flow-reduction label.

   Reference: Rules for Scoring Respiratory Events in Sleep: AASM Task Force Update — Section 4.1, Apnea Rule for Adults

3. 3A technician begins a manual CPAP titration for an adult with obstructive sleep apnea. What is the AASM guideline's recommended minimum starting pressure?

   1. A. 4 cm H2O
   2. B. 8 cm H2O
   3. C. 15 cm H2O
   4. D. 20 cm H2O

   Answer: A

   Explanation: The guideline states, "The recommended minimum starting CPAP should be 4 cm H2O" for pediatric and adult patients. The other pressures appear in related PAP guidance but are not the minimum CPAP starting value.

   Reference: Clinical Guidelines for the Manual Titration of Positive Airway Pressure in Patients with Obstructive Sleep Apnea — Section 4.2.1.2, minimum starting CPAP

4. 4During setup for an adult diagnostic polysomnogram, a technician selects the standard central EEG derivation. Which channel matches the AAST montage description?

   1. A. F4-M1
   2. B. C4-M1
   3. C. O2-M1
   4. D. E1-M2

   Answer: B

   Explanation: The guideline states that "a single central channel referenced to an ear mastoid site (C4-M1)" is sufficient. F4-M1 and O2-M1 are frontal and occipital EEG derivations; E1-M2 is an eye movement derivation.

   Reference: AAST Technical Guideline: Standard Polysomnography — Section 2.1.1.2, Electroencephalogram (EEG)

5. 5In an adult diagnostic PSG, nasal pressure amplitude falls 35% for 12 seconds and oxygen saturation falls 3% from baseline. The airflow does not meet apnea criteria. Which event should be scored?

   1. A. A respiratory effort-related arousal
   2. B. An obstructive apnea
   3. C. A hypopnea
   4. D. A central apnea

   Answer: C

   Explanation: The AASM adult hypopnea rule requires "≥ 30%" reduction for "≥ 10 seconds" plus "≥ 3% oxygen desaturation" or an arousal. All required elements are present, while the stated reduction does not meet the apnea threshold.

   Reference: Rules for Scoring Respiratory Events in Sleep: AASM Task Force Update — Section 4.2, Hypopnea Rule for Adults

6. 6During manual CPAP titration of a patient aged 20 years, the technician checks the recommended maximum CPAP pressure in the AASM guideline. What is that maximum?

   1. A. 10 cm H2O
   2. B. 15 cm H2O
   3. C. 20 cm H2O
   4. D. 30 cm H2O

   Answer: C

   Explanation: For patients at least 12 years old, the guideline gives a "recommended maximum CPAP" of "20 cm H2O" The 15 cm H2O figure applies below age 12, while 30 cm H2O is the adult maximum IPAP for bilevel titration.

   Reference: Clinical Guidelines for the Manual Titration of Positive Airway Pressure in Patients with Obstructive Sleep Apnea — Section 4.2.1.3, maximum CPAP

7. 7While placing the standard eye movement leads, a technician marks the site 1 cm lateral and below the outer canthus. Which label belongs at that site?

   1. A. E2
   2. B. M1
   3. C. E1
   4. D. M2

   Answer: C

   Explanation: The EOG methodology identifies "1 cm lateral and below (E1) the outer canthus of the eye." E2 is the upper outer-canthus site, while M1 and M2 label mastoid references.

   Reference: AAST Technical Guideline: Standard Polysomnography — Section 2.1.1.3, Electrooculogram (EOG)

8. 8A 14-second sequence in an adult PSG shows progressively flattened inspiratory nasal-pressure waves and ends in an EEG arousal. It meets neither apnea nor hypopnea criteria. If this optional event type is being scored, what is it?

   1. A. A respiratory effort-related arousal
   2. B. An obstructive apnea
   3. C. A central apnea
   4. D. An obstructive hypopnea

   Answer: A

   Explanation: The AASM rule calls a sequence of at least 10 seconds with inspiratory flattening leading to an arousal, when apnea and hypopnea criteria are absent, a "RERA." The case preserves the optional nature of scoring that event.

   Reference: Rules for Scoring Respiratory Events in Sleep: AASM Task Force Update — Section 4.3, RERA Rule for Adults

9. 9An adult still has obstructive respiratory events at 15 cm H2O of CPAP during an attended titration. Which PAP mode may the technician consider next under the AASM guideline and the study protocol?

   1. A. Bilevel positive airway pressure
   2. B. Adaptive servoventilation therapy
   3. C. Autotitrating positive airway pressure
   4. D. Fixed CPAP at the same pressure

   Answer: A

   Explanation: The guideline says, "If there are continued obstructive respiratory events at 15 cm H2O of CPAP during the titration study, the patient may be switched to BPAP." The wording is permissive; it does not require an automatic switch or support the other modes on these facts.

   Reference: Clinical Guidelines for the Manual Titration of Positive Airway Pressure in Patients with Obstructive Sleep Apnea — Section 4.3.1.1, indications for BPAP

10. 10A technician prepares the standard single ECG channel for an adult diagnostic sleep study. Which lead format does the AAST PSG guideline specify?

    1. A. Lead III
    2. B. Lead I
    3. C. Lead II
    4. D. Lead aVR

    Answer: C

    Explanation: The ECG methodology states, "The two standard ECG electrodes are applied in a lead II format." The other labels are real ECG lead configurations, but they are not the standard format specified here.

    Reference: AAST Technical Guideline: Standard Polysomnography — Section 2.1.1.6, Electrocardiogram (ECG)