RPSGT Practice Questions (2026) — Free Sample Questions with Answers

Answer: C

Increased REM sleep with a shortened REM latency: This pattern is typical of SSRI withdrawal (REM rebound), not ongoing SSRI use.

Marked increase in N3 slow-wave sleep amount: SSRIs do not substantially increase slow-wave sleep.

REM suppression with a prolonged REM latency: Correct. SSRIs suppress REM and lengthen REM latency; they can also cause eye movements in NREM and REM sleep without atonia.

Abundant sleep spindles and excess beta activity: Increased spindles and beta activity are characteristic of benzodiazepines and related hypnotics.

Antidepressants (SSRIs, SNRIs, TCAs) suppress REM; abrupt withdrawal causes REM rebound. Benzodiazepines increase spindles/beta and reduce N3.

Answer: B

A 58-year-old on daily methadone with loud snoring and witnessed apneas: Chronic opioid use raises the risk of central apnea and hypoventilation, so in-lab PSG is recommended.

A 47-year-old with snoring, witnessed apneas, obesity and daytime sleepiness, no comorbidities: Correct. HSAT is appropriate for uncomplicated adults with signs and symptoms indicating an increased risk of moderate-to-severe OSA.

A 62-year-old with ALS whose daytime breathing is beginning to weaken: Neuromuscular weakness and suspected hypoventilation are reasons to use in-lab PSG instead of HSAT.

A 70-year-old with severe COPD and a recent stroke who reports snoring: Significant cardiorespiratory disease and stroke history are exclusions for HSAT; in-lab PSG is recommended.

HSAT: uncomplicated adults with high pretest probability of moderate–severe OSA. Use in-lab PSG for significant cardiopulmonary disease, neuromuscular weakness, hypoventilation, chronic opioids, stroke or severe insomnia.

Answer: A

15 minutes after the first epoch of sleep, to allow detection of SOREM: Correct. Once sleep occurs, the nap continues for 15 minutes of clock time after the first epoch of sleep to determine whether REM sleep occurs.

Immediately after the first epoch of sleep, once latency is recorded: Ending at sleep onset is the MWT approach (after unequivocal sleep); MSLT naps continue to look for REM.

20 minutes after lights out, the same as for naps without any sleep: The 20-minute cutoff applies only when no sleep occurs during the nap.

40 minutes after lights out, so every nap has the same total length: 40-minute trials belong to the Maintenance of Wakefulness Test, not the MSLT.

MSLT: 5 naps at 2-hour intervals; end at 20 min if no sleep; if sleep occurs, continue 15 min after the first sleep epoch to look for SOREMPs.

Answer: A

15 events per hour: Correct. AHI = (30 + 6 + 54) ÷ 6 hours of sleep = 90 ÷ 6 = 15 events/h.

14 events per hour: This leaves out the central apneas; the AHI counts all apneas and hypopneas.

9 events per hour: This counts only the hypopneas (54 ÷ 6).

25 events per hour: This divides 90 events by 3.6, treating 360 minutes as 3.6 hours.

AHI = total apneas (obstructive, central, mixed) + hypopneas ÷ hours of total sleep time.

Answer: C

A 25% drop in the nasal pressure signal lasting 20 seconds, followed by a 4% desaturation: A 25% drop does not meet the required ≥30% reduction in signal amplitude.

A 40% drop in the nasal pressure signal lasting 8 seconds, followed by an arousal: Events must last at least 10 seconds to be scored.

A 35% drop in the nasal pressure signal lasting 14 seconds, followed by a 3% desaturation: Correct. Rule 1A: ≥30% drop in the hypopnea sensor signal for ≥10 seconds, associated with a ≥3% oxygen desaturation or an arousal.

A 95% drop in the oronasal thermal signal lasting 12 seconds, with continued effort: A ≥90% drop in the thermal sensor for ≥10 seconds is an apnea (obstructive here), not a hypopnea.

Adult hypopnea (1A): ≥30% drop for ≥10 s + ≥3% desaturation or arousal. Rule 1B (acceptable; used by Medicare) requires ≥4% desaturation.

Answer: A

Increase CPAP by 1 cm H2O, then wait at least 5 minutes before the next change: Correct. For patients 12 and older, CPAP is raised by at least 1 cm H2O at intervals of no less than 5 minutes when at least 2 obstructive apneas occur.

Increase CPAP by 5 cm H2O right away to eliminate all the apneas at once: Large jumps cause discomfort, arousals and possible treatment-emergent central apneas; increases are made in 1 cm H2O steps.

Keep the pressure the same until there are 10 apneas, then increase it: Waiting for 10 events leaves obstruction untreated; the threshold is 2 obstructive apneas in adults.

Switch to BPAP immediately, because apneas at 8 cm H2O mean CPAP failure: Switching to BPAP is considered for intolerance or persistent events at 15 cm H2O, not at 8 cm H2O.

Adult CPAP titration: start at 4 cm H2O; increase ≥1 cm H2O no more often than every 5 min for ≥2 obstructive apneas, ≥3 hypopneas, ≥5 RERAs or ≥3 min of loud snoring; maximum 20 cm H2O.