100+ Free RST Practice Questions

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Question 1

Score: 0/0

BiPAP (bilevel PAP) is indicated over standard CPAP for which clinical situation?

OSA in patients who are CPAP-intolerant or need high pressure, or have COPD overlap syndrome

Uncomplicated OSA with AHI 15–29/hr

Mild OSA in otherwise healthy patients

Central sleep apnea emerging on CPAP (treatment-emergent CSA)

to track

2026 Statistics

Key Facts: RST Exam

150

Exam Questions

ABSM Handbook 2020

4 hrs

Time Limit

ABSM Handbook

45%

Study Performance

Largest blueprint domain

$250

Exam Fee

ABSM 2020

5 years

Credential Valid

Recertification cycle

50 CEUs

Recertification

5-year cycle

The RST exam has 150 questions over 4 hours via Kryterion CBT. Three blueprint domains: Study Performance 45%, Record Scoring 30%, Understanding Sleep Disorders 25%. Eligibility requires high school diploma, BLS, and pathway-specific PSG experience in an AASM-accredited facility. Fee is $250. Certification is valid 5 years; recertification requires 50 sleep CE credits.

Sample RST Practice Questions

Try these sample questions to test your RST exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1According to AASM scoring rules, a sleep stage epoch is scored based on which time increment?

A.10 seconds

B.20 seconds

C.30 seconds

D.60 seconds

Explanation: AASM v3 rules score all sleep stages in consecutive 30-second epochs. Each epoch receives a single stage designation based on the predominant pattern.

2Which EEG waveform, appearing in vertex sharp waves and sleep spindles, primarily defines Stage N2 sleep?

A.K-complexes and sleep spindles

B.Alpha waves

C.Delta waves

D.Sawtooth waves

Explanation: N2 is scored when K-complexes or sleep spindles appear for the first time in an epoch or within 0.5 seconds of the previous epoch's ending. These are the defining features per AASM v3.

3The AASM defines a cortical arousal as an abrupt EEG frequency shift lasting at least how many seconds?

A.1 second

B.3 seconds

C.5 seconds

D.10 seconds

Explanation: An arousal requires an abrupt EEG shift (alpha, theta, or frequencies >16 Hz excluding spindles) lasting ≥3 seconds, with ≥10 seconds of stable sleep preceding it. In REM, concurrent chin EMG activation ≥1 second is required.

4An obstructive apnea is scored when oronasal thermal airflow drops by at least what percentage for at least 10 seconds with continued respiratory effort?

A.50%

B.70%

C.90%

D.100%

Explanation: AASM v3 requires ≥90% drop in oronasal thermal sensor signal amplitude from baseline for ≥10 seconds with persistent thoracoabdominal effort throughout the event.

5Which sensor is recommended by AASM for scoring hypopneas and RERAs due to its superior sensitivity to flow limitation?

A.Oronasal thermistor

B.Nasal pressure transducer

C.End-tidal CO2 monitor

D.Thoracic RIP belt

Explanation: The nasal pressure transducer detects subtle flow limitation and flattening better than the thermistor, making it the preferred sensor for hypopnea and RERA scoring per AASM guidelines.

6A hypopnea per AASM recommended (not acceptable) criteria requires a ≥30% drop in nasal pressure signal for ≥10 seconds associated with which of the following?

A.≥4% oxygen desaturation only

B.≥3% oxygen desaturation or an arousal

C.Any visible EEG change

D.≥2% oxygen desaturation or leg movement

Explanation: The AASM recommended hypopnea definition requires ≥30% drop in nasal pressure for ≥10 s plus ≥3% SpO2 desaturation OR an EEG arousal. The acceptable definition uses ≥4% desaturation.

7Central apneas differ from obstructive apneas in that they are characterized by the absence of which finding?

A.Airflow cessation

B.Oxygen desaturation

C.Respiratory effort

D.EEG arousal

Explanation: Central apneas lack respiratory effort (flat RIP belt signals) throughout the event, whereas obstructive apneas maintain thoracoabdominal effort against a closed upper airway.

8PLMS scoring requires individual limb movements lasting 0.5 to 10 seconds that occur in a series of at least how many consecutive movements separated by 5 to 90 seconds?

A.2

B.4

C.6

D.8

Explanation: AASM criteria define PLMS as ≥4 consecutive leg movements each lasting 0.5–10 s, with inter-movement intervals of 5–90 seconds. The leg EMG amplitude must be ≥8 μV above resting baseline.

9In the standard 10-20 electrode placement system, which electrode position is located at the midpoint between Fpz and Oz along the sagittal plane?

A.Fz

B.Cz

C.Pz

D.C3

Explanation: Cz is placed at the intersection of the nasion-inion line and the interaural line, representing the central midpoint of the scalp in the 10-20 system.

10For adult PSG, AASM requires EEG derivations F4-M1, C4-M1, and O2-M1. What is the rationale for referencing to the contralateral mastoid?

A.To increase signal amplitude

B.To reduce common-mode noise and enhance differential signal quality

C.To avoid cardiac artifact

D.To match the 10-20 standard for clinical EEG

Explanation: Referencing active frontal/central/occipital electrodes to the contralateral mastoid (M1) reduces common-mode interference while maximizing the differential signal representing cortical activity.

About the RST Exam

The RST credential, offered by the American Board of Sleep Medicine (ABSM), validates competency for sleep technologists in polysomnography setup, AASM sleep scoring, and sleep disorder recognition. The 150-question, 4-hour computer-based exam covers three domains: Study Performance (45%), Record Scoring (30%), and Understanding Sleep Disorders (25%). Eligibility requires a high school diploma, BLS certification, and one of five experience/training pathways. Certification is valid for 5 years; recertification requires 50 sleep CE credits.

Questions

150 scored questions

Time Limit

4 hours

Passing Score

Scaled score (results provided immediately at Kryterion test center)

Exam Fee

$250 (American Board of Sleep Medicine (ABSM) / Kryterion)

RST Exam Content Outline

45%

Study Performance

Electrode application (10-20 system, collodion, paste, impedance), PAP interventions (CPAP titration protocol, BiPAP S/T, ASV indications), patient care and education, artifact recognition (60 Hz, EKG, sweat, movement), diagnostic protocols (PSG, MSLT, MWT, split-night, HSAT types), instrumentation (thermistor, nasal pressure, RIP belts, SpO2, capnography, snore sensors, ECG), sleep center emergencies (BLS, emergency response), post-study activities (data export, infection control, EDF format)

30%

Record Scoring

Sleep staging (30-s epochs: W/N1/N2/N3/R criteria per AASM v3), waveform recognition (spindles, K-complexes, slow waves, sawtooth, vertex sharps, alpha), respiratory event scoring (apnea ≥90% drop ×10s, hypopnea ≥30% drop ×10s + 3% or arousal, central vs obstructive vs mixed, RERA, CSR cycles, UARS), movement scoring (PLMS: ≥4 events, 0.5-10s duration, 5-90s apart), cardiac event scoring (arrhythmia notation), pediatric scoring (apnea 2-breath rule, hypopnea criteria)

25%

Understanding Sleep Disorders

Sleep-related breathing disorders (OSA severity classification, UARS, OHS, CSA, Cheyne-Stokes, opioid-induced CSA), sleep-related movement disorders (RLS cardinal symptoms, PLMD, bruxism, RBD-REM without atonia), hypersomnias (narcolepsy types 1/2, MSLT criteria, cataplexy, hypocretin/orexin deficiency, idiopathic hypersomnia), pediatric sleep disorders (AHI ≥1/hr, adenotonsillectomy first-line), insomnia (chronic/short-term, psychophysiological, CBT-I), parasomnias (sleep terrors from N3, nightmares from REM, confusional arousals, sleepwalking)

How to Pass the RST Exam

What You Need to Know

Passing score: Scaled score (results provided immediately at Kryterion test center)
Exam length: 150 questions
Time limit: 4 hours
Exam fee: $250

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

RST Study Tips from Top Performers

1Memorize the RST blueprint weights: Study Performance 45%, Record Scoring 30%, Sleep Disorders 25%

2Master AASM v3 30-second epoch staging rules: alpha ≥50% = W, vertex sharps/theta = N1, spindles/K-complexes = N2, ≥20% slow waves = N3, low-amplitude mixed EEG + REMs + atonia = REM

3Know apnea vs hypopnea thresholds: apnea requires ≥90% thermistor drop ×10s; hypopnea requires ≥30% nasal pressure drop ×10s + ≥3% desaturation or arousal (recommended criteria)

4Differentiate obstructive (paradoxical RIP effort), central (flat RIP), and mixed apneas (initial central then obstructive)

5Learn CPAP titration protocol: start 4–5 cm H2O, increase 1 cm every ≥5 min, max 20 cm H2O; ASV for treatment-emergent CSA (contraindicated in CHF with EF ≤45%)

6Nail the 10-20 system: Cz at intersection of sagittal and coronal midpoints; electrode impedance <5 kΩ

7Review MSLT/MWT: 4–5 naps 2 hours apart, 20-min maximum, 15-min post-sleep recording; narcolepsy = mean SL ≤8 min + ≥2 SOREMPs

8Know PLMS criteria: ≥4 movements, 0.5–10 s each, 5–90 s apart, tibialis anterior electrodes

9Study ICSD-3 disorder categories: narcolepsy type 1 (orexin ≤110 pg/mL or ≥2 SOREMPs), RBD (REM without atonia), sleep terrors (N3 NREM), nightmares (REM)

10Practice biocalibration sequences: eyes open/closed, look left-right, blink, breathe deeply, hold breath, clench teeth, flex both feet

Frequently Asked Questions

What is the RST exam?

The RST (Registered Sleep Technologist) is a certification credential offered by the American Board of Sleep Medicine (ABSM). It validates that sleep technologists have achieved minimum competencies in polysomnography setup, AASM sleep scoring, and sleep disorder recognition. The exam consists of 150 multiple-choice questions administered over 4 hours via Kryterion CBT.

What are the RST eligibility requirements?

All candidates must have a high school diploma and current BLS for Healthcare Providers certification. There are five pathways: (A) CAAHEP/CoARC polysomnography program graduates, (B) A-STEP program + OJT in AASM-accredited facility, (C) licensed health professionals with supervised PSG experience, (D) current RPSGTs, and (E) employees of AASM-accredited facilities with A-STEP modules + 1 year supervised OJT.

How many questions are on the RST exam?

The RST exam consists of 150 multiple-choice questions with 4 hours allotted for completion. The exam is computer-based and administered at Kryterion testing centers. Results are provided immediately upon completion of the examination.

What content areas are covered on the RST exam?

The RST exam covers three domains: Study Performance (45%) including electrode application, interventions, patient care, artifact recognition, diagnostic protocols, instrumentation, emergencies, and post-study activities; Record Scoring (30%) covering sleep staging, waveform recognition, respiratory/movement/cardiac events, and pediatric scoring; and Understanding Sleep Disorders (25%) covering breathing disorders, movement disorders, hypersomnias, pediatric disorders, insomnia, and parasomnias.

What is the RST exam fee?

The ABSM RST examination fee is $250. If an application is rejected or incomplete, a $50 administrative fee is retained and $200 is refunded. Candidates who withdraw at least 2 weeks before the exam receive a $200 refund. Retaking within one year requires only the exam fee with no new documentation.

How long is RST certification valid?

RST certification is valid for 5 years from the date of issue. Recertification requires submitting proof of 50 sleep-related continuing education credits earned within the 5-year period through the ABSM website portal. CE certificates cannot be submitted by mail or fax.

How should I prepare for the RST exam?

Focus on the three blueprint domains. For Study Performance, master the 10-20 electrode system, PAP titration protocols, and AASM-standard sensor placements. For Record Scoring, internalize AASM v3 staging rules, arousal criteria, and respiratory event definitions. For Understanding Sleep Disorders, review ICSD-3 classifications emphasizing OSA spectrum, narcolepsy MSLT criteria, PLMS rules, and parasomnia staging. Use practice exams to identify weak sub-domains before your test date.