100+ Free ABDSM Practice Questions

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According to AASM/AADSM guidelines, OAT is recommended as first-line therapy for which category of OSA?

All severe OSA regardless of CPAP tolerance

Central sleep apnea

Pediatric OSA only

Mild-to-moderate OSA, or severe OSA in patients who cannot tolerate or refuse CPAP

to track

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Practice Pages

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2026 Statistics

Key Facts: ABDSM Exam

150

MCQ Items

ABDSM exam

3 hrs

Exam Time

ABDSM

21 cases

OAT Required

Application minimum

AHI ≥30

Severe OSA

AASM scoring

ABDSM is the dental sleep medicine diplomate credential. 150 MCQ, 3 hours, ~$1,500. Master AHI severity (5-15 mild, 15-30 mod, ≥30 severe), STOP-Bang screening, custom MAD > OTC per AADSM, OAT effectiveness criteria (≥50% AHI reduction OR AHI <10), MMA surgery (~90% effective), and Inspire hypoglossal nerve stimulation (BMI <32-35, AHI 15-65).

Sample ABDSM Practice Questions

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

1What is the primary anatomical site of upper airway collapse in most adult patients with obstructive sleep apnea?

A.Nasal cavity

B.Retropalatal and retroglossal regions of the pharynx

C.Larynx at the level of the vocal cords

D.Trachea below the cricoid cartilage

Explanation: The most common sites of pharyngeal collapse in adult OSA are the retropalatal (behind the soft palate) and retroglossal (behind the tongue base) regions, where the pharynx lacks rigid bony or cartilaginous support and depends on dilator muscle tone for patency.

2A patient's tonsils completely fill the oropharynx and obstruct more than 75% of the airway. What tonsil grade does this represent?

A.Grade 1

B.Grade 2

C.Grade 3

D.Grade 4

Explanation: Tonsil grading uses a 0-4 scale: 0 (absent/surgically removed), 1 (<25% obstruction), 2 (25-50%), 3 (50-75%), and 4 (>75%, often called 'kissing tonsils'). Grade 4 indicates severe obstruction.

3When the patient opens the mouth widely with tongue protruded, only the hard palate is visible. What is the Mallampati classification?

A.Class I

B.Class II

C.Class III

D.Class IV

Explanation: Mallampati Class IV indicates that only the hard palate is visible — the soft palate, uvula, and pillars are not seen. This suggests crowded oropharyngeal anatomy associated with OSA risk.

4Which muscle is the primary upper airway dilator that maintains pharyngeal patency during inspiration?

A.Genioglossus

B.Masseter

C.Sternocleidomastoid

D.Buccinator

Explanation: The genioglossus is the largest pharyngeal dilator muscle. It protrudes the tongue forward during inspiration, maintaining airway patency. Reduced genioglossus tone during sleep is central to OSA pathophysiology.

5The Friedman tongue position classification is most analogous to which other clinical assessment?

A.Tonsil grading

B.Mallampati classification

C.ESS score

D.Cormack-Lehane grade

Explanation: The Friedman tongue position (FTP) is similar to Mallampati but assessed with the tongue inside the mouth (not protruded). Both visualize oropharyngeal crowding by the soft palate, uvula, and tongue.

6Which anatomical feature on lateral cephalometric radiographs is associated with increased OSA risk?

A.Increased posterior airway space

B.Inferiorly positioned hyoid bone

C.Class II skeletal pattern with maxillary prognathism

D.Decreased mandibular plane angle

Explanation: An inferiorly positioned hyoid bone (increased mandibular plane to hyoid distance, MP-H) is a well-recognized cephalometric marker for OSA, as it reflects a longer, more collapsible airway and weakened tongue base support.

7Waldeyer's ring includes which lymphoid structures?

A.Palatine tonsils, adenoids, and lingual tonsils

B.Cervical lymph nodes only

C.Submandibular and sublingual glands

D.Parotid and submental nodes

Explanation: Waldeyer's ring is composed of pharyngeal lymphoid tissue — palatine tonsils, adenoids (pharyngeal tonsils), tubal tonsils, and lingual tonsils. Hypertrophy of these tissues is the most common cause of pediatric OSA.

8Which cranial nerve provides motor innervation to the genioglossus muscle?

A.CN V (trigeminal)

B.CN VII (facial)

C.CN X (vagus)

D.CN XII (hypoglossal)

Explanation: The hypoglossal nerve (CN XII) provides motor innervation to all intrinsic and most extrinsic tongue muscles, including the genioglossus. This is the basis for hypoglossal nerve stimulation therapy (Inspire).

9What is the Starling resistor model used to describe in OSA pathophysiology?

A.Cardiac output during apneas

B.Collapsibility of the upper airway based on transmural pressure

C.Renal sodium handling in OSA patients

D.Tongue muscle contraction force

Explanation: The Starling resistor model describes the upper airway as a collapsible tube whose patency depends on the relationship between intraluminal pressure, tissue pressure, and downstream pressure. Critical closing pressure (Pcrit) quantifies this collapsibility.

10Which neck circumference threshold in males is included in the STOP-Bang questionnaire as a risk factor?

A.Greater than 14 inches

B.Greater than 15 inches

C.Greater than 17 inches

D.Greater than 19 inches

Explanation: STOP-Bang uses a neck circumference threshold of >17 inches (43 cm) for males and >16 inches (41 cm) for females. Larger neck circumference reflects parapharyngeal fat deposition, a key OSA risk factor.

About the ABDSM Exam

ABDSM Diplomate certification for dentists practicing dental sleep medicine — primarily oral appliance therapy (OAT) for obstructive sleep apnea (OSA) and snoring. 150 MCQ exam covering airway anatomy + physiology, adult sleep medicine (AHI/RDI/ESS/STOP-Bang, PSG vs HSAT), pediatric sleep, oral appliance therapy (MAD vs TRD, custom vs OTC, titration), alternative treatments (CPAP, UPPP, MMA, hypoglossal nerve stimulation), and evaluation/treatment/follow-up. AADSM is the parent professional organization.

Questions

150 scored questions

Time Limit

3 hours

Passing Score

Scaled (ABDSM-set)

Exam Fee

~$1,500 (ABDSM)

ABDSM Exam Content Outline

30%

Oral Appliance Therapy (OAT)

MAD vs TRD, custom vs OTC, titration, side effects (TMJ, occlusal change), Herbst/TAP/Klearway designs

25%

Adult Sleep Medicine

OSA pathophysiology, AHI/RDI/ODI, ESS, STOP-Bang, PSG vs HSAT, AASM scoring

15%

Airway Anatomy & Physiology

Upper airway, Mallampati, Friedman tongue position, pharyngeal collapse, lymphoid tissue

10%

Pediatric Sleep

Pediatric OSA, adenotonsillar hypertrophy, T&A first-line, airway development

10%

Alternative Treatments

CPAP, UPPP, MMA, positional therapy, weight loss, hypoglossal nerve stim (Inspire)

10%

Evaluation, Treatment & Follow-up

Workup, referral, sleep test interpretation, follow-up titration, AADSM Definition of Effective

How to Pass the ABDSM Exam

What You Need to Know

Passing score: Scaled (ABDSM-set)
Exam length: 150 questions
Time limit: 3 hours
Exam fee: ~$1,500

Keys to Passing

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

ABDSM Study Tips from Top Performers

1Master AHI severity: <5 normal, 5-15 mild, 15-30 mod, ≥30 severe — drives OSA classification + treatment

2Memorize STOP-Bang scoring (8 questions; ≥3 = high OSA risk) and ESS (≥10 abnormal sleepiness)

3Drill OAT mechanism: MAD protrudes mandible/tongue; titrate 50-70% maximum to start, then advance based on symptoms + HSAT

4Know AASM/AADSM joint guidelines: OAT for mild-moderate or CPAP-intolerant severe OSA

5Apply AADSM Definition of Effective: ≥50% AHI reduction OR AHI <10 + symptom resolution

Frequently Asked Questions

How is OSA severity classified by AHI?

AASM scoring criteria for AHI (Apnea-Hypopnea Index per hour of sleep): <5 normal, 5-15 mild OSA, 15-30 moderate OSA, ≥30 severe OSA. Hypopnea = ≥30% airflow reduction with ≥3% O2 desaturation OR arousal (AASM 2012 alternate scoring rule with ≥4% desat without arousal also accepted by Medicare). RDI includes RERAs (Respiratory Effort Related Arousals).

When is OAT preferred over CPAP per AASM?

AASM/AADSM 2015 guidelines: OAT recommended for adult OSA who (1) prefer OAT over CPAP, OR (2) cannot tolerate CPAP, OR (3) have mild-moderate OSA. CPAP remains gold standard for severe OSA. Custom OAT preferred over over-the-counter "boil-and-bite" devices. OAT effective criteria: ≥50% reduction in AHI OR AHI <10/hr with normalization of symptoms.

What are the side effects of oral appliance therapy?

Common short-term: TMJ pain (10-50%, usually resolves within weeks), tooth/gingival pain, hypersalivation, dry mouth. Long-term: posterior open bite, retroclination of upper incisors, mesial drift of mandibular molars, occlusal contact changes (10-90% over years). All patients require occlusal monitoring at follow-up. Contraindications: active TMD, severe periodontal disease, complete edentulism without retention, central sleep apnea predominant.

How should I study for ABDSM?

Plan 100-200 hours over 3-6 months. Focus weighted study on Oral Appliance Therapy (30%) and Adult Sleep Medicine (25%) — together 55% of exam. Master AHI/RDI scoring per AASM, STOP-Bang for screening, OAT effectiveness criteria, MMA + Inspire as alternatives, and AADSM Definition of Effective. Read the AASM/AADSM joint OAT clinical practice guideline (2015). Build experience with sleep study interpretation.