100+ Free ABFM Sleep Medicine Practice Questions

No. The Sleep Medicine subspecialty exam is a single, multi-board exam co-sponsored by ABFM, ABIM, ABA, ABPN, ABOHNS, and ABP and administered by ABIM. ABFM-trained candidates register through the ABFM portal but sit the same content-equivalent exam at Pearson VUE that ABIM, ABA, ABPN, ABOHNS, and ABP candidates take. Score reports and certification are issued by your primary specialty board (ABFM in this case).

Candidates must hold active ABFM family medicine certification in good standing and have completed a 12-month ACGME-accredited Sleep Medicine fellowship. A valid, unrestricted medical license is also required before the certificate is issued. Candidates who completed fellowship training before ACGME accreditation existed may have qualified through the discontinued practice pathway, but for current applicants only fellowship-trained candidates are eligible.

The 2026 ABFM subspecialty exam fee is approximately $2,300 (subject to annual update; check the ABFM Sleep Medicine subspecialty page for current pricing). Candidates should also budget for a question bank, board review course (typically $500-$1,500), and travel to a Pearson VUE test center. Application is filed through the ABFM portal during the published registration window for the November administration.

ABIM-administered subspecialty exams typically deliver approximately 220 multiple-choice questions across 4 modules of about 60 questions each, with break time available between modules. Total seat time is roughly 10 hours including breaks. The exam is delivered at Pearson VUE test centers and uses single-best-answer multiple-choice questions.

Use the AASM Manual for the Scoring of Sleep and Associated Events (2023 rules). Focus on respiratory event thresholds (apnea ≥90% airflow drop ≥10s; hypopnea ≥30% drop with 3% desaturation or arousal under rule 1A or 4% desaturation under 1B), arousal criteria (≥3-second EEG frequency shift), sleep staging rules (N1/N2/N3/REM with N3 requiring ≥20% slow-wave activity), and pediatric-specific scoring.

ABFM Sleep Medicine certification follows the ABIM-administered maintenance pathway because ABIM runs the exam. Diplomates choose either a traditional 10-year recertification exam or the Longitudinal Knowledge Assessment (LKA), which delivers about 600 questions over 5 years and requires engagement with at least 500. ABFM does not run a separate FMCLA-style longitudinal product for the Sleep Medicine subspecialty; subspecialty MOC is through ABIM's framework.

AASM clinical practice guidelines recommend home sleep apnea testing (HSAT) for uncomplicated adults with a high pretest probability of moderate-to-severe OSA. Use in-lab attended polysomnography for children, patients with significant cardiopulmonary disease (CHF, COPD), suspected non-OSA sleep disorders (central apnea, hypoventilation, parasomnia, narcolepsy), neuromuscular disease, chronic opioid use, or when an HSAT is technically inadequate or non-diagnostic.

Adaptive servo-ventilation (ASV) is contraindicated in symptomatic heart failure with reduced ejection fraction (LVEF ≤45%) because of increased all-cause and cardiovascular mortality demonstrated in the SERVE-HF trial. In patients with preserved ejection fraction (LVEF >45%), ASV remains a reasonable option for treatment-emergent central sleep apnea after optimization of CPAP. CPAP, oxygen, or BPAP-S/T may be alternatives in HFrEF.

Per the 2024 AASM clinical practice guideline and 2020 IRLSSG recommendations, alpha-2-delta calcium channel ligands (gabapentin enacarbil, pregabalin) are now preferred first-line therapy for chronic persistent RLS over dopamine agonists, due to high rates of augmentation with long-term dopamine agonist use. Always check ferritin first; oral or IV iron is recommended when ferritin is ≤75 ng/mL with a target ferritin >100 ng/mL or transferrin saturation >20%.