Stephen Tarnoczy, BS, RRT, RPSGT, helps students prepare for the BRPT exam.

Being involved in sleep and teaching for more than 10 years now, I have been blessed with many opportunities to do what I enjoy and have found myself in a full-time position to teach not only entry-level technologists but also existing polysomnographers who are now required by New Jersey law to have their Registered Polysomnographic Technologist (RPSGT) credential in order to work in the field. Having employed a variety of educational techniques in my career, whether they were mini in-services, clinical pearls, or outright full credit college courses, I have covered a wide range of topics. Based on these experiences, I have developed strategies and foundations for succeeding on the Board of Registered Polysomnographic Technologists (BRPT) examination.

Whether the examination is on paper or a computer, the content is still given to you when you download the BRPT exam application. Many people fail to recognize two things when they take this examination. The first is there are no surprises. You are told what you are being tested on. The second is, you don’t need to come up with the correct answer. You are given the correct answer for every question asked. You just need to recognize it as being the most correct choice. There is much to learn about taking a standardized test just as there is to actually learning the content of the exam.


When you have made the commitment to send in your application for the examination and are ready to get serious, you should give yourself a minimum of 3 months to study, but I highly recommend 6 months. At least a half hour per day should be devoted to studying with no more than 35 to 45 minutes of continuous study without taking a 10- to 15-minute break. Flash cards are an excellent way to study because they: 1) Force you to look up information; 2) Make you write the information down, which aids in retention; and 3) Make it easy to study by yourself or in small groups.


Stephen Tarnoczy

The next thing you need to do is to figure out what to study. If you are an acquisition tech, it is a safe bet that scoring, report generation, and sleep stages will be your weakest topic areas. If you are a score tech and have not done nights in 5 years, you will probably need to brush up on the 10-20 system, filters, and amplifiers. Now, some of the biggest mistakes you can make while studying are: 1) Underlining text—use a highlighter instead; it improves retention; 2) Reading aloud or moving your lips while reading—you can read and retain more by reading faster and silently; and 3) Knowing what to read—be an exam writer, not an exam taker.

Let me expand on that last topic because it is probably the most critical concept of all, and it establishes the mindset for your entire preparation for this examination. When I teach in a college classroom, my students inevitably ask me what is going to be on the exam. My response is always, “There are ____ number of questions on this test/quiz. If you were writing this exam, what questions would you ask?” You would be amazed at how well students do with that little hint and change their thinking and studying habits. In fact, I often base some of my final exam questions on ones students submit for a few extra credit points. Not that I want to make it easy for them, but surprisingly, the content and wording of the questions are better than some of my own. It is this change in attitude or mindset that makes a huge difference in how successful one candidate might be over another. Two people can study for an equal amount of time, but if they study the wrong areas of focus, their results may be radically different. Hint: Don’t spend your time memorizing the year that REM sleep was discovered but rather the three main characteristics of REM.


If flash cards are not your style, you might want to write down notes as you are reading and put them into an outline format so that you can add to them later. Keep them organized for future study. Neatness also counts. It is much easier to study from writing that is neat and legible versus something you scratched out at 4 am during a night shift. Rewriting your notes also is another great way of retaining information. I used that particular technique through my entire college career as a student.

Study groups work great for some people and not well for others. I never had success with it myself as the groups always seemed to focus on the material I already knew and not what I wanted to study. However, as an instructor, I can tell you that many of my students have found this to be a time-efficient and worthwhile method. It is a personal choice as to how you want to spend your study time and make it most profitable for you.

What to study is obviously the most important step after determining which study technique works best for you. While training many medical residents through my years in critical care, I found that one method that always seemed to ring true was their bold type philosophy. With the complex language of medical texts, it is impossible to memorize everything in multiple 600+ page books. So the theory is that you focus on anything that is described in bold type, italics, charts, or graphs, or is separated by boxes of text. It is a great concept; usually you will see all of that material on an examination, but that is not where you should be solely spending all your efforts.

The BRPT gives you a list of texts that it believes are excellent resources, and you can find those listed in the candidate’s handbook. Keep in mind that these are resources and references and not meant to be read cover to cover. Use them as a source to look up a specific field of interest and highlight or write down the main concepts in simple language that you can understand. In regard to the Internet, make sure that your sources or Web-based information comes from reliable or accredited bodies, like the APT or the AASM and the links that they provide. Be wary of blogs, newsgroups, or self-sponsored Web pages that are not affiliated with nationally recognized organizations in the field of sleep.

So, by now, I’m sure some of you are saying, “Steve, what references do you use to teach your classes and students?” I use a combination of bits and pieces from many of the well-known and recognized texts along with journal articles in my class. Here is a listing of the seven major references that I would deem indispensable. They are by no means the only references that you should use nor are they meant to belittle any other sleep texts by their exclusion. These are just my personal references that I have built my classes around:

  1. Principles and Practice of Sleep Medicine, 4th ed—by Meir H. Kryger, MD; Thomas Roth, PhD; and William C. Dement, MD, PhD
  2. Atlas of Clinical Polysomnography—by Nic Butkov, RPSGT
  3. Rapid Interpretation of EKGs—by Dale Dubin
  4. Principles of Polysomnography—by William H. Spriggs
  5. AASM Clinical Practice Parameters
  6. Sleep MultiMedia: The Computerized Textbook of Sleep Medicine—edited by Michael J. Thorpy, MD
  7. A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects—by Allan Rechtschaffen and Anthony Kales

There are innumerable texts, publications, and reference articles that I use to supplement learning. It is important to vary the presentation format to hold attention and stimulate thinking, which benefits retention. PowerPoint presentations, slides, videos, and lectures are all used to present or reinforce material. The same process should be used when studying. Whether watching a video or slides, or reading, the material should be reviewed with note taking, outlines, and flash cards—all of which reinforce the material and help address various learning styles. The drudgery of reading the same sentence over and over again to strictly memorize works only for a few content areas, such as memorizing how to calculate the apnea/hypopnea index. The concepts and thought processes of trouble-shooting, problem-solving, or what to do next in a presented scenario are all based on understanding the material and knowing how to react to or interact with the questions asked. Remember, follow the directions when answering questions. The answer is not always what you would do in your particular sleep lab. Often the instructions are: Give the best answer or the answer that is closest to the correct answer. That philosophy goes a long way in aiding students to do well in any registry exam.


Sleep Education Resources

Many people who take the exam sign up for registry review courses that may be 1, 2, or even 4 days long. I happen to teach 4 days to cover material as thoroughly as possible. The biggest misconception with these classes is that you get a phonebook-sized manual and you will learn everything you need to know just by attending a brief summary session. There is no way that hearing the highlights for a few days will allow you to retain all the information you need to pass the examination. They are a great resource to prepare you and answer your questions, but you still need to study. Studying hard does not equate to studying smart. Focus your energies on areas you feel weak in or least experienced. Take practice exams. Write test questions and trade with your coworkers. Self-assessment exams are a great benchmark to see where you stand.

Also, don’t be afraid to skip questions. Answer the questions that are easiest so that you manage your time efficiently, and spend your time on the tougher questions later in the exam. This serves several purposes. It helps you in time management, which is critical. You have only 4 hours; if you are truly stumped, move on. Come back after you have worked your way through the questions and you have 100% confidence that you have answered correctly. By reviewing the entire exam, you may see the same question later but worded differently, or you may see hints or clues in other questions that trigger a spark to the correct answer in the skipped question. If you are uncertain which of four possible answers is correct, try to eliminate choices that you know are wrong; it improves your odds of guessing, which is always a last resort. Also remember that an unanswered question is a question marked wrong. If one part of the answer is false or incorrect, then the whole answer is incorrect and can be eliminated.

Be wary of answers with the words “always” or “never” in them because they are frequently incorrect and should be highly scrutinized. And then there is the age-old college advice, which I say tongue-in-cheek: when in doubt, chose answer C. Or in polysomnography, if you’re not sure which drug is the correct answer, choose Klonopin.

I hope some of these strategies are helpful. They are the highlights of a 2-hour lecture that I give when teaching people how to study, especially when they have been out of the academic environment for some time. Good luck and study smart.

Stephen Tarnoczy, BS, RRT, RPSGT, is clinical education specialist at SleepTech LLC, Kinnelon, NJ, and associate professor at Quinnipiac University—Respiratory Care and Polysomnography. He also serves on the education committee for the APT. He can be reached at .