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AASM Manual Exam 2025/2026 – 100+ Questions with Answers | Sleep Scoring, Polysomnography, Clinical Neurophysiology, Sleep Medicine

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This comprehensive study resource features over 100 verified exam questions and answers aligned with the AASM Manual 2025/2026, specifically curated for students and professionals involved in sleep study diagnostics and scoring. It serves as an essential review tool for mastering core topics in polysomnography, clinical neurophysiology, and sleep medicine, and is directly applicable to AASM-accredited standards. Content includes detailed explanations of EEG, EOG, and EMG electrode placements; criteria for scoring wakefulness (W), non-REM (N1, N2, N3), and REM sleep stages; pediatric-specific scoring rules; arousal criteria; sleep architecture components like K-complexes, spindles, and slow wave activity; as well as respiratory and motor event scoring. Additional coverage includes leg movement (PLM), cardiac event definitions (tachycardia, bradycardia, asystole), REM Behavior Disorder (RBD), and bruxism scoring. Relevant for: Undergraduate and graduate students studying Polysomnography, Sleep Technology, Neuroscience, Respiratory Therapy, or Allied Health Sciences Medical residents and fellows in Sleep Medicine or Neurology Candidates preparing for RPSGT, BRPT, or other AASM-related certifications Clinical instructors and educators in sleep labs and diagnostic programs This document is particularly useful for those enrolled in programs at major U.S. universities and clinical institutions offering sleep science and neurodiagnostic education. Keywords: AASM scoring, sleep staging, EEG placement, EOG derivations, EMG scoring, sleep spindles, K-complex, slow wave activity, REM rules, pediatric sleep scoring, hypnagogic hypersynchrony, alpha rhythm, bruxism scoring, PLM criteria, RBD diagnosis, sleep study exam, polysomnography certification, clinical sleep guide

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AASM Manual 2025/2026 Exam
Questions and Verified Answers |
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What are the recommended derivations? - 🧠ANSWER ✔✔There are 3;

(a)F4-M1; (b)C4-M1; (c)O2-M1


Where should backup electrodes be placed? Why? - 🧠ANSWER ✔✔They

should be placed at F3, C3, and M2 to allow the display of F3-M2, C3-M2,

and O1-M2 if the electrodes malfunction during the study.


What are alternative and acceptable derivations? - 🧠ANSWER ✔✔There

are 3; (a)F2-C2, (b)C2-O2, (c)C4-M1

Where should alternative backup electrodes be placed? Why? - 🧠ANSWER

✔✔They should be placed at Fpz, C3, O1, and M2 to allow substitution of

,Fz, C3 for Cz or C4, O1 for O2 and M2 for M1 if electrodes malfunction

during study.


What system is used for electrode positioning? Why? - 🧠ANSWER ✔✔10-

20 system; there is a minimum of 3 EEG derivations required in order to

sample activity from the frontal, central, and occipital regions.


What does "EOG" stand for? - 🧠ANSWER ✔✔Electro-Oculogram


What does M1 and M2 refer to? - 🧠ANSWER ✔✔They refer to the left/right

mastoid processes.

What is the recommended EOG derivations? Where are they placed? -

🧠ANSWER ✔✔The recommended derivations are E1-M2 and E2-M1. E1-

M2 is placed 1cm below the left-outer corner of the eye and E2-M1 is

placed 1cm above the right-outer corner of the eye.

What are the alternative and acceptable derivations for EOGs and where

should they be placed? - 🧠ANSWER ✔✔E1-Fpz and E2-Fpz; E1-Fpz is

placed 1cm lateral to the corner of the left eye and E2-Fpz is placed 1cm

lateral to the corner of the right eye.

Describe how using the alternative placement for EOGs (lateral of the

left/right corner of the eye) works - 🧠ANSWER ✔✔This alternative records

, the direction of the eye movement. Vertical movements will show in phase

directions and horizontal movement will show out-of-phase deflections.


What does "EMG" stand for? - 🧠ANSWER ✔✔Electromyogram


How many electrodes should be placed to record chin EMG? Where should

they be placed? - 🧠ANSWER ✔✔-3 electrodes


-one in the midline 1cm above the inferior edge of the mandible, one 2cm

right of the midline, and one 2cm below the inferior edge of the mandible

Why do we use these standard placements for chin EMGs? - 🧠ANSWER

✔✔The standard chin EMG derivation consists of an electrode below the

mandible that is referenced to the electrode above the mandible. The other

inferior electrode is backup to allow continued display of EMG activity if one

of the primary electrodes malfunctions.

What is the recommended terminology for stages of sleep? - 🧠ANSWER

✔✔There are 5 stages: W (wakefulness), N1, N2, N3 and R (REM)


What does N3 represent? - 🧠ANSWER ✔✔Slow wave sleep


How long is an epoch? - 🧠ANSWER ✔✔30 seconds




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