New93 role standards, now public
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Role standards

Imaging and diagnostics

Sleep technologist

What a sleep technologist must do alone on a night shift: record a polysomnogram that can be scored, titrate positive airway pressure to protocol, and recognise and escalate the patient who becomes unwell on the table. Drawn from the Registered Polysomnographic Technologist examination blueprint and the AASM scoring and titration standards.

Practice this assessmentHire for this role
Expectations
10
Safety red lines
4
Sources
3
Version
1

Built from Board of Registered Polysomnographic Technologists, American Academy of Sleep Medicine, American Academy of Sleep Medicine, Journal of Clinical Sleep Medicine. Reviewed by clinicians, last on .

01What the role is measured on#

Every verdict is made of the same five dimensions. Each is scored on its own, so a candidate sees where they are strong and where to work.

  • Clinical skillsThe hands-on and judgement work of the role: recognising what matters, acting in the right order, and knowing when something cannot wait.
  • Workflow and toolsGetting the work done in a real setting: the systems, records, equipment and handoffs the role runs on, used correctly and on time.
  • Patient communicationHow the role talks with patients, families and colleagues: listening, explaining plainly, and confirming what was understood.
  • Compliance and safetyThe rules that protect people: privacy, consent, infection control, reporting duties and the safety checks the role is accountable for.
  • Role knowledgeKnowing the job itself: what the role is responsible for, where its scope ends, and who to bring in when it does.

02What a ready hire does#

What a competent sleep technologist does on day one, dimension by dimension.

Clinical skills

  • Applies and calibrates the full polysomnography montage to AASM specifications and keeps every required channel valid through the night, or documents honestly when one is not.
  • Titrates positive airway pressure to the AASM guideline and the physician's protocol, fits the interface well, and adds oxygen or changes mode only as the protocol allows.

Workflow and tools

  • Explains how to find the cause of a signal or device problem from its pattern and fix it at the source, without disturbing the patient more than the problem requires.
  • Keeps technologist notes that let the physician and scorer understand the night: what happened, what was changed, and why.

Patient communication

  • Prepares a patient for PAP - mask fitting, desensitisation and what to expect - so they can sleep on it, and keeps to the education their role allows.
  • Explains the study and instructions in words the patient can use, adapted to their language and understanding, and checks they have landed.

Compliance and safety

  • Recognises from the signals and the patient that someone is becoming unwell during the night, and goes to the patient and acts under the lab's emergency procedure rather than just recording it.
  • Prevents falls in a patient who is wired up, sleepy and in an unfamiliar room at night.

Role knowledge

  • Reports a critical event to the on-call physician and emergency services as the lab's policy requires, confirms it has been received, and documents it.
  • Works within the physician's order and the lab's protocols, and leaves diagnosis, prescription and treatment decisions to the physician.

03Safety red lines#

Any one of these keeps a candidate from Ready Day One, whatever the rest of the score. They are published so nobody meets them for the first time in the assessment.

  • Lets a required channel stay invalid for a long stretch without trying to fix it and without documenting it, or presents a period with no valid airflow, oximetry or EEG as if it were valid, so it is scored and reported as good data.

    A study built on invalid signal gives a false diagnosis or pressure - untreated apnoea or an unneeded prescription - and the physician has no way of knowing.

  • Sees a sustained dangerous arrhythmia, severe desaturation that does not recover, or signs such as chest pain or a seizure, and does not go to the patient and start the lab's emergency procedure, treating it instead as an event to score or to mention in the morning.

    The technologist is often the only person awake with the patient, and a lethal arrhythmia or respiratory failure left unanswered can kill in minutes.

  • Tells the patient their diagnosis or severity, or tells them to change their prescribed pressure, stop a medicine, or stop therapy on their own.

    The patient acts on it: an untreated or wrongly treated sleep disorder, a stopped medicine, or a diagnosis the physician has not made.

  • For an event the lab's policy requires reported now, leaves a voicemail, a message or a chart note and carries on without confirming a clinician has received it, or does not escalate to a backup or emergency services when the on-call physician cannot be reached.

    A report nobody receives protects no one, and the patient stays in danger while the technologist believes the problem is handled.

04Outside the role#

Knowing where the role stops is part of the standard. Going past it is not extra credit.

  • Does not tell a patient their diagnosis, severity or study results.Explains that the sleep physician will review the study and discuss it, and records the question so it reaches them.
  • Does not start oxygen, change mode or convert to a split-night study outside the physician's order and the lab's protocol.Follows the protocol's criteria, and calls the on-call physician for a decision when the patient falls outside it.
  • Does not give medication, or manage an emergency beyond basic life support and the lab's emergency procedure.Starts basic life support if needed, calls emergency services or the on-site team, and stays with the patient.
  • Does not practise where a licence is required without it: several US states require a licence to practise polysomnography, and requirements outside the US differ.Works under the credential and licence the jurisdiction requires, and under the supervision the lab's accreditation sets out.

05How it is assessed#

  • A spoken assessment

    An examiner talks the candidate through realistic cases from this role, and follows up the way a senior colleague would.

  • Five dimensions

    Each answer is read against the expectations above and rated on the same four-level scale.

  • The 70 bar

    Every scorecard shows the score against 70, overall and for each dimension, with the reason for the verdict.

  • Safety first

    Crossing one of the safety red lines holds a pass back, however strong the rest was.

The four levels

  1. Not yet
  2. Developing
  3. Proficient
  4. Exemplary
How a verdict is made

06Sources and review#

Drawn from the certification frameworks and practice standards below, and reviewed by clinicians. Version 1, last reviewed .

Cited as sources. Not an endorsement by the organizations named.

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