ABDSM EXAM/ACTUAL QUESTIONS
AND ANSWERS. VERIFIED 2026.
Which of the following statements is true regarding a modified mallampati classification of the
oral pharynx?
A. Mallampati II allows visualization of only the hard palate
B. Malampati III allows visualization of only the hard palate
C. Malampati classifications are taken with the patient sedated and reclined
D. Mallampati classifications of IV have greater odds ratio than Mallampati classifications of I for
severe OSA - ANS D. Mallampati classifications of IV have greater odds ratio than Mallampati
classifications of I for severe OSA
What 8 item questionnaire was developed to perioperatively screen for risk of OSA?
A. ESS
B. STOP-BANG
C. MSLT
D. Berlin - ANS B. STOP-BANG
In the pathophysiology of sleep apnea, airway patency and stability is promoted by which
factor?
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,A. Increased lung volume
B. Shorter mandible
C. Increased parapharyngeal fat deposition
D. Negative inspiratory pressure
E. Reduced pharyngeal muscle dilator activity - ANS A. Increased lung volume
Oral appliance therapy commonly provides successful sole therapy for which of the following
sleep-related breathing disorders?
A. Primary central sleep apnea
B. Cheyne-Stoke periodic breathing
C. Obesity hypoventilation
D. Overlap syndrome (OSA and COPD)
E. None of the above - ANS E. None of the above
Which of the following is true about OSA and HTN?
A. Ambulatory BP is increased in OSA patients primarily due to increased salt intake associated
with elevated ghrelin levels
B. Ambulatory BP normally increases in the early AM before awakening - this increase is blunted
in OSA
C. Untreated OSA is associated with a similar risk of HTN at all severity levels
D. The risk of HTN in untreated OSA is due to intermittent hypoxia, sympathetic overactivation,
inflammation, and other complex factors - ANS D. The risk of HTN in untreated OSA is due to
intermittent hypoxia, sympathetic overactivation, inflammation, and other complex factors
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,Across a general population, what is the most common sleep disorder?
A. RLS
B. Narcolepsy
C. Delayed sleep phase syndrome
D. Insomnia
E. Obstructive sleep apnea - ANS D. Insomnia
Measurement has shown that patients with sleep apnea have smaller upper airways than those
without sleep apnea but manage to keep an open airway during wakefulness by:
A. Mouth Breathing
B. Increased muscle tone on inspiration
C. Increased blood flow to the soft tissue
D. Frequent bruxing - ANS B. Increased muscle tone on inspiration
Key features of sleep apnea as recorded during an in-lab sleep study include marked reduction
or absence of air flow, arousals from sleep, slowing of heart rate and:
A. Choking or gasping for air
B. Oxygen desaturation
C. Flattening of the nasal pressure signal
D. Flailing of the arms and legs
E. Sawtooth waves in the EEG - ANS B. Oxygen Desaturation
Who publishes the CPT codebook?
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, A. The Centers for Medicare and Medicaid Services
B. The American Medical Association
C. The Office of the Inspector General
D. The Durable Medical Equipment Service
E. The American Academy of Sleep Medicine - ANS B. The American Medical Association
A 48 year old man is treated with OAT for his moderate OSA. On repeat sleep testing, his apnea-
hypopnea index (AHI) has decreased to 3 events per hour, and he reports resolution of snoring
and daytime sleepiness. What is the most reasonable dental-medical sleep medicine follow up
regimen for this patient?
A. As needed
B. Every 6 months for the first year, then annually
C. Monthly for the first 6 months, then every 6 months
D. Every other year - ANS B. Every 6 months for the first year, then annually
Which of the following would exclude oral appliance therapy as a first treatment trial for OSA?
A. Xerostomia
B. Edentulism
C. Micrognathia
D. Steep mandibular plane angle - ANS B. Edentulism
Reviewing your patient's diagnostic polysomnogram, you note more than a 50% epoch consists
of alpha waves. According to the current PSG scoring guidelines, the patient is in which stage of
sleep?
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
AND ANSWERS. VERIFIED 2026.
Which of the following statements is true regarding a modified mallampati classification of the
oral pharynx?
A. Mallampati II allows visualization of only the hard palate
B. Malampati III allows visualization of only the hard palate
C. Malampati classifications are taken with the patient sedated and reclined
D. Mallampati classifications of IV have greater odds ratio than Mallampati classifications of I for
severe OSA - ANS D. Mallampati classifications of IV have greater odds ratio than Mallampati
classifications of I for severe OSA
What 8 item questionnaire was developed to perioperatively screen for risk of OSA?
A. ESS
B. STOP-BANG
C. MSLT
D. Berlin - ANS B. STOP-BANG
In the pathophysiology of sleep apnea, airway patency and stability is promoted by which
factor?
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,A. Increased lung volume
B. Shorter mandible
C. Increased parapharyngeal fat deposition
D. Negative inspiratory pressure
E. Reduced pharyngeal muscle dilator activity - ANS A. Increased lung volume
Oral appliance therapy commonly provides successful sole therapy for which of the following
sleep-related breathing disorders?
A. Primary central sleep apnea
B. Cheyne-Stoke periodic breathing
C. Obesity hypoventilation
D. Overlap syndrome (OSA and COPD)
E. None of the above - ANS E. None of the above
Which of the following is true about OSA and HTN?
A. Ambulatory BP is increased in OSA patients primarily due to increased salt intake associated
with elevated ghrelin levels
B. Ambulatory BP normally increases in the early AM before awakening - this increase is blunted
in OSA
C. Untreated OSA is associated with a similar risk of HTN at all severity levels
D. The risk of HTN in untreated OSA is due to intermittent hypoxia, sympathetic overactivation,
inflammation, and other complex factors - ANS D. The risk of HTN in untreated OSA is due to
intermittent hypoxia, sympathetic overactivation, inflammation, and other complex factors
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,Across a general population, what is the most common sleep disorder?
A. RLS
B. Narcolepsy
C. Delayed sleep phase syndrome
D. Insomnia
E. Obstructive sleep apnea - ANS D. Insomnia
Measurement has shown that patients with sleep apnea have smaller upper airways than those
without sleep apnea but manage to keep an open airway during wakefulness by:
A. Mouth Breathing
B. Increased muscle tone on inspiration
C. Increased blood flow to the soft tissue
D. Frequent bruxing - ANS B. Increased muscle tone on inspiration
Key features of sleep apnea as recorded during an in-lab sleep study include marked reduction
or absence of air flow, arousals from sleep, slowing of heart rate and:
A. Choking or gasping for air
B. Oxygen desaturation
C. Flattening of the nasal pressure signal
D. Flailing of the arms and legs
E. Sawtooth waves in the EEG - ANS B. Oxygen Desaturation
Who publishes the CPT codebook?
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, A. The Centers for Medicare and Medicaid Services
B. The American Medical Association
C. The Office of the Inspector General
D. The Durable Medical Equipment Service
E. The American Academy of Sleep Medicine - ANS B. The American Medical Association
A 48 year old man is treated with OAT for his moderate OSA. On repeat sleep testing, his apnea-
hypopnea index (AHI) has decreased to 3 events per hour, and he reports resolution of snoring
and daytime sleepiness. What is the most reasonable dental-medical sleep medicine follow up
regimen for this patient?
A. As needed
B. Every 6 months for the first year, then annually
C. Monthly for the first 6 months, then every 6 months
D. Every other year - ANS B. Every 6 months for the first year, then annually
Which of the following would exclude oral appliance therapy as a first treatment trial for OSA?
A. Xerostomia
B. Edentulism
C. Micrognathia
D. Steep mandibular plane angle - ANS B. Edentulism
Reviewing your patient's diagnostic polysomnogram, you note more than a 50% epoch consists
of alpha waves. According to the current PSG scoring guidelines, the patient is in which stage of
sleep?
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
