ABDSM EXAM TRAINER: 250 HIGH-YIELD QUESTIONS FOR
DENTAL SLEEP SPECIALISTS LATEST VERSION WITH
VERIFIED ANSWERS | GRADED A+ 2025|26 LATEST
UPDATE
Q1. Which physiologic change during sleep most directly predisposes to upper
airway collapse in obstructive sleep apnea (OSA)?
A. Increased upper airway dilator muscle tone
B. Decreased pharyngeal muscle tone during REM and NREM sleep
C. Increased functional residual capacity
D. Increased ventilatory drive
Answer: B. Decreased pharyngeal muscle tone during REM and NREM sleep
Rationale: Loss of pharyngeal dilator tone during sleep reduces airway patency
and predisposes to collapse.
Q2. The apnea–hypopnea index (AHI) is defined as:
A. Number of apneas per hour of sleep only
B. Number of apneas plus hypopneas per hour of sleep
C. Total minutes of oxygen desaturation per night
D. Number of arousals per hour of sleep
Answer: B. Number of apneas plus hypopneas per hour of sleep
Rationale: AHI quantifies apneas + hypopneas per sleep hour and is used to grade
OSA severity.
,Q3. Which PSG (polysomnography) parameter best distinguishes central from
obstructive apneas?
A. Presence of respiratory effort during the event
B. Oxygen saturation nadir
C. Arousal index
D. Snoring intensity
Answer: A. Presence of respiratory effort during the event
Rationale: Obstructive apneas show continued respiratory effort; central apneas
show absent effort.
Q4. First‑line therapy for moderate to severe OSA in adults is:
A. Mandibular advancement device (MAD) only
B. Continuous positive airway pressure (CPAP) therapy
C. Uvulopalatopharyngoplasty (UPPP) as first step
D. Weight loss only
Answer: B. Continuous positive airway pressure (CPAP) therapy
Rationale: CPAP is the gold standard for moderate–severe OSA, improving AHI
and symptoms.
Q5. Which dental appliance mechanism most effectively reduces upper airway
collapse?
A. Tongue‑retaining device that holds tongue anteriorly
B. Maxillary expansion plate only
C. Soft palate stiffening splint only
D. Occlusal equilibration only
Answer: A. Tongue‑retaining device that holds tongue anteriorly
,Rationale: Tongue‑retaining devices and MADs advance/support anterior
structures to enlarge airway.
Q6. Indication for an oral appliance (MAD) over CPAP includes:
A. Severe OSA with AHI > 40 and significant daytime sleepiness
B. Mild to moderate OSA and intolerance or refusal of CPAP
C. Central sleep apnea predominance
D. Uncontrolled hypertension only
Answer: B. Mild to moderate OSA and intolerance or refusal of CPAP
Rationale: MADs are effective for mild–moderate OSA or when CPAP is not
tolerated.
Q7. Which craniofacial feature is most commonly associated with increased OSA
risk?
A. Maxillary prognathism
B. Retrognathia (mandibular retrusion)
C. Wide nasal aperture only
D. High‑arched palate only
Answer: B. Retrognathia (mandibular retrusion)
Rationale: Retrognathia reduces posterior airway space and increases OSA risk.
Q8. The primary contraindication to mandibular advancement device therapy is:
A. Mild OSA only
B. Severe temporomandibular joint (TMJ) disease with limited opening
C. Age over 65 only
, D. Controlled hypertension only
Answer: B. Severe temporomandibular joint (TMJ) disease with limited opening
Rationale: Significant TMJ pathology or insufficient dentition can preclude MAD
use.
Q9. Which objective outcome is most commonly used to measure oral appliance
efficacy?
A. Reduction in AHI on follow‑up PSG or home sleep testing
B. Patient‑reported snoring only
C. Weight change only
D. Blood pressure only
Answer: A. Reduction in AHI on follow‑up PSG or home sleep testing
Rationale: AHI reduction is the standard objective metric for treatment efficacy.
Q10. In dental sleep medicine, titration of a mandibular advancement device is
intended to:
A. Increase vertical opening only
B. Incrementally advance the mandible to reduce AHI while monitoring side
effects
C. Retract the mandible to reduce snoring
D. Immobilize the TMJ permanently
Answer: B. Incrementally advance the mandible to reduce AHI while monitoring
side effects
Rationale: Titration balances airway improvement with comfort and TMJ/dental
side effects.
DENTAL SLEEP SPECIALISTS LATEST VERSION WITH
VERIFIED ANSWERS | GRADED A+ 2025|26 LATEST
UPDATE
Q1. Which physiologic change during sleep most directly predisposes to upper
airway collapse in obstructive sleep apnea (OSA)?
A. Increased upper airway dilator muscle tone
B. Decreased pharyngeal muscle tone during REM and NREM sleep
C. Increased functional residual capacity
D. Increased ventilatory drive
Answer: B. Decreased pharyngeal muscle tone during REM and NREM sleep
Rationale: Loss of pharyngeal dilator tone during sleep reduces airway patency
and predisposes to collapse.
Q2. The apnea–hypopnea index (AHI) is defined as:
A. Number of apneas per hour of sleep only
B. Number of apneas plus hypopneas per hour of sleep
C. Total minutes of oxygen desaturation per night
D. Number of arousals per hour of sleep
Answer: B. Number of apneas plus hypopneas per hour of sleep
Rationale: AHI quantifies apneas + hypopneas per sleep hour and is used to grade
OSA severity.
,Q3. Which PSG (polysomnography) parameter best distinguishes central from
obstructive apneas?
A. Presence of respiratory effort during the event
B. Oxygen saturation nadir
C. Arousal index
D. Snoring intensity
Answer: A. Presence of respiratory effort during the event
Rationale: Obstructive apneas show continued respiratory effort; central apneas
show absent effort.
Q4. First‑line therapy for moderate to severe OSA in adults is:
A. Mandibular advancement device (MAD) only
B. Continuous positive airway pressure (CPAP) therapy
C. Uvulopalatopharyngoplasty (UPPP) as first step
D. Weight loss only
Answer: B. Continuous positive airway pressure (CPAP) therapy
Rationale: CPAP is the gold standard for moderate–severe OSA, improving AHI
and symptoms.
Q5. Which dental appliance mechanism most effectively reduces upper airway
collapse?
A. Tongue‑retaining device that holds tongue anteriorly
B. Maxillary expansion plate only
C. Soft palate stiffening splint only
D. Occlusal equilibration only
Answer: A. Tongue‑retaining device that holds tongue anteriorly
,Rationale: Tongue‑retaining devices and MADs advance/support anterior
structures to enlarge airway.
Q6. Indication for an oral appliance (MAD) over CPAP includes:
A. Severe OSA with AHI > 40 and significant daytime sleepiness
B. Mild to moderate OSA and intolerance or refusal of CPAP
C. Central sleep apnea predominance
D. Uncontrolled hypertension only
Answer: B. Mild to moderate OSA and intolerance or refusal of CPAP
Rationale: MADs are effective for mild–moderate OSA or when CPAP is not
tolerated.
Q7. Which craniofacial feature is most commonly associated with increased OSA
risk?
A. Maxillary prognathism
B. Retrognathia (mandibular retrusion)
C. Wide nasal aperture only
D. High‑arched palate only
Answer: B. Retrognathia (mandibular retrusion)
Rationale: Retrognathia reduces posterior airway space and increases OSA risk.
Q8. The primary contraindication to mandibular advancement device therapy is:
A. Mild OSA only
B. Severe temporomandibular joint (TMJ) disease with limited opening
C. Age over 65 only
, D. Controlled hypertension only
Answer: B. Severe temporomandibular joint (TMJ) disease with limited opening
Rationale: Significant TMJ pathology or insufficient dentition can preclude MAD
use.
Q9. Which objective outcome is most commonly used to measure oral appliance
efficacy?
A. Reduction in AHI on follow‑up PSG or home sleep testing
B. Patient‑reported snoring only
C. Weight change only
D. Blood pressure only
Answer: A. Reduction in AHI on follow‑up PSG or home sleep testing
Rationale: AHI reduction is the standard objective metric for treatment efficacy.
Q10. In dental sleep medicine, titration of a mandibular advancement device is
intended to:
A. Increase vertical opening only
B. Incrementally advance the mandible to reduce AHI while monitoring side
effects
C. Retract the mandible to reduce snoring
D. Immobilize the TMJ permanently
Answer: B. Incrementally advance the mandible to reduce AHI while monitoring
side effects
Rationale: Titration balances airway improvement with comfort and TMJ/dental
side effects.
