ABDSM Dental Sleep Medicine Exam Prep Test Bank
450+ Practice Questions with Correct Verified Answers |
2026-2027 Edition
This comprehensive test bank contains 450+ verified questions for the American
Board of Dental Sleep Medicine (ABDSM) certification examination, covering all
essential domains including sleep physiology, OSA pathophysiology, oral
appliance therapy, sleep testing, patient management, and pediatric sleep
medicine .
Content Area Overview
Domain Topic Approx. Weight
1 Sleep Physiology & Pathophysiology of SDB 13%
2 Sleep Testing (PSG, HSAT, MSLT, MWT) 13%
3 Evidence-Based Alternatives for SDB Treatment 9%
4 Dental Sleep Medicine History, Exam & Imaging 13%
5 Oral Appliance Therapy (OAT) – Selection & Fabrication 12%
6 OAT Calibration & Effectiveness Assessment 8%
7 Long-Term Follow-Up & Management 8%
8 Pediatric Sleep Breathing Disorders 8%
,Domain Topic Approx. Weight
9 Medical vs Dental Model & Practice Guidelines 8%
10 Side Effect Management & Maintenance 8%
SECTION 1: SLEEP PHYSIOLOGY AND PATHOPHYSIOLOGY OF SDB
(Questions 1-60)
Question 1: Which neurons are sleep-promoting in the brain?
A) Orexin neurons in the lateral hypothalamus
B) Ventrolateral Preoptic System (VLPO) and Median Preoptic Nuclei (MNPO)
C) Locus coeruleus neurons
D) Tuberomammillary nucleus neurons
Answer: B) Ventrolateral Preoptic System (VLPO) and Median Preoptic Nuclei
(MNPO)
Rationale: The VLPO and MNPO are sleep-promoting neuron groups. Loss of VLPO
neurons promotes profound insomnia and sleep fragmentation. Orexin neurons,
locus coeruleus, and tuberomammillary nucleus are wake-promoting .
Question 2: What does the "flip-flop switch" refer to in sleep physiology?
A) The transition between REM and NREM sleep
B) Mutual inhibition of sleep and wake promoting neurons triggered by changes
in drive
C) The circadian rhythm phase shift
D) The mechanism of arousal from sleep
Answer: B) Mutual inhibition of sleep and wake promoting neurons triggered by
changes in drive
Rationale: The flip-flop switch describes the mutual inhibition between sleep-
promoting (VLPO) and wake-promoting neuron groups. This creates a bistable
,system where the brain is either in a sleep or wake state, with rapid transitions
between the two .
Question 3: Caffeine promotes wakefulness by suppressing or blocking:
A) Thyroid stimulating hormone
B) Growth hormone
C) Orexin
D) Adenosine
Answer: D) Adenosine
Rationale: Caffeine acts as an adenosine receptor antagonist. Adenosine
accumulates during wakefulness and promotes sleep pressure; blocking it
enhances wakefulness .
Question 4: In sleep, which of the following occurs?
A) Heart rate increases 10-20 BPM
B) Heart rate slows 10-20 BPM
C) Blood pressure increases
D) Body temperature rises
Answer: B) Heart rate slows 10-20 BPM
Rationale: During sleep, heart rate slows 10-20 BPM, breathing slows, muscles
relax, and blood pressure decreases (with a morning dip). Body temperature
decreases during sleep, then begins to rise just before morning wake time .
Question 5: According to current PSG scoring guidelines, more than 50% of an
epoch consisting of alpha waves indicates which sleep stage?
A) Stage I NREM
B) Stage II NREM
C) Stage III NREM
D) Stage REM
Answer: A) Stage I NREM
Rationale: Stage I NREM sleep is characterized by alpha wave activity (8-12 Hz) in
more than 50% of the epoch. This is the lightest stage of sleep, representing the
transition from wakefulness to sleep .
, Question 6: In the pathophysiology of sleep apnea, airway patency and stability is
promoted by which factor?
A) Increased lung volume
B) Shorter mandible
C) Increased parapharyngeal fat deposition
D) Negative inspiratory pressure
E) Reduced pharyngeal muscle dilator activity
Answer: A) Increased lung volume
Rationale: Increased lung volume exerts traction on the upper airway, promoting
patency. Factors that reduce lung volume (obesity, supine position) worsen
airway collapsibility. Shorter mandible, fat deposition, and reduced dilator activity
all promote airway collapse .
Question 7: 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
Answer: B) Increased muscle tone on inspiration
Rationale: During wakefulness, increased upper airway dilator muscle tone
compensates for anatomically smaller airways. This protective muscle activity is
lost during sleep, allowing airway collapse to occur .
Question 8: With regards to biomechanical properties of the upper airway, which
statement is true?
A) Sleep apnea patients paralyzed during general anesthesia demonstrated airway
compliance similar to healthy subjects
B) Sleep apnea patients had more negative closing pressures
C) Sleep apnea patients demonstrate a more positive Pcrit
D) There is no correlation between collapsibility when awake and when asleep
450+ Practice Questions with Correct Verified Answers |
2026-2027 Edition
This comprehensive test bank contains 450+ verified questions for the American
Board of Dental Sleep Medicine (ABDSM) certification examination, covering all
essential domains including sleep physiology, OSA pathophysiology, oral
appliance therapy, sleep testing, patient management, and pediatric sleep
medicine .
Content Area Overview
Domain Topic Approx. Weight
1 Sleep Physiology & Pathophysiology of SDB 13%
2 Sleep Testing (PSG, HSAT, MSLT, MWT) 13%
3 Evidence-Based Alternatives for SDB Treatment 9%
4 Dental Sleep Medicine History, Exam & Imaging 13%
5 Oral Appliance Therapy (OAT) – Selection & Fabrication 12%
6 OAT Calibration & Effectiveness Assessment 8%
7 Long-Term Follow-Up & Management 8%
8 Pediatric Sleep Breathing Disorders 8%
,Domain Topic Approx. Weight
9 Medical vs Dental Model & Practice Guidelines 8%
10 Side Effect Management & Maintenance 8%
SECTION 1: SLEEP PHYSIOLOGY AND PATHOPHYSIOLOGY OF SDB
(Questions 1-60)
Question 1: Which neurons are sleep-promoting in the brain?
A) Orexin neurons in the lateral hypothalamus
B) Ventrolateral Preoptic System (VLPO) and Median Preoptic Nuclei (MNPO)
C) Locus coeruleus neurons
D) Tuberomammillary nucleus neurons
Answer: B) Ventrolateral Preoptic System (VLPO) and Median Preoptic Nuclei
(MNPO)
Rationale: The VLPO and MNPO are sleep-promoting neuron groups. Loss of VLPO
neurons promotes profound insomnia and sleep fragmentation. Orexin neurons,
locus coeruleus, and tuberomammillary nucleus are wake-promoting .
Question 2: What does the "flip-flop switch" refer to in sleep physiology?
A) The transition between REM and NREM sleep
B) Mutual inhibition of sleep and wake promoting neurons triggered by changes
in drive
C) The circadian rhythm phase shift
D) The mechanism of arousal from sleep
Answer: B) Mutual inhibition of sleep and wake promoting neurons triggered by
changes in drive
Rationale: The flip-flop switch describes the mutual inhibition between sleep-
promoting (VLPO) and wake-promoting neuron groups. This creates a bistable
,system where the brain is either in a sleep or wake state, with rapid transitions
between the two .
Question 3: Caffeine promotes wakefulness by suppressing or blocking:
A) Thyroid stimulating hormone
B) Growth hormone
C) Orexin
D) Adenosine
Answer: D) Adenosine
Rationale: Caffeine acts as an adenosine receptor antagonist. Adenosine
accumulates during wakefulness and promotes sleep pressure; blocking it
enhances wakefulness .
Question 4: In sleep, which of the following occurs?
A) Heart rate increases 10-20 BPM
B) Heart rate slows 10-20 BPM
C) Blood pressure increases
D) Body temperature rises
Answer: B) Heart rate slows 10-20 BPM
Rationale: During sleep, heart rate slows 10-20 BPM, breathing slows, muscles
relax, and blood pressure decreases (with a morning dip). Body temperature
decreases during sleep, then begins to rise just before morning wake time .
Question 5: According to current PSG scoring guidelines, more than 50% of an
epoch consisting of alpha waves indicates which sleep stage?
A) Stage I NREM
B) Stage II NREM
C) Stage III NREM
D) Stage REM
Answer: A) Stage I NREM
Rationale: Stage I NREM sleep is characterized by alpha wave activity (8-12 Hz) in
more than 50% of the epoch. This is the lightest stage of sleep, representing the
transition from wakefulness to sleep .
, Question 6: In the pathophysiology of sleep apnea, airway patency and stability is
promoted by which factor?
A) Increased lung volume
B) Shorter mandible
C) Increased parapharyngeal fat deposition
D) Negative inspiratory pressure
E) Reduced pharyngeal muscle dilator activity
Answer: A) Increased lung volume
Rationale: Increased lung volume exerts traction on the upper airway, promoting
patency. Factors that reduce lung volume (obesity, supine position) worsen
airway collapsibility. Shorter mandible, fat deposition, and reduced dilator activity
all promote airway collapse .
Question 7: 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
Answer: B) Increased muscle tone on inspiration
Rationale: During wakefulness, increased upper airway dilator muscle tone
compensates for anatomically smaller airways. This protective muscle activity is
lost during sleep, allowing airway collapse to occur .
Question 8: With regards to biomechanical properties of the upper airway, which
statement is true?
A) Sleep apnea patients paralyzed during general anesthesia demonstrated airway
compliance similar to healthy subjects
B) Sleep apnea patients had more negative closing pressures
C) Sleep apnea patients demonstrate a more positive Pcrit
D) There is no correlation between collapsibility when awake and when asleep
