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Primed for New Challenges: Polysomnography Comes of Age

The BRPT celebrates 30 years of credentialing leadership staff.

Polysomnography has come a long way since eight pioneering sleep technologists passed the Board of Registered Polysomnographic Technologists’ (BRPT) first registered polysomnographic technologist (RPSGT) qualifying exam at Stony Brook University in 1979—30 years ago. This 30th anniversary year seems a good time to take stock of BRPT’s progress and review the most important trends in our profession today.

With the rapid growth of sleep medicine, the ranks of RPSGTs have grown to include more than 14,000 RPSGT-credentialed technologists worldwide. The number of RPSGTs has doubled in the past 4 years, and the field is expected to continue to grow despite the challenges of the current economic climate.

A Distinct, Allied Health Care Profession

As President of the BRPT, my goal is to stay true to the organization’s commitment to best credentialing practices and to continue to foster ethical practices and continued competence for those who earn the RPSGT credential.

Today, it’s paramount that the profession of polysomnography be recognized as a distinct, specialized allied health profession, with responsibility for all aspects of patient care, including best testing and monitoring procedures, support of treatment therapies, and patient education. Registered technologists are key players in the multidisciplinary medical teams who strive to help patients with sleep disorders get healthy rest. RPSGTs can look to the BRPT for support and advocacy, in close cooperation with our partners in the American Association of Sleep Technologists (AAST) and the American Academy of Sleep Medicine (AASM). Our roles are changing in this fast-evolving medical field. A strong partnership with our colleagues in the field of sleep medicine is critical as we face the challenges before our discipline today and look to the future, and the new challenges it is sure to bring.

A Top Priority: Standardized Education for Sleep Technologists

It has become increasingly important to promote the development of standardized education for polysomnographic technologists. As a credentialing board, the BRPT cannot sponsor educational activities: we can’t “teach to the exam.” We do, however, take education and credentialing “best practices” very seriously and maintain our own accreditation with the National Organization for Competency Assurance (NOCA). Sleep technologists learn from programs accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP), and through professional organizations, specialized sleep schools, local and community colleges, and online courses. One of the core challenges facing our discipline today continues to be the development and availability of high-quality, standardized educational opportunities for sleep technologists.

To enhance technologist education, the AASM created the Accredited Sleep Technologist Education Program (A-STEP). The BRPT adopted this endeavor as an initial educational step, and requires RPSGT candidates applying through the 18-month experiential pathway to complete a program of online A-STEP Self-Study modules. However, the BRPT shares the commitment of the AAST and AASM—the Allied Professional Sleep Societies—to promote the continued development of formal educational programs for people entering the field of polysomnography, as well as those already involved in sleep medicine. For educators in the allied health arena, there is a real opportunity, and we encourage you to step up to the challenge of helping to develop a sufficient number of accredited, high-quality, accessible educational programs.

Growing Recognition of the Credential

Many thought leaders believe RPSGT-credentialed sleep technologists will become only more valuable as regulatory requirements, including requirements regarding portable monitoring, continue to evolve. The Centers for Medicare and Medicaid Services (CMS) requires that PSG testing be monitored by a credentialed technologist when performed in an independent diagnostic testing facility. Effective July 1, 2009, the AASM facility accreditation guidelines will require at least one RPSGT on staff, and mandate that all other technologists be enrolled in an educational program leading directly to RPSGT exam eligibility.

Is There a Place for Different Credentials in Sleep Technology?

The field of sleep medicine and the demand for credentialed RPSGTs are rapidly expanding. Increased public awareness of the importance of sleep and the relationship between sleep apnea and other diseases has raised the profile of sleep medicine and often generated aggressive competition for patients. With increased awareness came a rush to open new labs; sadly, the quality of technology, technologists, and patient care in many of these new labs has been compromised.

Does the BRPT face a new challenge as the American Association for Respiratory Care (AARC) launches a sleep credential? As a credentialing body, committed to the value of a strong credentialing process in raising the level of professionalism in any discipline, we applaud an effort that validates core competencies in a field where patient care is of the utmost importance. As we celebrate our 30th anniversary, we are dedicated to maintaining the RPSGT credential as the gold standard in the field of sleep technology, a recognition we have earned through decades of diligent, focused work specifically in the field of sleep technology. We will keep our focus on the integrity of the RPSGT exam and on promoting quality patient care offered by credentialed, competent technologists. Applications for the RPSGT exam were up a record-breaking 75% in 2008. The volume of 2009 RPSGT exam applications continues to exceed expectations.

A Future Full of Change and Possibility

I see our evolving profession as having “one foot in reality and one foot in possibility.” In the next 10 years, I believe we will see the role of sleep technologists continue to evolve to focus not only on the performance of sleep studies and appropriate therapeutic interventions, but to include—to an ever-increasing degree—patient education and long-term management of sleep disorders as chronic diseases. “One way to see obstructive sleep apnea is as a medical condition that requires a lifetime of care, as does insulin resistance. Sleep technologists will become the sleep-disorder managers for primary care groups,” said Philip R. Westbrook, MD, AASM past president and founder of Advanced Brain Monitoring Inc, in a presentation at the 2008 BRPT Symposium. He envisions—correctly, I believe—a greatly expanded future role for sleep technologists in ongoing patient care.

As a leader in the field of sleep technology, the BRPT works in partnership with the broader sleep community. We serve as an advocate for the concerns of RPSGTs, including career development and expanded professional opportunities, standards of conduct, legislative and regulatory issues, and the vital job of growing our profession to meet the need for sleep technologists. BRPT’s mission—past, present and future—continues to be to advance quality patient care by advancing the sleep technology profession.


Becky Appenzeller, RPSGT, R EEG T, CNIM, is president of the Board of Registered Polysomnographic Technologists. For further information contact rtmagazine@nullallied360.com.

BRPT Initiatives

BRPT activities are far-reaching. Here are four key current program areas:

  • The BRPT Symposium: The BRPT Annual Symposium offers an exchange of opinions, ideas, and experiences in the polysomnographic profession by bringing together RPSGTs and thought leaders to discuss the challenges facing our field today. The Third Annual BRPT Symposium, “Celebrating the Past/Shaping the Future,” will be held September 18–20 at The Hyatt Regency Savannah in Savannah, Ga. This event, open only to RPSGTs, will be a highlight of BRPT’s 30th anniversary year. Attendance has doubled since the first symposium in 2007, as more RPSGTs take advantage of the opportunity to catch up with colleagues, participate in the development of items for the RPSGT examination, network, learn from leaders in the field, and earn valuable CECs toward RPSGT recertification.
  • Job Task Analysis: What Does an RPSGT Do? The BRPT is in the process of performing a new job task analysis (JTA). The JTA is a professionally directed, multistep process to identify the job responsibilities of an RPSGT. A primary part of this process was a survey distributed earlier this year to all RPSGTs in the BRPT database. The response was excellent. The result of the JTA will be a new RPSGT exam blueprint that will help assure that the RPSGT exam continues to test against the knowledge, skills, and abilities required of RPSGTs.
  • Recertification and Keeping Current: Recertification for RPSGTs begins in 2011. BRPT is developing a manageable tool for RPSGTs to report continuing education activities. The allied health professions, including polysomnographic technology, change rapidly, and BRPT actively promotes continuing education for RPSGTs by requiring 50 CECs every 5 years to maintain the credential. Our Web site, www.brpt.org, will be the go-to resource for RPSGTs looking to identify continuing education opportunities and submit their application for recertification.
  • Going Global: The sleep technology profession is growing around the world, and we are working actively to maintain BRPT as the leader worldwide in credentialing for sleep technologists. A BRPT task force focuses specifically on issues impacting sleep technologists internationally. A credential recognized and accepted internationally will help set global standards for technologists, bringing equivalency in quality, greater professional credibility, and exciting career mobility through international reciprocity.