What to study for the 2013 ABIM Sleep Board Exam
Recommendations
Clinical Professor of Medicine
Case Western
Reserve University School of Medicine, Cleveland
Board Certified in
Pulmonary and Sleep Medicine
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1. Highly recommended for Sleep Board Review
- do not pass up!
American Academy of Sleep Medicine I recommend joining AASM (if you're not already a member) because of the great educational opportunities it offers. Some activities -- like the national educational and board review courses -- are open to all (higher fees for non-members), whereas others require membership (mainly access to the "members only" section of the AASM web site). AASM's board review offerings are listed together in one area called Board Review Resources. AASM also has an Online Learning Center that contains links to the Practice Exams and "Scoring Reviews." Scoring Reviews consist of 200 Epochs where you can practice scoring sleep staging, arousals, limb movements and respiratory events. All the AASM recommendations are listed below, but only specific items with internet links are HIGHLY RECOMMENDED. Study all the linked items in this category. Other, non-linked items that I mention in this section will be listed again (with internet links) in a lower category of recommendation. a. NATIONAL REVIEW COURSES. You can take AASM's course without being a member, at a slightly higher registration fee. See Category 4, Review Courses, below. b. PRINT PUBLICATIONS. The following two books, though published 3 years apart, are part of a package.
ICSD, 2nd edition, is the 'bible' of sleep medicine because it includes the official classification of sleep disorders, along with their diagnostic criteria, clinical course, pathology and pathophysiology. However, it is bereft of case examples and figures. That lack was remedied in 2008 with Case Book of Sleep Medicine that gives illustrative cases for almost every diagnosis. How to use these books? You should be familiar with the ICSD 2nd edition (either the regular version or the shorter ICSD 2nd edition "pocket version") and refer to it frequently, especially when studying a particular disorder, e.g. primary insomnia. I recommend reviewing the entire Case Book, concentrating on conditions you are less familiar with. Some of the people who put this book together also write exam questions. The AASM Manual for the Scoring of Sleep and Associated Events, 2007, These scoring rules update the decades-old rules (published in 1968) by Rechstaffen and Kales. The bottom line is you should know everything in this manual about how to score a PSG. Unfortunately, the 2007 Manual created many confusing points and raised unanswered questions. To some extent these points and questions were clarified in a later AASM publication and web site:
COMMENT: I considered not placing these two items into the Highly Recommended category, since one is aimed at technologists and the other is just a Q&A. But if the AASM 2007 Manual is in this category, it only makes sense to include materials that help explain it. In my opinion, the clear writing and explanations of the Technologist's Handbook (which tracks the 2007 Manual paragraph by paragraph) should have been the orginal publication. (One example: Handbook gives a graphic explanation for measuring duration of an apnea that explains the ambiguous rules published in 2007.) As for the FAQ's, they are relatively brief, and also help clarify several confusing areas in the 2007 Manual. View these 3 items as a package: the 2007 Manual, the the 2009 Handbook, and the FAQs. Study them for the board exam. c. Web site offerings: There is a wealth of material on AASM's web site, including lectures, journal articles, and quizzes (some requiring AASM membership). Go to AASM Learning Center for the most immediate items. You should spend time and review EVERYTHING THAT COULD BE RELATED TO BOARD EXAM QUESTIONS. As a minimum, be sure to closely study the American Academy of Sleep Medicine Practice Exams 1-6 and the new Sleep Study Scoring Tests 1-3. THESE PRACTICE EXAMS ARE HIGHLY RECOMMENDED ($25 each for members). They have been updated for the 2011 board exam. Some questions from the first edition of these practice tests were on the 2007 board exam!! I also recommend you subscribe to AASM's Scoring Reviews. Per AASM, "20% of the questions [on the board exam] will be devoted to sleep evaluation."d. Various CDs, including webinars. See more about ASSM's webinars in Category 2. American College of Chest Physicians Like AASM, ACCP also publishes excellent materials for sleep board review. I don't recommend joining ACCP unless you are a chest-oriented physician, but do take advantage of their board-review offerings (higher fees for non-members). There are several ACCP opportunities for sleep board review: a. NATIONAL REVIEW COURSES. Many of the people who teach the AASM courses also lecture for ACCP. See Category 4, Review Courses, below. b. PRINT PUBLICATIONS. There are several, including the syllabus from their annual review course. However, the only HIGHLY RECOMMENDED print item is ACCP SEEK - Sleep, 2nd Edition, 2010 . SEEK provides 100 case-based questions and answers, many with figures (PSG, actigraphy, sleep log). "ACCP SEEK - Sleep" is just the type of study guide needed for the board exam. An added plus: CME for this book is available. c. ACCP Web Site. There is some useful information on sleep for members; see Category 2. American Thoracic
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2. Excellent because of Q & A format
or short reviews of sleep topics, but not as crucial to board review
as Category 1
On-line Board Exam Review, produced by the Atlanta School of Sleep Medicine. This 9-hour live Webinar was held October 15, 2011 and consisted of multiple choice board-type review questions. Five different board-certified sleep physicians presented the questions and discussed the answers. (Full disclosure: I was one of the faculty.) The webinar is now available in archived format. Kryger's Sleep Medicine Review, by Meir H. Kryger, MD, Russell Rosenberg, PhD, G. Vernon Pegram, PhD and Lawrence Martin, MD. Elsevier, 2011. Questions reflect the same topics used in the sleep board exam. (Full Disclosure: I am one of the authors). Kryger's Sleep Medicine Review offers ability to obtain CME credits from the Atlanta School of Sleep Medicine, and is also available as a searchable text on-line, via Expert Consult.
Sleep Medicine Pearls, 2nd edition, by Richard B. Berry. Hanley & Belfus, 2003. Excellent case reviews by one of the physicians who wrote the board exam. It's somewhat dated but still very useful.
Review of Sleep Medicine, Alon Avidon and Teri J. Barkoukis, 3rd Edition, Elsevier Saunders, 2011. The 3rd edition, like the first two, is geared to Sleep Board review, and contains both straigthforward text and lots of test questions. Also available online in searchable format at Expert Consult series.
AASM Webinars for Board Review. The webinars are hour-long lectures
by experts in the field, originally broadcast live over the internet
and now available on CD. They are no doubt worthwhile for board review,
but cost is a main drawback. This set of 5 lectures is $460 for
non-members ($300 for members). In 2009 AASM also came out with
Webinars on Board Review Trouble Spots, including
Pediatric
Pulmonology and Sleep Apnea ($115/$75). Again, this is expensive for
a single lecture, but if you can split the cost with a group it might be
worth it. However, dollar for dollar, your money is better spent on
items in Category 1, or on a single comprehensive course with
many more lectures (live or on DVD).
MP3 files on sleep topics from recent ACCP conventions. In
search box type "sleep". You can listen to these in your car,
a painless way to pick up useful information on sleep disorders.
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3. Use as reference only -- not as
primary study aid
Principles and Practice of Sleep Medicine, 5th ed. (printed text + e-edition), published Nov 1, 2010. MH Kryger, T Roth and WC Dement, editors. Elsevier Saunders. This is the standard textbook of sleep medicine. I strongly recommend buying the version that comes with the e-edition, for continual updates plus access to videos and other web-based features not in the printed book. Another feature of the e-edition are Self Assessment Questions, in a timed format. While these questions are not specifically designed for board review (as is Kryger's Sleep Medicine Review, in Category 2 above), they should not be passed up. The e-edition can be previewed at Expert Consult. PPSM should be in every sleep physician's library. As for board review, when you come across topics in the Category 1 & 2 materials (above) about which you need more info, refer to PPSM. (Note: If you have any interest in the history of sleep medicine -- admittedly not a board review topic -- you will enjoy Dr. Kryger's video interviews of the major figures in Sleep: Nathaniel Kleitman, William Dement, Colin Sullivan, et al.)
AASM Practice Parameters. These are state of the art reviews of evidence-based sleep medicine, by experts in each area. I would especially peruse the later ones (2006-2010), to get a good feel for accepted practice standards. These reprints from Sleep are available free on the AASM web site. |
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4. Review Courses
Sleep Review Courses are listed separately because they are relatively expensive and time consuming, and don't really fit any of the other categories. You can pass the exam without ever attending one, but they are very popular and, time permitting, definitely recommended (at least one). If nothing else, they focus your attention on what's important to review on your own. There are many more courses than you'll have time for, and only a few are listed here. Note also that many of these live courses are now available on DVD; while still expensive, DVDs eliminate travel and hotel costs, and can be reviewed at your leisure. If you have time for only one comprehensive course, choose either the ACCP or AASM board review course. ACCP Board Review. The previous ACCP courses are available on DVD; see the ACCP catalogue. AASM Board Review Course. There are several courses offered each fall. If you register for the exam you will be receiving brochures. School of Clinical Polysomnography in Medford, Oregon offers a 3 day review of polysomnography, given by Nic Butkov. I took the course and found it very helpful, mainly because Mr. Butkov is a real expert on the subject and also a very good teacher. School of Sleep Medicine, Stanford University. This is probably the oldest of the comprehensive review courses. People who have attended state it is very good. The course is also available on DVD.
Atlanta School of Sleep Medicine.
Offers multiple courses, some specifically designed for sleep board review.
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5. Books and Non-books to consider if you wish to leave no stone unturned.
In particular, the three Atlases are well worth perusing if you have time left over after catergories 1 & 2. The first entry under Non-books is also worth a look; though pricey it comes with an unusual guarantee. Books are listed in reverse order of publication; links are to amazon.com. Titles noted as Expert Consult series are also available on-line in a completely searchable format.
Berry's Fundamentals of Sleep Medicine, Richard Berry, Elsevier Saunders, 2011. Expert Consult series. Dr. Berry is also author of the popular Sleep Medicine Pearls, listed in Category 2.
The Concise Sleep Medicine Handbook: Essential Knowledge for the Boards & Beyond, David E. Westerman, GSSD Publishers, Atlanta, 2011. This self-published book is by a faculty member of the Atlanta School of Sleep Medicine, which offers board review courses (see Category 4). It is aptly named ("Concise") and includes detailed outlines of just about all sleep medicine topics. It is what physicians would probably compile as a study aid for themselves if they had the time.
Atlas of Clinical Sleep Medicine, Meir Kryger, editor, Elsevier Saunders, 2010. Expert Consult series, This Atlas is chock full of images from sleep medicine, including patient photos, PSG epochs and colored graphs. Dr. Kryger is also the senior editor of Principles and Practice of Sleep Medicine, 5th ed.. As with that book, Atlas is also available as a searchable text on-line, via Expert Consult.
Atlas of Sleep Medicine, by Lois Krahn, Michael Silber and Timothy Morgenthaler. Informa Health Care, 2010.
Atlas of Clinical Polysomnography, Nic Butkov, RPSGT, 2nd Edition. Synapse Media, 2010.
Sleep Medicine in Clinical Practice, 2nd Edition, by Michael Silber, Lois E. Krahn and Timothy Morgenthaler. Informa Health Care, 2010.
Somnology: Learn SLEEP MEDICINE in One Weekend, by Teofilo Lee-Chiong. CreateSpace, 2009.
Sleep Disorders Medicine, by Sudhansu Chokroverty. Saunders, 2009. Expert Consult series,
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6. Journals
Chest (ACCP), Sleep (ASSM) and AJRCCM (ATS) are all leading medical journals with emphasis on original research. They also publish reviews of sleep topics that can be useful for board review (including the AASM Practice Parameters mentioned in Category 3). However, journals per se are a low-order priority for studying for the sleep boards. Most journal articles relevant for board review (such as the AASM Practice Parameters) are available on line. If you do want to peruse current or back issues of journals, the two I recommend are Journal of Clinical Sleep Medicine and Sleep Medicine Clinics. Journal of Clinical Sleep Medicine is included with membership in AASM. One article in JCSM you should find especially interesting is Development and Results of the First ABMS Subspecialty Certification Examination in Sleep Medicine (J Clin Sleep Med 2008;4(5):505-508). It explains how the exam was created, how it's scored, and gives the pass rates per type of examinee, (fellowship trained vs. practice experience vs. previous ABMS certification). |
Introduction to this web site
Lawrence Martin, MD
I took the ABIM sleep board certification exam November 2007, the first time it was given. I am a practicing pulmonologist and, like most candidates that year (1034 out of 1882), entered via the practice pathway (ie, no sleep medicine fellowship). ABIM allowed the first 3 exams (2007, 09 and 11) to be taken without a year of fellowship training. Now, after the 2011 exam, you must have a one year subspecialty sleep fellowship training in an accredited program to take any future exam. The only exception is if you took the ABIM exam once and did not pass; then you can sit for it again.
I did not underestimate the test, nor should you. The pass rate of that first exam was 73%. For the 2011 exam, pass rate was just 62%. It is a one day computer-based exam; details are provided at the ABIM Sleep Exam web site. The exam is comprehensive and covers clinical decision making and basic science (and a lot more pediatrics than was advertised). It is the SAME TEST for all, given under the auspices of several cooperating boards: internal medicine, family practice, pediatrics, neurology and otolaryngology.
In preparation I took several out-of-town courses, including both the AASM and ACCP board review courses. Board review courses are worthwhile, mainly to get you out of the office, focus your attention and highlight what's important. But the most bang for your buck will be studying on your own, from materials that closely reflect what you need to know. I reviewed and studied numerous texts, CDs, DVDs and web site offerings, and found they ranged from very helpful (see HIGHLY RECOMMENDED) to a waste of time.
For the 2011 exam, organizations and publishers produced new books and new editions at a fast clip. The same process should continue for the 2013 exam. As new information becomes available I'll try to keep this web site current.
In this web site are my recommendations of what to study (and what you can pass up) in preparation for 2013 sleep exam. Please email me with any comments or other recommendations to larry.martin@roadrunner.com.
The 2 links below are to web sites that help explain CPAP vs. BiPAP vs. ASV. The 1st
site compares the 3 modes of postive pressure for sleep patients; the 2nd site compares the two brands
currently available for ASV (ResMed and Respironics). While they are not designed
as board review web sites, you may find them helpful nonetheless.
Non-invasive positive pressure therapy: CPAP, BiPAP, ASV |
Adaptive Servo Ventilation: ResMed vs. Respironics
Finally, the 4 links below are to web sites I have authored for a general audience on sleep topics. They include patient-centered stories, plus detailed information about specific conditions such as sleep apnea, narcolepsy and insomnia. You may find the sites interesting and perhaps even informative, but they are not intended for sleep board review.
Sleep Home Page | Internet Sleep Links | Books about sleep disorders (with links to Amazon.com) | Drugs for Sleep & Awake - The Good and the Bad
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Copyright � Lawrence Martin, MD
First posted November 10, 2008, with continuous updates. Last
updated: February 4, 2012.
Today is
Nex ABIM Sleep Board Exam is November 2013
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