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Polysomnographer
Polysomnographer
Name
First
Last
Date
MM slash DD slash YYYY
Self-Assessment Rating Scale
No Experience
Theory or observation only during the past 12 months
Limited Experience
Performed less than 12 times within the past 12 months and may need a review
Experienced
Performed at least once per month within the past 12 months and may need minimal assistance
Highly Skilled
Performed on at least a weekly basis over the past 12 months; proficient
Work Settings
No Experience
Limited Experience
Experienced
Highly Skilled
Hospital
Independent Lab
Study Types
No Experience
Limited Experience
Experienced
Highly Skilled
Adult MSLT/MWT
Pediatric MSLT/MWT
Seizure study
Research study
Portable sleep study
Electrode Placement - EEG
No Experience
Limited Experience
Experienced
Highly Skilled
Standard 10-20 hookup
Seizure hookup
Full head hookup
Electrode Placement - Body
No Experience
Limited Experience
Experienced
Highly Skilled
ECG
Limb leads
Intercostal leads
Face
Monitoring
No Experience
Limited Experience
Experienced
Highly Skilled
EEG
ECG
PLM
O2 saturation
End-tidal CO2
Staging and Scoring
No Experience
Limited Experience
Experienced
Highly Skilled
Sleep stages
Arousal
Respiratory events
Periodic breathing
Complex sleep apnea
Cheyne-Stokes
Obstructive sleep apnea
Hypopnea
Mask Fitting
No Experience
Limited Experience
Experienced
Highly Skilled
Full face
Nasal mask
Nasal pillow
Titration
No Experience
Limited Experience
Experienced
Highly Skilled
CPAP
BiPAP
ASV
VPAP
Medication Effect on Sleep Study
No Experience
Limited Experience
Experienced
Highly Skilled
SSRI
Tricyclic antidepressants
Benzodiazepines
Alcohol
Opioids
Caffeine/Stimulants
Equipment
No Experience
Limited Experience
Experienced
Highly Skilled
Nihon Kohden
Respironics
ResMed
Signature
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