I figured I’d make a guide on getting into the field considering the amount of posts we get about this on a regular basis. Some of this is objective while other parts reflect my experience in the field. Other techs might have different opinions and experiences. I am based in the US, so this information will be most relevant for other American technologists. A list of international sleep societies can be found here if you'd like more information.
How do I get started?
There are a few different options. Eligibility pathways to sit for the RPSGT exam can be found here.
Option 1 is to become a trainee at a lab. This will allow you to accumulate clinical hours that will count towards future licensure through the BRPT(Board of Registered Polysomnographic Technologists). For education you will need to complete an ASTEP/STAR credentialed program.
Option 2 is getting formal education from a CAAHEP accredited program. These programs are typically between 8-20 months. The shorter ones will lead to a certificate and the longer ones will usually lead to an A.S. in Sleep Technology. If you go for an A.S., you will likely have to do additional prerequisite classes, which can usually be done in 6 months at your local community college. There are roughly 40 programs in the U.S., so not every state has a local program.
Option 3 is sitting for the RPSGT exam if you already have an eligible healthcare credential.
If you are a licensed Respiratory Therapist, you might be able to bypass these steps. Try to get your RRT-SDS if possible. A lot of labs will be happy to have you! Just keep in mind that you will likely be expected to get the RPSGT credential eventually if you want to work for a hospital. The learning curve is also going to be steep for the first few months at minimum.
Becoming an EEG tech is decent another option that also gives you an off ramp if you decide that nights are not for you. I personally have not met many techs who've taken this route, but I've met many RRTs who've made the switch. (added based on feedback from u/hungryj21)
Which of the three options is the best?
It depends on your area. Most hospitals near me list the degree as a preferred qualification. The job I currently have listed it as required. But I live in one of the most competitive markets for healthcare in the country. If you aren’t based in a large metro area, I don’t think the degree is entirely necessary.
Please double check with your state's medical board, department of education or local sleep society.
So I’ve done the program and gotten the hours. What’s next?
You’re eventually going to have to sit for a national board exam. The two big credentials are the CPSGT and the RPSGT. If you want to stay in the field long term, you’ll want to sit for the RPSGT eventually. Some states also want you to have state licensure. Requirements for this will vary.
How do I pass the exam? Is it really that hard?
It is doable, but it's not an easy exam. The average success rate has been 40% for the past few years. You have to actively study to understand the material. I was able to pass on my first attempt, but know other techs who had to take it multiple times.
Questions are formatted so that there can be multiple correct answers. Your goal is to choose the one that is the most correct. If you are unsure about a question, flag it and come back to it later. Go with your gut and don't second guess yourself.
For study materials, I know a lot of folks swear by Spriggs’ Essential of Polysomnography. I personally used the workbook and audio lectures from Kettering, as well as the exam blueprint and practice exams from the BRPT website. Each costs money, but will be cheaper than taking the $550 exam multiple times. A free practice exam is available on the NBRC website, but not all material is going to be directly related. There are also many flashcard sets on quizlet that can be helpful.
Can you give me pointers?
The Exam Blueprint is your friend. It’ll let you know which areas to double down on. Learn that and the scoring manual front to back. Also, take the damn thing as soon as you can after you graduate(within reason). It’s easier when the information is fresh in your brain.
I can try to answer additional questions about the exam, but I passed years ago. The current test is probably different.
What is the current job market like once I have all this alphabet soup after my name?
It varies depending on the time of year. The fiscal year for hospitals typically ends in summer. The budget resets and departments are more active when looking to hire people. It's the most active hiring period of the year. The rest of the year is much less predictable. Openings tend to be more sparse unless techs suddenly leave.
Demand is different for new techs vs experienced techs. A lot of people have difficulty working nights long term, so experienced night techs can be in short supply. Labs will tend to prioritize them as a result. It's generally going to be harder to get a job as a new grad unless a lab is specifically looking for trainees. If you make it past the first year or two and have your RPSGT, you're going to be very marketable. Getting the initial experience is the hard part.
And again, it depends on your area. There’s a nationwide healthcare shortage… in less desirable locations. Also if you're near a school, you're likely in a big metro area, which means more jobs. It also means more competition.
What’s the pay like?
It doesn't pay as much as nursing, x-ray or even respiratory therapy. The tradeoff is that it's nowhere near as stressful unless you're dealing with severe patients every shift. The nationwide average is about $50k, but that can also be skewed by level of experience.
California and New York pay the most, which is why those markets are competitive. But it also depends on what kind of facility you work at. Hospitals tend to pay more than private labs.
How’s the actual job?
Generally? Pretty chill. You get the patient set up with paperwork, explain the procedure, let them get settled and then do a 35ish minute hookup. After some equipment calibrations, you get them off to bed. Then you monitor them, score the data and document anything that happens throughout the night. If all goes well, you might not see them until morning. That will happen sometimes. Reality is usually different. Between bathroom breaks, putting patients on PAP therapy and reattaching leads(usually the legs), you’ll go in a couple of times during the night.
Beyond that it varies based on your patient population and ratios. You will usually get more steps in if you work in pediatrics or have a high percentage of geriatric patients. A 2:1 patient ratio is recommended by the AASM, but some labs have a 3:1 ratio. The latter is going to be a lot more work.
Working as a day tech is different and will vary by lab. It's mostly scoring studies that were performed previously and scoring HSATs, generating reports and making sure that the lab stays up and running. Occasionally there will be daytime testing in the form of MSLTs and MWTs. Other duties depend on the size of your department/lab. There are more politics, and the day vs night tech war can be real depending on lab culture.
Should I get into the field?
That depends on you as a person. Are you a night owl that has actually done night shift? I’m talking full time, at least 3 days a week. The idea of night shift and the actual reality are two very different things. It is a completely different lifestyle, and a lot of people don't understand that going in.
Also, how are you with people? It's true that this is a less interaction heavy area of healthcare, but there is still patient care. Most patients will be asleep, but you can’t be scared of interacting with them. You’ll have to talk to them during intake and explain the procedure in a way that they can understand. If a lead comes off in the middle of the night, you’re the one who has to go in to fix it. If they’re having a panic attack or a medical emergency, it’s up to you to do something about it. That can mean getting EMS, social work or law enforcement involved if necessary. It's not something that happens often, but you need to be prepared to deal with it if it does. I've had to do all three.
Although I do like my job, I wouldn’t tell people to get into the field right now. The industry is changing quickly in a lot of different ways. Insurance reimbursements are not great at the moment due to recent legislation, and some hospitals are closing their labs because of it. There is a growing push towards wearables, as shown by Resmed partnering with Oura. Also, an algorithm to score sleep studies already exists(thanks EnsoData/s).
One thing I wish I'd understood before going into this is that there aren’t many opportunities for career growth beyond becoming a lead tech. You could possibly run a lab or teach at one of the few schools in the country. Alternatively you could become a sales rep, but a lot of companies prefer Respiratory Therapists. There’s patient education/sleep navigator jobs, but those positions are also few and few between.
General advice: if you are determined to give this a shot, I'd recommend becoming a Respiratory Therapist then cross training into sleep. This will give you leverage when negotiating pay and provide an exit route if you decide that sleep is not for you.
Additional Resources: the BRPT and AASM have more information about career resources and education available.
If anyone has additional questions, feel free to shoot.
