American Board of Internal Medicine (ABIM) Certification Practice Exam

For the general population, out-of-center sleep testing is indicated for which of the following conditions?

1. Severe COVID-19

2. Uncomplicated moderate to severe obstructive sleep apnea

3. Chronic lung disease requiring hospitalization

4. Pneumothorax

The correct answer is: Uncomplicated moderate to severe obstructive sleep apnea

Out-of-center sleep testing is a practical and effective means of diagnosing obstructive sleep apnea (OSA) in the general population, particularly for individuals who present with uncomplicated moderate to severe forms of this condition. This type of testing usually occurs in the patient's home rather than in a sleep lab and involves the use of portable monitoring devices. It is appropriate for people who show signs and symptoms typical of OSA, such as loud snoring, excessive daytime sleepiness, and witnessed apneas, especially when these symptoms align with clinical criteria indicating the possibility of moderate to severe sleep apnea. In the context of the other conditions listed, out-of-center sleep testing is not as suitable. Severe COVID-19 typically requires hospital care and monitoring that cannot be adequately fulfilled through out-of-center methods. Likewise, chronic lung diseases necessitating hospitalization would require more intensive evaluation and possibly concurrent treatment that out-of-center testing cannot provide. Lastly, a pneumothorax, being an acute medical condition, demands immediate medical assessment and intervention that is far more complex than what an out-of-center sleep test can handle. Thus, uncomplicated moderate to severe obstructive sleep apnea stands out as the appropriate condition for out-of-center sleep testing, as it aligns with the guidelines that support home-based assessment for