Setting a New Standard in Titration

As patient complexity in sleep labs increases, so does the need for precise titrations and a deeper understanding of pathophysiology and clinical presentations.

Developed in response to valuable feedback from BRPT credential holders, the new Advanced Titration Certificate (ATC) will enable technologists to demonstrate proficiency in advanced titration techniques, recognizing their expertise and reinforcing their commitment to excellence in patient care.

The new ATC exam will be available this summer. Similar to the BRPT’s Pediatric Sleep Certificate, the ATC, is a specialized certification for RPSGT credential holders proficient in complex titration procedures, such as volume-targeted ventilation, neurostimulator therapies, and oxygen therapy.

“The ATC advances sleep medicine’s evolution toward precision care,” says Khemar Ballaho, MBA, RPSGT, a member of BRPT’s ATC Task Force. “As the field has grown, technological advancements, research, and standardized competencies have refined our understanding of sleep disorders, segmenting patients into distinct phenotypes and endotypes. This shift has driven more targeted treatments across specialties like pulmonology, neurology, and psychiatry.”

Earning the ATC not only positions technologists as leaders in the field but may also elevate standards across sleep medicine. “By identifying highly skilled practitioners, the ATC ensures patients receive the right diagnosis, treatment, and management, further elevating the standard of care,” Ballaho says.

 Exam Development

The Advanced Titration Task Force, composed of experienced subject matter experts, developed the ATC exam following the BRPT’s established test development processes. A key first step was conducting a job task analysis to define the exam’s content blueprint. This involved gathering industry insights to assess the relevance and importance of advanced titration knowledge and skills.

The ATC Task Force then meticulously reviewed references, structured the exam blueprint, and dedicated countless hours to crafting a rigorous catalog of exam items. Each item underwent peer review, committee approval, and multiple validation steps to ensure accuracy and relevance. The result is a comprehensive exam that sets a new BRPT standard for recognizing advanced titration expertise.

Enhancing Patient Outcomes

The ATC keeps practitioners current with industry standards and best practices and directly supports improved patient care. Rather than relying on flowchart scenarios, the exam emphasizes indications, contraindications, and the underlying pathophysiology of respiration and ventilation. This deeper understanding leads to more precise titration, ultimately enhancing patient outcomes.

An advanced skillset also fosters a positive and reassuring environment for patients. When technologists are confident in their skills, patients are more likely to trust their care plan and feel at ease during testing and treatment. This trust contributes to better patient cooperation and adherence to treatment plans, which can further improve clinical outcomes.

“The ATC will directly impact patient care and clinical outcomes through establishing a new standard,” says Jack Woolcomb, RPSGT, CCSH, ESRS-EST, a member of the BRPT’s ATC Task Force. “ATC holders demonstrate advanced expertise in titrations through rigorous training, education, and experience. This certificate elevates global titration standards, enhancing patient care and outcomes through the standardization of this critical skill.”

Expanding Career Opportunities

Earning the ATC can be a powerful career move for sleep health practitioners, validating their expertise in complex titration procedures and demonstrating a commitment to professional growth. Beyond enhancing clinical skills, the ATC deepens knowledge in managing complex patient scenarios, distinguishing practitioners in the field.

“As AI and home sleep testing become standard, sleep labs will see the most complex cases,” says Linda Lebrun, BSc, RPSGT, CCHS, a member of the BRPT’s ATC Task Force. “Sleep technologists will need advanced skills to support diagnosis and treatment effectively. Mastery of co-morbid conditions and their impact on the cardiovascular, respiratory and nervous systems will set ATC-certified technologists apart. This certificate isn’t for the faint-hearted—it proves a deep, advanced expertise in sleep medicine.”

The ATC also opens doors to advanced career opportunities, such as senior or lead technologist roles. Certified professionals are well-positioned to take on greater responsibilities, mentor staff, and drive best practices within their organizations.

“Given CMS reimbursement cuts, sleep labs that employ technologists skilled in advanced modalities and complex patient care will be best positioned to stay competitive,” Ballaho says. “ATC-certified technologists will play a crucial role in helping sleep labs and DMEs manage complex titrations and patient needs effectively. Beyond that, they have the potential to become future patient navigators, educators and trainers, shaping the next generation of sleep medicine professionals.”

In addition to senior and mentorship roles, ATC-certified sleep technologists may pursue opportunities in research, education, product development, and consulting. They can help train future technologists, support manufacturers in product development and sales training, or advise sleep labs and health care organizations. The ATC not only strengthens qualifications but also expands career paths that build on advanced expertise.

Shaping the Future of Sleep Technology

The ATC has the potential to significantly shape the future of sleep technology by promoting a higher level of clinical understanding and consistency in patient care. Technologists well-versed in the latest advances not only enhance patient care, they help drive innovation in the field.

The ATC also fills key gaps in sleep medicine by formally recognizing advanced skills, enhancing professional credibility, and encouraging ongoing professional development. In doing so, this new certificate supports the continued evolution of sleep medicine.

The BRPT remains committed to listening and responding to changes in the field. Our goal is to ensure the ATC remains aligned with current best practices and continues to meet the evolving needs of sleep health practitioners.

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About the Advanced Titration Certificate Exam

RPSGT and CCSH credential holders are eligible to sit for the BRPT’s Advanced Titration Certificate Exam. Upon receiving a passing score of 70 percent or higher, candidates will be awarded an assessment-based certificate in Advanced Titrations in the form of a digital badge. The online exam cost is $200.

The exam consists of 75 multiple-choice questions covering three domain areas:

• Domain 1: Advanced Knowledge
• Domain 2: Physiology and Clinical Presentation
• Domain 3: Evaluation and Treatment

Study materials will include a list of approved references that were used to validate the exam items. These references are widely recognized and accessible to an international audience. Additionally, the ATC Task Force prioritized sources that are available online at low or no cost, promoting equitable access to the study materials for all candidates.

The ATC exam blueprint served as the framework to verify that the exam content is aligned with the weight (importance) of each topic and also served as a checkpoint to validate that the exam supports the intended learning outcomes.

By Jill West, BA, RPSGT, CCSH

Source: SleepWorld Magazine May/June 2025

Jill is a member of the BRPT Board of Directors and Chair of the Advanced Sleep Titration Task Force.