What are the requirements to become board certified in sleep medicine?

Board Certification in Sleep Medicine

To become board certified in sleep medicine, you must complete an ACGME-accredited sleep medicine fellowship (typically 12 months) after finishing residency training in a primary specialty, then pass the sleep medicine certification examination administered by your primary board (such as the American Board of Internal Medicine). 1, 2

Primary Training Requirements

Prerequisite Residency Training

• Complete an ACGME-accredited residency in one of the primary specialties that offer sleep medicine board certification pathways, including internal medicine, family medicine, pediatrics, neurology, psychiatry, otolaryngology, or anesthesiology 2, 3
• Obtain board certification (or board eligibility) in your primary specialty before or concurrent with sleep medicine certification 2

ACGME-Accredited Sleep Medicine Fellowship

• Complete a minimum of 12 months of training in an ACGME-accredited sleep medicine fellowship program 1, 2, 3
• The fellowship must provide comprehensive, multidisciplinary training covering all aspects of sleep disorders, including obstructive sleep apnea, central sleep apnea, insomnia, narcolepsy, restless legs syndrome, parasomnias, and circadian rhythm disorders 1, 2
• Training includes supervised interpretation of polysomnography, home sleep apnea testing, multiple sleep latency tests, and maintenance of wakefulness tests 2
• Fellows must gain experience in both diagnostic and therapeutic aspects of sleep medicine, including positive airway pressure therapy management and behavioral sleep medicine 1, 2

Board Certification Examination

Eligibility Requirements

• Successfully complete an ACGME-accredited sleep medicine fellowship 2, 3
• Hold current board certification in your primary specialty from an ABMS member board 2
• The examination is administered by the American Board of Internal Medicine (for most specialties) or the respective primary board for your specialty 2

Examination Content

• The board examination tests comprehensive knowledge across all sleep disorders, sleep physiology, diagnostic testing interpretation, and treatment modalities 2
• Both written and practical components assess competency in clinical sleep medicine 2

Maintaining Certification

Continuing Medical Education

• Board-certified sleep specialists must participate in ongoing continuing medical education specific to sleep medicine 4
• Maintenance of certification requirements include periodic recertification examinations and demonstration of continued competence 2

Alternative Pathways (Historical Context)

Grandfathering Period (Now Closed)

• Prior to the ACGME fellowship requirement, physicians could become board certified through a practice pathway that required documentation of clinical experience and passing the examination 2, 3
• This pathway is no longer available; fellowship training is now mandatory for all new candidates 3

Clinical Practice Standards

Supervision and Practice Requirements

• Board-certified sleep medicine physicians (or those who have completed fellowship training and are awaiting the next examination opportunity) are qualified to independently interpret sleep studies and manage sleep disorders 4
• Sleep medicine practice should occur under the auspices of an AASM-accredited sleep center to ensure quality standards 4
• Physicians supervising portable monitoring, home sleep apnea testing, or telemedicine services must be board certified in sleep medicine or fulfill eligibility criteria for the certification examination 4

Common Pitfalls to Avoid

• Do not assume that general medical training or self-study alone qualifies you to practice sleep medicine—formal fellowship training is mandatory for board certification 3
• Do not confuse the old practice pathway with current requirements—the grandfathering period has ended and fellowship training is now the only route 3
• Be aware that the fellowship requirement has created workforce challenges, but alternative training models (such as competency-based programs) are being explored to maintain training rigor while improving flexibility 1, 3
• Recognize that sleep medicine requires multidisciplinary knowledge spanning pulmonology, neurology, psychiatry, and otolaryngology—comprehensive fellowship training is essential 2, 5