Oregon Bulletin

January 1, 2012


Oregon Health Licensing Agency
Chapter 331

Rule Caption: Exempt sleep labs from the definition of respiratory care if certain standards and guidelines are met.

Adm. Order No.: HLA 13-2011(Temp)

Filed with Sec. of State: 11-22-2011

Certified to be Effective: 11-22-11 thru 5-10-12

Notice Publication Date:

Rules Adopted: 331-705-0072

Subject: in November 2010, the Respiratory Therapist Licensing Board adopted temporary administrative rules regarding Sleep Lab Exemption, to allow for certain respiratory care services (e.g. positive airway pressure) to be performed by unlicensed individuals in sleep labs under a medical doctor. The primary purpose for the temporary rule was to allow the 2011 Legislative Assembly time to consider licensing polysomnographers or sleep technicians within the Respiratory Therapist Licensing Board. The 2011 Legislative Assembly passed SB 723 which created the Respiratory Therapist and Polysomnographic Technologist Licensing Board. According to the bill, the Oregon Health Licensing Agency can start licensing polysomnographic technicians as of January 1, 2012. The bill also requires that all individuals practicing polysomnography must be licenses by January 1, 2013. This temporary rule continues to allow certain respiratory care services (e.g. positive airway pressure) be performed by unlicensed individuals in sleep labs under a medical doctor.

Rules Coordinator: Samantha Patnode—(503) 373-1917


Sleep Lab Exemption

This rule is in effect through January 1, 2013, upon requirement for licensure for polysomnographic technologists.

(1) The following are exempt from the definition of Respiratory Care Services under ORS 688.800(7) when performed in a sleep lab environment:

(a) Positive airway pressure titration on spontaneously breathing patients;

(b) Supplemental low-flow oxygen therapy during polysomnogram (up to 6 liters per minute);

(c) Capnography during polysomnogram;

(d) Cardiopulmonary resuscitation;

(e) Pulse oximetry;

(f) Electrocardiography;

(g) Respiratory effort including thoriac and abdominal;

(h) Plethysmography blood flow;

(i) Nasal and oral airflow monitoring;

(j) Monitoring the effects positive airway pressure, used to treat sleep-related breathing disorders, has on sleep patterns, provided that the device does not extend into the trachea;

(k) Monitoring the effect on sleep patterns of an oral device that does not extend into the trachea and that is used to treat sleep apnea;

(l) Maintenance of nasal and oral airways that do not extend into the trachea;

(m) The use of continuous positive airway pressure and bi-level modalities;

(n) Set-up for use of durable medical equipment; and

(o) Long term follow-up care.

(2) For the purpose of this rule, “sleep lab” is:

(a) A physical space, including any commercial space, used by a hospital for conducting sleep testing and under the supervision of a medical director; or

(b) A facility accredited by the American Academy of Sleep Medicine or the Joint Commission for conducting sleep testing under the supervision of a medical director.

(c) A facility provisionally accredited by the AASM for conducting sleep testing under the supervision of a medical director.

 (3) For purpose of this rule, “medical director” means the medical director of any inpatient or outpatient facility or department who is a physician licensed by the State of Oregon and who has special interest and knowledge in the diagnosis and treatment of sleep disorders.

(4) For the purpose of this rule, “sleep lab” does not include the home environment.

(5) The exemption under this rule does not include partial or full ventilatory support services involving tidal volume regulation or which require the setting of respiratory back-up rates unless these services are for the treatment of central and mixed sleep apnea.

(6) All documentation and information regarding the provisional accreditation or accreditation through the AASM must be made available to the agency if requested.

(7) All policies, procedures and protocols for unlicensed individuals related to positive airway pressure treatment and titration including but not limited to central and mixed sleep apnea must be made available to the agency if requested.

Stat. Auth.: ORS 676.606, 676.607, 676.611, 676.615, 688.830

Stats. Implemented: ORS 688.800, 688.805

Hist.: HLA 13-2011(Temp), f. & cert. ef. 11-22-11 thru 5-10-12

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