1. A. A licensed polysomnographic technologist may practice only under the supervision of a licensed physician.
2. B. A licensed polysomnographic technologist may practice only in a hospital sleep laboratory or a stand-alone sleep center.

3. C. The scope of practice of a licensed polysomnographic technologist includes and is limited to the following:

   1. (1) Monitoring and recording physiologic data during sleep, including sleep-related respiratory disturbances;
   2. (2) Using data collected under §C(1) of this regulation to assist a licensed physician in the diagnosis and treatment of sleep and wake disorders;
   3. (3) Assisting with the diagnosis and treatment of individuals who suffer from sleep disorders as a result of developmental defects, the aging process, physical injury, disease, or actual or anticipated somatic dysfunction;
   4. (4) Observing and monitoring physical signs and symptoms, general behavior, and general physical responses to polysomnographic evaluation, and determining whether initiation, modification, or discontinuation of a treatment regimen is warranted;
   5. (5) Using evaluation techniques that include limited cardiopulmonary function assessments, the need and effectiveness of therapeutic modalities and procedures, and the assessment and evaluation of the need for extended care; and

   6. (6) Using the following techniques, equipment, and procedures:

      1. (a) Continuous positive airway pressure, bi-level positive airway pressure titration, or adaptive servo-ventilation on spontaneously breathing patients;
      2. (b) Supplemental low flow oxygen therapy during polysomnogram;
      3. (c) Capnography during polysomnogram;
      4. (d) Cardiopulmonary resuscitation;
      5. (e) Pulse oximetry;
      6. (f) PH probe placement and monitoring;
      7. (g) Esophageal pressure;
      8. (h) Sleep staging, including surface electroencephalography, surface electrooculography, and surface submental electromyography;
      9. (i) Surface electromyography of arms and legs;
      10. (j) Electrocardiography;
      11. (k) Respiratory effort, including thoracic and abdominal;
      12. (l) Plethysmography blood flow;
      13. (m) Snore monitoring;
      14. (n) Audio or video monitoring;
      15. (o) Implementation of a written or verbal order from a licensed physician that requires the practice of polysomnography;
      16. (p) Monitoring the effects a nasal device used to treat sleep apnea has on sleep patterns provided that the device does not extend into the trachea; and

      17. (q) Monitoring the effects an oral device used to treat sleep apnea has on sleep patterns provided that:

          1. (i) The oral device does not extend into the trachea;
          2. (ii) A dentist has evaluated the structures of the patient's oral and maxillofacial region for purposes of fitting the oral device;
          3. (iii) A dentist made or directed the making of the oral device; and
          4. (iv) A dentist directs the use of the oral device.
4. D. The scope of practice of a polysomnographic technologist does not include administering medications.

Authority: Health Occupations Article, §§1-213, 1-221, 1-606, 14-205, and 14-5C-01—14-5C-23, Annotated Code of Maryland

Effective date: December 1, 2008 (35:24 Md. R. 2078)

Regulation .01B amended as an emergency provision effective October 1, 2009 (36:17 Md. R. 1311); amended permanently effective October 5, 2009 (36:20 Md. R. 1528)

Regulation .01B amended effective March 5, 2012 (39:4 Md. R. 337)

Regulation .01E, F adopted effective May 11, 2015 (42:9 Md. R. 647)

Regulation .02B amended effective August 15, 2016 (43:16 Md. R. 900); September 29, 2025 (52:19 Md. R. 956)

Regulation .04 amended effective December 22, 2014 (41:25 Md. R. 1485); September 29, 2025 (52:19 Md. R. 956)

Regulation .04A amended effective June 20, 2016 (43:12 Md. R. 667)

Regulation .04C repealed effective August 15, 2016 (43:16 Md. R. 900)

Regulation .04G amended as an emergency provision effective October 1, 2009 (36:17 Md. R. 1311); amended permanently effective October 5, 2009 (36:20 Md. R. 1528)

Regulation .04G amended effective March 5, 2012 (39:4 Md. R. 337)

Regulation .06 amended effective September 29, 2025 (52:19 Md. R. 956)

Regulation .07 amended effective January 2, 2017 (43:26 Md. R. 1446)

Regulation .07A amended effective September 29, 2025 (52:19 Md. R. 956)

Regulation .07B, C amended effective December 22, 2014 (41:25 Md. R. 1485)

Regulation .08B amended effective August 15, 2016 (43:16 Md. R. 900); January 2, 2017 (43:26 Md. R. 1446)

Regulation .09 amended effective May 11, 2015 (42:9 Md. R. 647); September 29, 2025 (52:19 Md. R. 956)

Regulation .10 amended effective September 29, 2025 (52:19 Md. R. 956)

Regulation .10A amended effective May 11, 2015 (42:9 Md. R. 647)

Regulation .11 amended effective September 29, 2025 (52:19 Md. R. 956)

Regulation .12 amended effective May 11, 2015 (42:9 Md. R. 647); September 29, 2025 (52:19 Md. R. 956)

Regulation .12D—H adopted effective July 22, 2013 (40:14 Md. R. 1175)

Regulation .13 adopted effective July 22, 2013 (40:14 Md. R. 1175)

Regulation .13 amended effective May 11, 2015 (42:9 Md. R. 647)

Regulation .13A amended effective September 29, 2025 (52:19 Md. R. 956)