Frequently Asked Questions

General Questions
How-To Videos
Administrator Account Registration
Individual User Account Registration
Staff Management
Exam Reports
Exam Credits, Pricing and Payment
Individuals Working at Multiple Centers
Technical Problems

General Questions

Q: Do I have to use the AASM Inter-scorer Reliability Testing system to be in compliance with the Standards for Accreditation?
A: No. The program is optional. The AASM Inter-scorer Reliability Testing system is intended to provide a convenient, easy-to-use alternative for a facility-specific program to meet the requirements for inter-scorer reliability in the Standards for Accreditation.
Q: How are scoring records chosen for this program?
A: The system uses patient records submitted by several accredited sleep facilities and selected by AASM educators. Each exam features a full 200-epoch recording from actual research subjects, pediatric patients and adult patients with and without CPAP. The AASM removes the patient identification and screens the records for artifacts. No other modifications are made to the records.
Q: How is the AASM Gold Standard score determined for each record?
A: The AASM Gold Standard score for each record is based on a consensus by the AASM Panel of AASM Gold Standard Scorers, which consists of a technologist, an educator and a physician. All records that do not have an initial consensus are carefully reviewed and discussed by members of the panel.
Q: What are the AASM Standards for Accreditation regarding inter-scorer reliability?
A: Section F of the AASM Standards for Accreditation states that a sleep facility must demonstrate inter-scorer reliability as part of the facility's quality assurance program. All technical staff members who score sleep studies for a facility must participate, and a designated board certified sleep specialist must serve as a facility's gold standard. For sleep facilities that use AASM Inter-scorer Reliability, the AASM's panel of Gold Standard scorers will serve as the gold standard. To review the AASM Standards, including those specific to inter-scorer reliability,  download the AASM Standards for Accreditation or the fact sheet on inter-scorer reliability requirements.
Q: Is there a penalty if my technologists don’t reach their set criterion for agreement with the gold standard scorer?
A: There is no penalty. Centers that incorporate the data into their quality assurance program should lead a review of the AASM Manual for the Scoring of Sleep and Associated Events, if there is consistent low agreement among technologists. Scorers may also reference record review videos and the scoring blog to refine their scoring skills. If additional training is required, you may direct your technologists to the AASM A-STEP Modules about scoring.
Q: Do I need to take the exam from start to finish, or can I leave and come back?
A: You are allowed to leave and come back to an exam. However, you must complete an exam before it expires or your results will be submitted based on the portion of the exam that you have completed. Exams will expire three months following their release. Exam cannot be “re-opened” once they have expired.
Q: I missed an exam and it is no longer displaying on my Dashboard. How do I access the missed exam?
A: All exams expire three months following their release. Any uncompleted exams are automatically deleted from the user Dashboard on the expiration date. Access cannot be re-given to any deleted exams. Please contact your facility administrator to view their policy for “making-up” a missed ISR exams in house.
Q: How long should it take to score each record exam?
A: The length of time it takes to score all 200 epochs included in the record exam will depend on the user. It should take no more than two hours; experienced scorers may be able to complete the test in less than half an hour.
Q: Can I take an exam over again if I did poorly or did not complete all questions?
A: No. For the purposes of maintaining compliance with Standards for Accreditation, the AASM Inter-scorer Reliability Testing Program allows individuals to take each month’s exam only once.
Q: I’m a physician, can I claim the Free CEC after completing the monthly assessment exam and record review quiz?
A: No, the CEC is a free Continuing Education Credit for RST's and RPSGT's only.
Q: My facility is currently participating in the 30-day Free Trial. Can I claim the free CEC during the trial?
A: No, during the 30-day free trial technologist aren’t able to claim any CEC's. However once the facility has purchased the system, technologists may go back and complete the available post-tests to claim CECs. Note technologists have access up to 6 months to complete the Record Review video and post-test to claim the free CECs.

Administrator Account Registration

Q: How do I get my facility started with using the AASM Inter-scorer Reliability system?
A: The first step in getting your facility set up is by beginning a 30-day free trial and setting up your administrator account. Please see the video for instructions on getting your administrator account set up
Q: What if I do not know my facility's accreditation number or primary email address?
A: You may obtain your facility’s accreditation number by contacting the AASM’s accreditation department by email at or by phone at (630) 737-9700.
Q: Does the contact person for this program (account administrator) need to be the same person as the primary contact for our facility’s accreditation?
A: No. You may designate any individual at your facility to serve as account administrator for your inter-scorer reliability testing program. This individual will receive an email confirmation every time a new scorer registers an account using your facility’s access code. The account administrator will also receive an alert by email and on their dashboard when the facililty's credit balance is low.
Q: How do we change the account administrator for our facility?
A: Log in to your facility’s account, click on My Account page and select the edit button under the Contact Information to update your facility’s information.
Q:  How do I take a record exam as an administrator? 
A:  You will have to register a separate user account to take record exams. You may register as a temporary user if you do not want your exam to count towards your facility's score. Note if you are logged into the Administrator account you must physically sign out and then sign in to your individual ISR account to complete the exams.
Q: I have a scorer who missed an exam and now has no access to complete. How can they make up the exam for that month?
A: All exams expire three months following their release. Any uncompleted exams are automatically deleted from the user's dashboard on the expiration date. Access cannot be re-given to any deleted exams. To stay compliant for accreditation the Medical Director or Sleep Physician must pull a blind study for the technologist to score in house to make-up the missed exam.

Individual User Account Registration

Q: My facility sent me an invitation to set up my account, what do I have to do to get started?
A: If you received an invitation email or access code, you can either set up a new scoring account or if you have an existing scoring account, you can link your existing account to your new facility. Please see the video for instructions on getting your scoring account set up
Q: My administrator has confirmed me, how do I access the exams?
A: Log in to your scoring account and from your dashboard the 3 available exams will be shown. Please see the following video for instructions on using your scoring account. This video discusses how to access the exams, the scoring instructions, navigating the record, and accessing the record review videos and post-test for CECs
Q: I forgot my username and password, how do I reset them?
A: There is no need to reset your username and password. All usernames and passwords are stored in the ISR database. Please contact the AASM at 630-737-9700 or email to obtain your username and password.
Q: I have locked myself out of the ISR system. How do reset my access?
A: There is no need to reset your access, they system automatically resets the counter at noon and midnight each day. 
Q: I need to make changes to my name, degree and contact information. How do I update my user account?
A: To make changes to your contact information click on the My Account page to update address, email and phone #. To make changes to your name and degree please contact the AASM at 630-737-9700 or email
Q: I have registered an account using the access code that was emailed to me, but I can’t take any record exams. Why?
A: It's possible that your administrator has not yet confirmed you as a user for their facility. Administrators must confirm scorers before they may begin taking record exams. If your facility is on a pay-per-credit plan, you will not be able to access record exams if there are no remaining credits for the facility account. Notify your administrator, who can purchase additional credits for your facility.
Q: I have changed facilities or work at more than one location that uses this program. Do I need to have a separate account for each facility?
A: No. See the FAQ section below regarding individuals that work at multiple facilities.

Staff Management

This short video will explain how to invite and deactivate staff members as needed
Q: How do I add scorers to my facility?
A: To add a scorer, go to the Manage Staff page and select the “Send Invite” link. You will be prompted to enter the scorer's email address. The scorer will receive an email with your facility's access code and directions to register. Once the user has registered an account, you will receive a confirmation email. An administrator must approve the scorer in the Manage Staff page before they can begin taking record review exams.
Q: A user has registered an account using my facility's access code and I don't know who they are. Will this person be able to use our purchased exam credits?
A: No. Until you approve the user, they will not have access to your facility's credits or be able to begin scoring record exams for your facility. If someone uses your facility’s access code to set up an account, go to the Manage Staff page, select Deny User and select Apply to delete this individual.
Q: One of our scorers has left our facility or is no longer scoring sleep studies. Should I delete them from our account?
A: There are two ways of removing a user's access to your center’s exam credits:
  1. By deactivating their account, the individual will no longer contribute results to your facility; however, if you wish to reactive them at some point in the future, you will be able to do so without the need to re-register with your facility.
  2. By deleting their account, the individual will no longer contribute results to your facility but their results from previously taken exams will not be lost. In the future if you wish to provide this individual with access to your center’s exam credits, they will need to add your center’s access code once again. You must first deactivate the user before you can delete their account.
Q: I sent our access code to our facility’s scorers and they have all set up individual accounts, but cannot take any exams. What’s wrong?
A: Either you have not confirmed these users on the Manage Staff page or your facility no longer has access to record exams because of the subscription has expired or it has no remaining credits. You can purchase additional credits or subscribe for unlimited access on the Purchase Payment Plan page. 
Q: What is the difference between a Regular and a Temporary user?
A: Regular users should be scorers whose results would be included with your facility's data for accreditation purposes. This includes all full and part-time staff. A temporary user is not included on your facility's reports. Staff who wish to use the program for training purposes or job candidates should register as a Temporary user.

Exam Reports

Q: How do I access different reports for my staff?
A: You can access 4 different reports through your administrator account: Quality Assurance, Compliance, Staff and Exam Reports. Please see the video for instructions on how to access these reports
Q: How do I change my facility's passing score?
A: On the My Account page, select the Edit link above your facility's passing score. A facility may set the passing score to any value. The default passing score is 85 percent. 
Q: I am trying to view one of my staff’s exam results, but all statistics are marked with “???”. Why is this?
A: At the time that this individual took the exam in question, they were either not an approved member of your staff, or your center did not have any available exam credits. To add these results to your center’s account, please contact the AASM at

Exam Pricing and Payment

Q: Can I pay by check?
A: Yes. To pay by check, submit this form with your payment to the AASM at: American Academy of Sleep Medicine, Attn: ISR Program, 2510 North Frontage Road, Darien, IL 60561.
Q: Does the AASM accept purchase orders as payment?
A: No. Purchase orders are not acceptable as payment for exam credits or subscriptions. Payments can be made online, by fax or by mail, with a check or credit card.

Individuals Working at Multiple Facilities

Q: I work at more than one facility that uses this program. Do I need to have a separate account for each facility?
A: No. Through the AASM’s Inter-scorer Reliability assessment system, you score for multiple facilities with only one user account. You will only need to take each exam once and the results will be added to all of your facilities' accounts.
Q: How do I add another facility to my account?
A: Log in to your account and go to the My Account page. On the right side of the page, you will be given the option to add another facility by entering its access code.
Q: What happens if one of my facilities does not have an active subscription plan when I’m ready to take the next exam?
A: Please notify your administrator that your facility does not have an active subscription. The facility will need to contact the AASM to renew the facility's account. If you take the exam when a facility does not have an active subscription or credits, your results will not be added to that facility's account. The facility's administrator will have the ability to add your results to their account by contacting the AASM.

Technical Problems

Q: I am having performance problems with ISR. What can I do?
A: Browser Incompatibility
Users with outdated versions of Microsoft Internet Explorer may experience problems with AASM ISR. Internet Explorer 7 and 8 on Windows XP may run into slow load times. IE 6 or earlier is not compatible with the system.  By upgrading your browser, you will considerably improve the system performance. We recommend using Google Chrome, which is free and available for Windows XP or above.

Slow Computer
Users with older computers with a slower processor and/or limited memory may notice sluggish performance on record exams. The system uses your computer to do calculations to determine how each epoch displays on your screen. If your browser is current, but scoring is still slow, try to free up memory on your computer by closing all other programs.

Users with slow internet connections may find that epochs take several moments to load. This may be because the internet speed is not fast enough to download AASM Inter-scorer Reliability resources in a timely manner. All of these resources are very small files, so this is unlikely. If you have tried these steps and still have performance problems with record exams, please contact us. 
Q: Signals are appearing slowly or blocked by the network, how do I fix this problem?
A: The signals are served through a third-party source server network. Try changing the Source Server Selection under Setting on the epoch screen from the default Akamai CDN to Amazon S3 and hit save. If the Source Server is blocked, a Network Administrator may need to unblock or white list the source servers.

Network administrators will need to unblock or white list the follow Source Server URLS:
Akamai CDN - 
Amazon S3 -