Sleep classification according to AASM and RechtschaffenKales: effects on sleep scoring parameters
| Autor: | Gerhard Kloesch, Josef Zeitlhofer, Georg Dorffner, Bernd Saletu, Silvia Parapatics, Doris Moser, Georg Gruber, Peter Anderer, Marion Boeck, Esther Heller, Andrea Schmidt, Erna Loretz, Heidi Danker-Hopfe |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Polysomnography Sleep spindle Context (language use) Audiology Sleep medicine Nocturnal Myoclonus Syndrome Developmental psychology Young Adult Reference Values Physiology (medical) medicine Reaction Time Humans Slow-wave sleep Aged Aged 80 and over Cerebral Cortex Sleep Stages medicine.diagnostic_test Age Factors Reproducibility of Results Parkinson Disease Middle Aged Anxiety Disorders Practice Guidelines as Topic Female Neurology (clinical) Sleep (system call) Evaluation of AASM Sleep Scoring Criteria Psychology |
| Zdroj: | Sleep. 32(2) |
| ISSN: | 0161-8105 |
| Popis: | FOR APPROXIMATELY 40 YEARS THE ONLY WIDELY ACCEPTED STANDARD FOR DESCRIBING THE HUMAN SLEEP PROCESS WAS THE MANUAL OF SLEEP CLASSIFICATION by Rechtschaffen and Kales.1 On the basis of these scoring rules, sleep recordings are divided into 7 discrete stages (wake, stage 1, stage 2, stage 3, stage 4, stage REM, and movement time). Even though in many cases this standard is useful, the rules of Rechtschaffen and Kales have also been criticized for leaving plenty of room for subjective interpretation, which leads to a great variability in the visual evaluation of sleep stages.2,3 Last but not least, the standard rules were developed for young healthy adults4,5 and do not necessarily directly apply to elderly subjects and patients. The American Academy of Sleep Medicine (AASM)6 modified the standard guidelines for sleep classification by Rechtschaffen and Kales and developed a new guideline for terminology, recording method, and scoring rules for sleep-related phenomena. The manual is the result of a review of literature, analysis and consensus which addresses 7 topics: digital analysis and reporting parameters, visual scoring, arousal, cardiac and respiratory events, movements and pediatric scoring. One of the major changes is a change in terminology: in the AASM classification, sleep stages S1 to S4 are referred to as N1, N2, and N3, with N3 reflecting slow wave sleep (SWS, RK stage REM is referred to as stage R. According to the AASM manual, a minimum of 3 EEG derivations, sampling activity from the frontal, central, and occipital regions, has to be recorded. The recommended derivations are F4-M1, C4-M1, and O2-M1 (right-sided active electrodes and a reference over the left mastoid, rather than the ear).7 The new manual also deals with the definition of the sleep-wake transition, sleep spindles, K-complexes, slow wave sleep, and REM sleep, as well as arousals and major body movements. In summary, the major changes of the new manual comprise EEG derivations, the merging of stages 3 and 4 into N3, the abolition of stage “movement time,” the simplification of many context rules as well as the recommendation of sampling rates and filter settings for polysomnographic (PSG) reporting and for user interfaces of computer-assisted sleep analysis.6 To date there are no studies evaluating the effects of the new standard on sleep scoring data. The aim of the present investigation was to describe in detail differences between visual sleep scoring according to the Rechtschaffen and Kales classification and scoring based on the new AASM guidelines in normal subjects of different age groups and sleep-disturbed patients. |
| Databáze: | OpenAIRE |
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