The visual scoring of sleep in adults
Michael H. Silber,Sonia Ancoli-Israel,Michael H. Bonnet,Sudhansu Chokroverty,Madeleine Grigg-Damberger,Max Hirshkowitz,Sheldon Kapen,Sharon Keenan,Meir H. Kryger,Thomas Penzel,Mark R. Pressman,Conrad Iber +11 more
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TLDR
The work of the AASM Visual Scoring Task Force is described, including methodology, a literature review and the rationale behind the new rules, which define onset and termination of REM sleep periods and propose alternative measures for non-alpha generating subjects.Abstract:
The 1968 Rechtschaffen and Kales (R & K) sleep scoring man- ual was published 15 years after REM sleep was discovered. Advances in the ensuing 28 years warranted a re-look at visual scoring of sleep stages. This paper describes the work of the AASM Visual Scoring Task Force, including methodology, a literature review and the rationale behind the new rules. Reliability studies of R & K scoring were reviewed; reliabil- ity was low for stage one and moderate for slow wave sleep. Evidence indicated that K complexes and slow waves are expressed maximal fron- tally, spindles centrally and alpha rhythm over the occipital region. Three derivations of EEG, two of electro-oculography, and one of chin EMG were recommended. Scoring by 30-second epochs was retained. New terminology for sleep stages was proposed. Attenuation of alpha rhythm was determined to be the most valid electrophysiological marker of sleep onset. Alternative measures were proposed for non-alpha generating subjects. K complexes associated with arousals were determined to be insufficient alone to define the new stage N2. No evidence was found to justify dividing slow wave sleep into two stages. No reasons were found to alter the current slow wave amplitude criteria at any age. The phenomena of REM sleep were defined. The rules for defining onset and termination of REM sleep periods were simplified. Movement time was eliminated and major body movements defined. Studies are needed to test the reliability of the new rules. Future advances in technology may require modification of these rules with time.read more
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American association of clinical endocrinologists and american college of endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity.
W. Timothy Garvey,Jeffrey I. Mechanick,Elise M. Brett,Alan J. Garber,Daniel L. Hurley,Ania M. Jastreboff,Karl Nadolsky,Rachel Pessah-Pollack,Raymond A Plodkowski +8 more
TL;DR: The final recommendations recognize that obesity is a complex, adiposity-based chronic disease, where management targets both weight-related complications and adiposity to improve overall health and quality of life.
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Adult obstructive sleep apnoea.
TL;DR: Obstructive sleep apnoea is an increasingly common disorder of repeated upper airway collapse during sleep, leading to oxygen desaturation and disrupted sleep, and has also been linked to myocardial infarction, congestive heart failure, stroke, and diabetes mellitus though not definitively.
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REM sleep behavior disorder
TL;DR: Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia manifested by vivid, often frightening dreams associated with simple or complex motor behavior during REM sleep as discussed by the authors.
Journal ArticleDOI
Interrater reliability for sleep scoring according to the Rechtschaffen & Kales and the new AASM standard
Heidi Danker-Hopfe,Peter Anderer,Josef Zeitlhofer,Marion Boeck,Hans Dorn,Georg Gruber,Esther Heller,Erna Loretz,Doris Moser,Silvia Parapatics,Bernd Saletu,Andrea Schmidt,Georg Dorffner +12 more
TL;DR: The results of this study underline that the modification of the scoring rules improve IRR as a result of the integration of occipital, central and frontal leads, but decline IRR on the other hand specifically for N2, due to the new rule that cortical arousals with or without concurrent increase in submental electromyogram are critical events for the end of N2.
Journal ArticleDOI
The genetic and molecular regulation of sleep: from fruit flies to humans.
TL;DR: Findings have given valuable insights into the molecular underpinnings of sleep regulation and function that might lead the way to more efficient treatments for sleep disorders.
References
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The measurement of observer agreement for categorical data
J. R. Landis,Gary G. Koch +1 more
TL;DR: A general statistical methodology for the analysis of multivariate categorical data arising from observer reliability studies is presented and tests for interobserver bias are presented in terms of first-order marginal homogeneity and measures of interob server agreement are developed as generalized kappa-type statistics.
Journal ArticleDOI
A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects.
TL;DR: Techniques of recording, scoring, and doubtful records are carefully considered, and Recommendations for abbreviations, types of pictorial representation, order of polygraphic tracings are suggested.
Book
Principles and Practice of Sleep Medicine
TL;DR: Part 1: Normal Sleep and Its Variations; Part 2: Abnormal Sleep.