AASM Manual for the Scoring of Sleep and Associated Events Version 3

Flashcards covering the technical specifications, scoring rules, and reporting parameters from the AASM Manual Version 3 for adult, pediatric, and infant sleep studies.

How is Total Sleep Time (TST) calculated according to the AASM Manual?

The time spent in stages $N1 + N2 + N3 + R$.

What is the formula for calculating Percent Sleep Efficiency?

$(TST/TRT) \times 100$ where $TST$ is Total Sleep Time and $TRT$ is Total Recording Time.

What is the recommended maximum electrode impedance for EEG, chin EMG, and EOG recordings?

$$5\,k\Omega$$

What are the desirable and minimal sampling rates for recording EEG, EOG, EMG, and ECG signals?

Desirable sampling rate is $\ge 500\,Hz$ and the minimal rate is $200\,Hz$.

What are the routinely recommended filter settings for EEG and EOG channels?

Low-frequency filter of $0.3\,Hz$ and high-frequency filter of $35\,Hz$.

How is Slow Wave Activity defined in the scoring of adult sleep stages?

EEG waves with a frequency of $0.5-2.0\,Hz$ and a peak-to-peak amplitude of $> 75\,\mu V$, measured over the frontal regions.

What are the frequency ranges for Delta, Theta, Alpha, and Beta waves as specified by the manual?

Delta: $0-3.99\,Hz$, Theta: $4-7.99\,Hz$, Alpha: $8-13\,Hz$, and Beta: $> 13\,Hz$.

What is the definition of a Sleep Spindle?

A train of distinct sinusoidal waves with frequency $11-16\,Hz$ (most commonly $12-14\,Hz$), with a duration $\ge 0.5\,seconds$.

What are the criteria for scoring an arousal during sleep stages N1, N2, or N3?

An abrupt shift of EEG frequency lasting at least $3\,seconds$, with at least $10\,seconds$ of stable sleep preceding the change.

How does the scoring of an arousal during Stage R sleep differ from other stages?

It requires the standard EEG frequency shift plus a concurrent increase in submental EMG lasting at least $1\,second$.

What constitutes asystole in patients from age 6 years through adulthood?

Cardiac pauses during sleep lasting longer than $3\,seconds$.

What is the definition of Sinus Bradycardia during sleep for adults?

A sustained ($> 30\,seconds$) sinus heart rate of $< 40\,beats\ per\ minute$.

How is a candidate Leg Movement (LM) event defined for possible inclusion in a PLMS series?

A movement lasting $0.5-10\,seconds$ with a minimum amplitude increase of $8\,\mu V$ in EMG voltage above resting baseline.

What are the requirements for a collection of movement events to be defined as a PLMS series?

A minimum of 4 consecutive leg movements with a period length between onsets of $5-90\,seconds$.

What is the required signal drop for scoring a respiratory event as an apnea?

A drop in the peak signal excursion by $\ge 90\%$ of the pre-event baseline using an oronasal thermal sensor or PAP device flow signal.

What is the minimum duration for scoring an apnea in adult patients?

$$\ge 10\,seconds$$

What are the criteria for scoring a hypopnea in adults according to the recommended rule?

A peak signal excursion drop of $\ge 30\%$ for $\ge 10\,seconds$ associated with a $\ge 3\%$ oxygen desaturation or an arousal.

For pediatric patients, what is the minimum duration for scoring an obstructive apnea?

The event must last at least the duration of 2 breaths during baseline breathing.

What is Trace Alternant (TA) and during which state is it typically seen in infants?

An EEG pattern characterized by alternating runs of high voltage ($50-150\,\mu V$) delta bursts and lower amplitude theta activity, generally seen in Stage N (NREM).

Define Respiratory Effort-Related Arousal (RERA) for adult patients.

A sequence of breaths lasting $\ge 10\,seconds$ with increasing respiratory effort or flattening of the inspiratory signal leading to an arousal, without meeting apnea or hypopnea criteria.