Normative values of polysomnographic parameters in childhood and adolescence: Quantitative sleep parameters

Scholle, Sabine; Beyer, Uta; Bernhard, Michaël; Eichholz, Stephan; Erler, Thomas; Graneß, Petra; Goldmann-Schnalke, Barbara; Heisch, Katharina; Kirchhoff, Frank; Klementz, Karsten; Koch, Gerhard; Kramer, Annmarie; Schmidtlein, Christoph; Schneider, Barbara; Walther, Birgit; Wiater, Alfred; Scholle, Hans‐Christoph

doi:10.1016/j.sleep.2010.11.011

Cited by 132 publications

(123 citation statements)

References 21 publications

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“…37,40 The prospective longitudinal study by Sankupellay et al confirmed that stages NREM 2 and 3 sleep could be scored in infants 3 months or older.…”

Section: Differences In Sleep Architecture When Scoring Sleep In Chilmentioning

confidence: 95%

“…40 Last but not least, several pediatric sleep specialists decry lumping stages 3 and 4 into NREM 3 sleep 35,36,40 because it dilutes it as a robust marker of homeostatic drive, sleep debt, pathology, and sleep development. [59][60][61][62][63][64] No studies have been published evaluating or contesting the validity or reliability of AASM rules for scoring periodic limb movements of sleep, cardiac events, or REM sleep without atonia in a PSG.…”

Section: Technical Considerations Recommended By the Aasm Manualmentioning

confidence: 99%

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The AASM Scoring Manual Four Years Later

Grigg-Damberger

2012

Journal of Clinical Sleep Medicine

123

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lent and incident blood pressure; 6,7 (2) lower neurocognitive test scores; 8 and (3) automobile crashes due to sleepiness. 9 The respiratory review paper also provided suffi cient evidence for scoring hypopneas which caused as little as ≥ 20% to 30% fall in airfl ow and/or ≥ 2% or ≥ 3% desaturations. [10][11][12] However, the AASM wanted rules for scoring hypopneas which had substantial or excellent interscorer reliability. Interrater reliability (IRR) as it relates to scoring sleep in a PSG measures how closely individuals score the same sleep study. IRR when scoring a PSG depends upon the: (1) skill, experience, and training of scorer; (2) technical quality of study; (3) clarity and simplicity of scoring rules; (4) diligence with which scoring rules are applied; and (5) degree of physiological ambiguity of the sleep/wake patterns. 13 When two or more individuals score a stage of sleep or an event in a PSG differently, it can introduce enough variability to lead to a false positive or false negative for a particular diagnosis.The IRR for scoring respiratory events in a PSG is particularly affected by the: (1) duration of the event; (2) degree of reduction in the amplitude of the measured signal(s); (3) level of the oxyhemoglobin desaturation associated with it; and (4) presence and duration of arousal which accompanies it. Ayappa et al. found the percent scoring agreement for scoring apneas using a nasal pressure sensor was excellent (0.91) but only moderate for hypopneas (0.69) or fl ow limitation events (0.64).14 The more subtle the reduction in airfl ow, the more diffi cult to achieve good interscorer agreement: one scorer identifi ed 35% more fl ow limitation events than the other. Whitney et al. found a hypopnea associated with 2% to 5% desaturations could be scored with IRR of 0.90, but scoring agreement inPurpose of Review: Review published studies and critiques which evaluate the impact and effects of the American Academy of Sleep Medicine (AASM) Sleep Scoring Manual in the four years since its publication. Findings: Using the AASM Manual rules to score sleep and events in a polysomnogram (PSG) results in: (1) very large differences in apnea-hypopnea indexes (AHI) when using the recommended and alternative rule for scoring hypopneas in adults; (2) increases in NREM 1 and sleep stage shifts with compensatory decreases in NREM 2 in children and adults when following rule 5.C.b. for ending NREM 2 sleep; (3) increases in NREM 3 in adults scoring slow wave activity in the frontal EEG derivations; (4) improved interscorer reliability; and (5) successfully identifi ed fragmented sleep in children with obstructive sleep apnea (OSA) from primary snorers or normal controls because they had more NREM 1 and stage shifts using rule 5.C.b. Criticism of the Manual most often cited: (1) two rules for scoring hypopneas; (2) alternative EEG montage cancellation effects; (3) scoring stages 3 and 4 as NREM 3; and (4) too few rules for scoring arousals and REM sleep without atonia. Summary: Four years have passed since the...

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“…37,40 The prospective longitudinal study by Sankupellay et al confirmed that stages NREM 2 and 3 sleep could be scored in infants 3 months or older.…”

Section: Differences In Sleep Architecture When Scoring Sleep In Chilmentioning

confidence: 95%

Section: Technical Considerations Recommended By the Aasm Manualmentioning

confidence: 99%

The AASM Scoring Manual Four Years Later

Grigg-Damberger

2012

Journal of Clinical Sleep Medicine

123

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“…55 To assess if participants still experienced clinically significant insomnia after treatment we coded for each participant whether average SOL or WASO exceeded 30 minutes, and whether SE was lower than 90% at post-treatment. [56][57][58] Two participants did not provide any sleep log measurements at post-treatment. Little's MCAR test was not significant (X 2 (10)= 8.53, p=.578) indicating that these data were missing completely at random.…”

Section: Discussionmentioning

confidence: 99%

Differential effects of online insomnia treatment on executive functions in adolescents

et al. 2015

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“…Pendant le sommeil paradoxal, il existe un découplage entre le poumon et le cerveau. La respiration n'est plus contrôlée [52][53][54][55]. De nombreuses pathologies respiratoires chroniques de l'enfant et du nourrisson (bronchites chroniques obstructives, asthme, dysplasie bronchopulmonaire, etc.)…”

Section: Sur Le Plan Respiratoireunclassified

Explorations fonctionnelles respiratoires et polysomnographies chez le nourrisson et l’enfant : aspects pratiques

Boulé

2015

Journal de Pédiatrie et de Puériculture

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Normative values of polysomnographic parameters in childhood and adolescence: Quantitative sleep parameters

Cited by 132 publications

References 21 publications

The AASM Scoring Manual Four Years Later

The AASM Scoring Manual Four Years Later

Differential effects of online insomnia treatment on executive functions in adolescents

Explorations fonctionnelles respiratoires et polysomnographies chez le nourrisson et l’enfant : aspects pratiques

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