Scoring and Sleep Stage E (D-26 - ) Flashcards
What stage is notable for eye movements (SEM)?
N1
What stage is notable for K complexes?
N2 (N2 has to have K complexes or sleep spindles. You don’t need both.)
What stage is notable for slow waves (Delta waves)?
N3
This stage normally occurs 90 min after sleep onset.
REM
This stage is notable for low frequency and high amplitude.
N3
What stage is notable for sleep spindles?
N2 but may persist into N3
What stage is notable for one or more K complexes unassociated with arousal?
N2
What marks the end of stage N2? (x3)
Transition to stage W
An arousal
A major body movement followed by slow eye movements and low amplitude mixed frequency EEG without non-arousal associated K complexes. (If no slow eye movements, continue N2)
What stages are notable for sleep spindles and K-complexes? (x2)
One stage has larger, wider K complexes and sleep spindles. Which stage?
N2 and N3.
N3 has larger, wider K complexes and sleep spindles.
When 20% or more of an epoch contains slow wave activity, score as what stage?
N3
At what stage is the chin EMG at the lowest point?
REM
What stage is notable for Theta sawtooth waves in EEG?
REM
In what phase of sleep to you see “tonic” or Phasic or non-tonic” waveforms? What’s the difference between them?
REM
Tonic is “tame” or smooth
Phasic or Non-Tonic is “Frantic”, or rough and jagged.
What stage of sleep is notable for frequency of 0.5 - 2 Hz and an amplitude of 75 uV peak to peak?
N3 (N3 is the only stage that has an amplitude requirement.)
What stage of sleep is marked by a low amplitude, mixed frequency activity, usually 4-7 Hz?
N1
What stage of sleep is notable for Vertex waves (V waves)?
N1
What stage of sleep is referred to as “drowsy sleep” or “Somnolent sleep”?
N1
What stage of sleep is notable for parasomnias, such as sleep-talking, bet-wetting, and night terrors?
N3
When does most of the REM stage occur?
During the last 1/3 of the night
During this stage of sleep, the brain is active but the body is paralyzed.
REM
If you see epochs with low amplitude, mixed frequency EEG activity without K complexes, or sleep spindles, score as ___ (stage?)
N2
To score as N1, slow eye movements are (required/not required).
Not required
What stage is notable for hypnic jerks?
N1 (Hypnic jerks are more commonly seen when the patient is sleep deprived)
When bursts of Theta waves are seen with hypnic jerks, what stage is scored?
N1
Theta waves are the most common sleep frequency in what stage?
N1
This stage is seen in the frontal region.
N3
Memorable dreams occur during what stage?
REM
In the absence of eye movements for Epochs following one or more epochs of REM, if the EEG continues with low amplitude, mixed frequency without K complexes or sleep spindles and the chin EMG remains low, score as ___ (Stage?)
REM
What stage of sleep is notable for transient muscle activity- short, irregular bursts of EMG activity superimposed on low EMG tone?
REM
What stage is notable for sleep spindles?
N2
What stage is notable for K complexes?
N2
What stage is notable for Theta waves that are 4-7.999 Hz?
N1
What stage is notable for a decrease in muscular activity?
N2
When 20% of slow wave activity is seen in the epoch, score as ___ (stage?)
N3
What stage occupies 45-55% of sleep in adults?
N2
In what stage is alpha activity replaced by low voltage activity and usually theta waves?
N1
What stage comprises 30-35% of sleep in adults?
N3
What stage makes up 20-25% of sleep time?
REM
What stage is notable for low amplitude, mixed frequency EEG?
REM
End scoring Stage R when the patient transitions to __ or __.
W or N3
End scoring Stage R when an increase in ___ EMG is seen.
Chin EMG
End scoring Stage R when ___ occurs, followed by ___ amplitude, ___ ___ EEG, and ___ eye movements.
An arousal
Low amplitude, mixed frequency EEG
Slow eye movements.
End scoring stage R when ___ ___ ___ is seen, followed by ___ ___ ___ and ___ amplitude, ___ ___ EEG is seen.
Major body movement
Slow eye movements
Low amplitude, mixed frequency EEG.
If the patient is in REM sleep and you see no slow eye movements and the chin EMG remains low, what should you score?
Continue as Stage R
If one or more non-arousal K complexes or sleep spindles are present in the first half of the epoch and no rapid eye movement, but chin EMG is still low, what should you score?
N2
Arousal rule: When looking at EEG frequency, how do you score arousal?
An abrupt shift of EEG frequency greater than 16 Hz (not spindles) lasting at least 3 seconds with 10 seconds of stable sleep preceding the change.
Arousal rule: When the patient is in REM sleep, how do you score an arousal?
A concurrent increase in submental EMG that lasts 1 second.
Which stage decreases with age?
N3
What are sawtooth waves and what stage of sleep are they found in?
Trains of sharply contoured or triangular, 2-6 Hz waves over central head regions and often (not always) preceding a burst of rapid eye movements.
Seen in REM sleep.
