Scoring and Sleep Stages F (D-37 - D-40) Flashcards
What is the minimum and maximum duration of an LM (limb movement) event?
0.5-10 seconds
What is the minimum amplitude of an LM (limb movement) event?
8 uV increase in voltage above resting EMG
What is the timing of an onset of an LM (limb movement) event?
The point at which there’s an 8 uV increase in EMG voltage above resting EMG
What is the timing of an ending of an LM (limb movement) event?
The start of a period lasting at least 0.5 sec during which the EMG does not exceed 2 uV above resting EMG.
To define a PLM series, the minimum amount of consecutive LM events is ___.
4 LM.
To define a PLM series, the minimum period length between LM to include them as part of a PLM series is ___ seconds. The maximum period length is ___.
Minimum: 5 seconds
Maximum: 90 seconds
Leg movements on 2 different legs separated by less than 5 seconds between movement onsets are counted as ___.
They’re counted as a single leg movement.
When should an arousal and limb movement occurring in the same PLM movement be considered associated with each other?
When they occur simultaneously
When they overlap
Less than 0.5 sec between the end of one event and the onset of the other event.
When should a limb movement NOT be scored?
If it occurs during the period from 0.5 seconds preceding an apnea or hypoxia to 2.5 seconds following the respiratory event.
How do you define sustain muscle activity (tonic activity) in REM sleep?
REM sleep with at least 50% of the epoch having a loud chin EMG.
How do you define excessive transient muscle activity (Phasic activity)?
In a 30 second epoch of REM sleep divided into 10 sequential 3-second mini-epochs, at least 50% (5) of the mini-epochs contain bursts of transient muscle activity.
What is RBD? How do you define excessive transient muscle activity (Phasic activity) in RBD?
RBD: Rapid Eye Movement Sleep Behavior Disorder
Excessive transient muscle activity bursts are 0.1-5 seconds in duration and at least 4 times as high in amplitude as the background EMG activity.
There are two kinds of bruxism. What are they?
Sustained and phasic bruxism
How long does bruxism have to last to score it?
3 seconds
Bruxism is usually scored by chin EMG. When can you score it by audio?
If there are 2 audible cases in one night.
If you want to score PSG features of a rhythmic movement disorder, what are the minimum & maximum frequencies?
0.5 Hz to 2 Hz.
What are the minimum number of individual movements required to make a cluster of rhythmic movements?
4
Bruxism: Chin EMG activity must be between __ and __ seconds long and at least # must occur in regular sequence.
0.25 to 2 seconds.
At least 3 must occur.
How do you score an apnea or hypopnea duration?
Measure from the nadir preceding the first breath that is clearly reduced to the beginning to the first breath that approximates the baseline breathing amplitude.
What is the top of a waveform called?
What is the bottom of the waveform called?
Zenith and nadir
What sensor should you use to determine apnea duration? (There are two sensors you can use.)
The oronasal thermal sensor or PAP device flow signal.
What sensor should you use to determine hypopnea duration? (There are two sensors you can use.)
The nasal pressure signal or PAP device flow signal.
When should you score an event as an apnea event?
A drop in the peak signal excursion (by greater than 90%) and the duration of the 90% drop lasts at least 10 seconds.
When should you score an apnea event as obstructive?
Apnea criteria is met and associated with continued inspiratory effort.
When should you score an apnea event as central?
Apnea criteria is met and associated with absent inspiratory effort.
When should you score an apnea event as mixed?
Apnea criteria is met and no airflow or effort is seen followed by a period of no airflow with respiratory effort.
