Scoring Transitions

Question 1

After an arousal from N2 sleep, what is the next epoch?

Answer 1

The next epoch is based upon itself:

• Greater than 50% Alpha = awake
• Less than 50% Alpha and vertex waves = N1
• K complexes or sleep spindles in the first half of the epoch = N2
• K complexes or sleep spindles in the 2nd half of the epoch = N1 (next epoch = N2)

Question 2

After an arousal from REM sleep, what is the next epoch?

Answer 2

• LAMF & SEMs = N1

- LAMF & NO SEMs = continue REM

Question 3

Define major body movement

Answer 3

Where movement obscures greater than one half of the epoch

Question 4

What do I score the epoch as that has major body movement?

Answer 4

• Any alpha = wake
• No alpha but the prior and next epoch is wake = wake
• Otherwise score it the same as the next epoch

Question 5

What do I score the epoch as if the major body movement occurs during N2 sleep?

Answer 5

• LAMF & SEM = N1

- LAMF & NO SEM = N2

Question 6

Where does REM sleep start?

Answer 6

-Find the start of REM sleep and then go back to the last epoch of N2 sleep and start there

or

-Score REM from the point where the chin EMG drops to REM level

Question 7

What are the rules for continuing REM (without rapid eye movements)?

Answer 7

Continue scoring REM sleep as long as there is LAMF and the chin EMG is low (no K complexes or sleep spindles)

Question 8

What are the rules for ending REM sleep?

Answer 8

• Transition to Wake or N3
• Increased EMG chin tone
• Arousal (see rules)
• MBM (See rules)
• N2 if K complexes or sleep spindles are seen in the first half of the epoch

Question 9

What is the rule for continuing N2 sleep?

Answer 9

If a K complex appears in any of epoch without an accompanying arousal, that epoch is N2. All subsequent epochs with LAMF are also N2 even if they don’t have spindles or K complexes unless they have an arousal or they meet criteria for N3 or REM sleep.