Abstract
Background
In 2007, the American Association of Sleep Medicine (AASM) published recommendations for recording and scoring polysomnograms. These were revised in 2014 and 2015, and the given rules should be applied to polysomnography in both adults and children.
Objective
The scoring of pediatric polysomnograms is complicated by development-dependent alterations in specific patterns. The present article aims to demonstrate that in particular situations, the AASM rules for scoring and evaluation of sleep and associated events in children are worthy of further discussion.
Materials and methods
The problems associated with performing and evaluating results of sleep studies are illustrated using individual examples. Polysomnography was performed according to AASM rules.
Results and conclusion
This article highlights the problems associated with recording and scoring pediatric polysomnograms according to AASM rules with respect to the number of necessary electrodes, study over one or two nights, scoring of sleep stages (specific patterns for scoring sleep stages and the delta wave amplitude criterion), arousal definition, scoring movements and movement times, and scoring the respiratory pattern. Individual examples are discussed in each case. Beyond the fundamental aspects laid down in the AASM rules, recording and scoring polysomnograms in children necessitates additional understanding of development-specific characteristics.
Zusammenfassung
Hintergrund
2007 wurden von der American Association of Sleep Medicine (AASM) Empfehlungen zur Durchführung und Bewertung von Polysomnographien veröffentlicht, die 2014 und 2015 überarbeitet wurden und sowohl im Erwachsenen- als auch im Kindesalter angewendet werden sollen.
Ziel der Arbeit
Die Bewertung von Polysomnographien ist im Kindesalter durch die entwicklungsbedingte Veränderung von spezifischen Mustern erschwert. Die Arbeit soll zeigen, dass im Einzelfall die Empfehlungen der AASM bezüglich der Mustererkennung und -bewertung im Kindesalter diskussionswürdig sind.
Material und Methoden
In Einzelbeispielen wird auf Probleme bei der Durchführung und Bewertung von Untersuchungen im Schlaf hingewiesen. Die Ableitungen wurden entsprechend der AASM-Regeln durchgeführt.
Ergebnisse und Diskussion
Hinweise zur Problematik der Ableitung und Auswertung von Polysomnographien im Kindesalter nach den AASM-Regeln wurden bezüglich der Anzahl von Messwertaufnehmern, der Untersuchung in 1 oder 2 Nächten, der Bewertung der Schlafstadien (spezifische Muster zur Schlafstadienerkennung und Amplitudenkriterium Deltawellen), der Arousaldefinition, der Bewertung von Bewegungen und Bewegungszeiten und der Bewertung des Atemmusters gegeben. Einzelbeispiele werden jeweils erläutert. Über die AASM-Regeln hinaus erfordert die Durchführung und Auswertung von Polysomnographien im Kindesalter ein zusätzliches Wissen über entwicklungsspezifische Besonderheiten.
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S. Scholle states that she has no competing interests.
All studies on humans described in the present manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current, revised form). Informed consent was obtained from all patients included in studies. Written consent was obtained from the parents of all children.
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Scholle, S. Scoring of pediatric polysomnograms. Somnologie 21 (Suppl 1), 9–18 (2017). https://doi.org/10.1007/s11818-016-0071-7
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DOI: https://doi.org/10.1007/s11818-016-0071-7