Manual der American Academy of Sleep Medicine

Abstract

In the 2007 manual of the American Academy of Sleep Medicine (AASM), all parameters for a cardiorespiratory polysomnography (PSG) were published for the first time in an evidence-based manner including technical specifications and rules for derivations and scoring. After the regularly planned review and revision, the current version 2.0 was published. The significant modifications and their possible impact on clinical routine in Germany are discussed. The most important changes are related to the measurement and scoring of the parameters of breathing. Only one definition remains for the scoring of hypopneas with a flow decrease of 30 % over at least 10 s associated with either a desaturation of at least 3 % or an arousal. In addition, apneas should be rated if they start or end in an epoch scored as wake whenever the patient showed sleep before or afterwards. The revised version allows the measurement of both apneas and hypopneas using an oronasal thermistor or a nasal pressure transducer in the case the other method is not possible due to technical reasons. Furthermore, the definitions and scoring of hypoventilation and Cheyne-Stokes breathing have changed. Concerning sleep scoring, it should be noted that stage N3 can also be determined using C4-M1 depending on the use of recommended or alternative electroencephalogram (EEG) and electrooculogram (EOG) combinations. Although the now unified rule for the rating hypopneas and the possibility to detect apneas or hypopneas using one method seem to be a great simplification for clinical routine, other recommendations must be proven in practice. With the publication of version 2.0 of the AASM manual, it must be asked whether the procedures of the manual should be mandatory for use in Germany or if at least specific basic principles could also be used with older PSG equipment. From the scientific position, the use of the AASM manual version 2.0 for sleep research is indespensible. © 2013 Springer-Verlag Berlin Heidelberg.