An Australasian Commentary on the AASM Manual for the Scoring of Sleep and Associated Events

Abstract

The aim of this document was to provide a commentary on the AASM Manual for Scoring of Sleep and Associated Events in an Australasian context. A panel of Australasian sleep professionals developed the commentary. Each member was tasked with reviewing an assigned section and reporting back with potential AASM Manual clarifications and alterations. These suggestions were evaluated by the panel and ultimately resulted in the recommendations in this document. The panel recognised that the AASM manual significantly advanced the standardisation of polysomnography recording, analysis, and reporting; however, there were sections of the AASM Manual where the panel determined there were clarifications, additions, or alterations required. Some of the key panel recommendations included: (1) advice to exclude arousals in awake epochs in the arousal index, (2) recommendation of a single hypopnoea definition, as well as single options for EEG and EOG placements, (3) a minimum duration for the central and mixed components of a mixed apnoea, (4) the addition of a baseline definition for scoring respiratory events, (5) the addition of criteria for defining oxygen desaturation, and (6) advice change so that the scoring and reporting of respiratory effort-related arousals (RERAs) and snoring is ‘recommended’ rather than ‘optional’. While it is anticipated that the recommendations will improve standardisation across Australasian sleep services many of the recommendations are also relevant in a global setting and should be considered for inclusion in future updates of the AASM Manual.