Scoring of pediatric polysomnograms

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.

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