REM sleep latency changes after version 2.1 of the AASM manual for scoring sleep.
AASM manual for scoring sleep
Latency test
Multiple sleep
Narcolepsy
REM latency
REM sleep onset
Journal
Sleep medicine
ISSN: 1878-5506
Titre abrégé: Sleep Med
Pays: Netherlands
ID NLM: 100898759
Informations de publication
Date de publication:
02 2022
02 2022
Historique:
received:
08
11
2021
revised:
21
12
2021
accepted:
21
01
2022
pubmed:
19
2
2022
medline:
2
4
2022
entrez:
18
2
2022
Statut:
ppublish
Résumé
The classical criteria for scoring REM sleep changed in version 2.1 of the AASM manual for scoring sleep, by allowing N1 epochs with atonia precedent and contiguous to definite REM sleep to be scored as REM sleep in the absence of rapid eye movements when the EEG was compatible. This may shorten the REM latency in the Multiple Sleep Latency Test (MSLT) in naps with wake/N1 to REM transitions, characteristic of narcolepsy type 1. Since REM latency of <5 or <6 min is a biomarker of NT-1 we have assessed the impact of this change in scoring REM sleep in the MSLT. Ninety-two consecutive five-nap MSLT studies (460 naps) performed in our center between 2013 and 2019 for evaluation of hypersomnolence with ≥1 sleep onset REM (SOREM) naps were included. REM latencies were measured using both classical and new criteria. SOREMs occurred in 255 (55.9%) naps, 134 directly from wake/N1. By using the new criteria REM latency shortened in 29.1% of these naps (mean 0.2 ± 0.5, range 0-3 min, p < 0.01), predominantly in females. Twenty-eight percent of MSLTs had at least one nap with a shortened REM latency (mean 0.1 min ± 0.2, p < 0.01). Only two MSLTs changed their REM latency to <5 min and none to <6 min with the new rules. The criterion to define REM sleep onset significantly influences its latency and should be considered when comparing studies performed before or after version 2.1 modification. The clinical relevance of this scoring change is probably minimal.
Sections du résumé
BACKGROUND
The classical criteria for scoring REM sleep changed in version 2.1 of the AASM manual for scoring sleep, by allowing N1 epochs with atonia precedent and contiguous to definite REM sleep to be scored as REM sleep in the absence of rapid eye movements when the EEG was compatible. This may shorten the REM latency in the Multiple Sleep Latency Test (MSLT) in naps with wake/N1 to REM transitions, characteristic of narcolepsy type 1. Since REM latency of <5 or <6 min is a biomarker of NT-1 we have assessed the impact of this change in scoring REM sleep in the MSLT.
METHODS
Ninety-two consecutive five-nap MSLT studies (460 naps) performed in our center between 2013 and 2019 for evaluation of hypersomnolence with ≥1 sleep onset REM (SOREM) naps were included. REM latencies were measured using both classical and new criteria.
RESULTS
SOREMs occurred in 255 (55.9%) naps, 134 directly from wake/N1. By using the new criteria REM latency shortened in 29.1% of these naps (mean 0.2 ± 0.5, range 0-3 min, p < 0.01), predominantly in females. Twenty-eight percent of MSLTs had at least one nap with a shortened REM latency (mean 0.1 min ± 0.2, p < 0.01). Only two MSLTs changed their REM latency to <5 min and none to <6 min with the new rules.
CONCLUSIONS
The criterion to define REM sleep onset significantly influences its latency and should be considered when comparing studies performed before or after version 2.1 modification. The clinical relevance of this scoring change is probably minimal.
Identifiants
pubmed: 35180477
pii: S1389-9457(22)00020-X
doi: 10.1016/j.sleep.2022.01.019
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
142-144Informations de copyright
Copyright © 2022 Elsevier B.V. All rights reserved.