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  • Basics of Sleep Staging CMP

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    Compumedics endeavors to ensure the validity and accuracy of the information within. However, we cannot be held responsible for inaccuracies, opinions or practices that often vary between various experts or are without established acceptable medical standards.

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    Compumedics endeavors to ensure the validity and accuracy of the information within. However, we cannot be held responsible for inaccuracies, opinions or practices that often vary between various experts or are without established acceptable medical standards.

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    Attribution Non-Commercial (BY-NC)
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    23 views25 pages

    Basics of Sleep Staging CMP

    Uploaded by

    entgo8282
    Compumedics endeavors to ensure the validity and accuracy of the information within. However, we cannot be held responsible for inaccuracies, opinions or practices that often vary between various experts or are without established acceptable medical standards.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPS, PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    Sleep Staging Basics

    Copyright 2006 Compumedics Ltd.

    The following presentation is being provided for informational and educational purposes only. While Compumedics endeavors to ensure the validity and accuracy of the information within, we cannot be held responsible for inaccuracies, opinions or practices that often vary between various experts or are without established acceptable medical standards. Please consult your own medical director for clarification or for policies that are specific to your facility. We welcome your comments, suggestions and corrections. Please e-mail your comments to: marketing@compumedics.com.au

    Copyright 2006 Compumedics Ltd.

    Sleep Staging Variables


    Electroencephalogram (EEG) - acquired by surface electrodes on the scalp at standardized locations (10-20 system) Electrooculogram (EOG) - acquired by surface electrodes placed at the outer canthus of each eye Electromyogram (EMG) - acquired by surface electrodes placed on the chin muscle (sub-mental)

    Copyright 2006 Compumedics Ltd.

    Sleep Staging Channels

    Copyright 2006 Compumedics Ltd.

    EEG
    Frequency and amplitude change with sleep stage: Wake: high frequency Stage 1, REM: low amplitude, mixed frequency, vertex waves Stage 2: spindles, k-complexes Stage 3/4: delta waves Standard sleep epoch is 30 seconds

    Copyright 2006 Compumedics Ltd.

    EOG
    EOG records voltage changes caused by eye movement; EOG changes with sleep stage Wake: random, high amplitude:

    Stage 1: slow rolling:

    REM: very flat with occasional rapid eye movements:

    Copyright 2006 Compumedics Ltd.

    EMG
    Recorded as the potential between two surface electrodes placed several centimeters apart Typically, the chin (submental) muscle is used because it exhibits large differences during sleep, aiding in the identification of stages Wake - high activity Sleep - lower activity REM sleep - paralysis of skeletal muscles

    Copyright 2006 Compumedics Ltd.

    Sleep Stage Criteria


    Awake
    Alpha or faster > 50% of epoch Many eye movements High EMG
    ALPHA WAVES

    THETA WAVES

    Stage 1
    Alpha or faster < 50 % of epoch Increasing theta activity Slow rolling eyes Vertex sharp waves
    Copyright 2006 Compumedics Ltd.

    VERTEX WAVE

    Sleep Staging Criteria


    Stage 2
    Sleep Spindles
    12-14 cps 0.5 second duration or longer Sleep Spindle

    and/or K-complexes
    Sharp negative deflection followed by nearly equal positive deflection At least 0.5 seconds in duration

    K-complex

    < 3 minutes apart


    Copyright 2006 Compumedics Ltd.

    Sleep Staging Criteria


    Stage 3 - Delta Waves (75uV) 20-50% of epoch Stage 4 - Delta > 50 % of epoch
    DELTA WAVES

    Copyright 2006 Compumedics Ltd.

    Sleep Staging Criteria


    REM
    Lowest EMG Rapid Eye Movements (REMs) Spindles or K-complexes > 3 minutes apart Saw-tooth EEG Low-amplitude, mixed frequency EEG similar to stage 1

    Copyright 2006 Compumedics Ltd.

    Stage: Awake

    Copyright 2006 Compumedics Ltd.

    Stage 1 Sleep

    Copyright 2006 Compumedics Ltd.

    Stage 2 Sleep

    Copyright 2006 Compumedics Ltd.

    Stage 3 Sleep

    Copyright 2006 Compumedics Ltd.

    Stage 4 Sleep

    Copyright 2006 Compumedics Ltd.

    Stage REM Sleep

    Copyright 2006 Compumedics Ltd.

    Stage REM Sleep

    Sawtooth waveform pattern seen in REM sleep.


    Copyright 2006 Compumedics Ltd.

    Infant Sleep Patterns


    Circadian rhythm not established prior to week 10 or 11 from birth. Consolidation of sleep usually occurs by week 16-17. Between 24-36 weeks Active-Quiet Sleep pattern is established. At 5-6 months R&K rules can be applied. Age is corrected for normal gestational age.

    Copyright 2006 Compumedics Ltd.

    Changing Sleep Patterns With Age

    Copyright 2006 Compumedics Ltd.

    Active Sleep - Infant


    Continuous cycling of wakefulness-active sleep (REM) and quiet sleep(NREM). Sleep onset is usually to active sleep (REM) Mixed, low-voltage, irregular EEG Suppressed EMG Intermittent REMs Frequent muscle twitches and body movements

    Copyright 2006 Compumedics Ltd.

    Active Sleep - Infant

    Copyright 2006 Compumedics Ltd.

    Quiet Sleep - Infant


    High voltage, slow-wave EEG activity Trace alternant, 3-8 sec. burst of high voltage slow waves, alternating with 4-8 seconds of low voltage mixed freq. waves EMG tonic Eye movements absent Minimal body movement

    Copyright 2006 Compumedics Ltd.

    Quiet Sleep - Infant

    Copyright 2006 Compumedics Ltd.

    Infant Sleep Staging


    Wake, Active (REM) Sleep, Quiet (NREM) Sleep, Indeterminate, Movement or Artifact. If an epoch can not be staged as Wake, Active or Quiet, it is Indeterminate. Crying is considered awake. Artifact is scored if one minute or more of recording is unscorable.

    Copyright 2006 Compumedics Ltd.

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