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Clinics in Chest Medicine Jun 2010Polysomnography (PSG) is an essential tool for diagnosis of a variety of sleep disorders. The results of PSG should be interpreted in the context of a patient's history... (Review)
Review
Polysomnography (PSG) is an essential tool for diagnosis of a variety of sleep disorders. The results of PSG should be interpreted in the context of a patient's history and medications and observation in the sleep laboratory. As new technologies evolve, it is expected that the field will evolve. Further work is needed to determine if computerized scoring, with or without human revision, may reliably replace visual scoring in normal and abnormal sleep. Improved techniques to measure and quantify sleep itself will allow for more meaningful assessment of sleep disruption that can lead to the recognition of new disorders and better predictions of the outcomes of these disorders.
Topics: Arousal; Continuous Positive Airway Pressure; Electrocardiography; Humans; Monitoring, Ambulatory; Plethysmography; Polysomnography; Sleep Apnea Syndromes; Sleep Stages; Sleep, REM
PubMed: 20488287
DOI: 10.1016/j.ccm.2010.02.005 -
Archives of Disease in Childhood.... Jun 2020A 5-year-old child presents to a paediatric clinic with their parents because of concerns about snoring, which is loud, every night and associated with respiratory... (Review)
Review
A 5-year-old child presents to a paediatric clinic with their parents because of concerns about snoring, which is loud, every night and associated with respiratory pauses. This has been present for 6 months. Can clinical evaluation diagnose sleep-disordered breathing in children or are further investigations required? Should further investigations include oximetry or polysomnography? If a polysomnogram is performed, how are the results interpreted? In this paper we describe the indications for polysomnography, outline the parameters measured and decode a clinical polysomnography report.
Topics: Adolescent; Child; Child, Preschool; Female; Humans; Male; Oximetry; Pediatrics; Polysomnography; Practice Guidelines as Topic; Sleep Apnea Syndromes; Snoring; Surveys and Questionnaires
PubMed: 31615846
DOI: 10.1136/archdischild-2018-316031 -
Sleep Medicine Clinics Dec 2016Polysomnography provided a means to objectively study sleep. Initial challenges were technical; the next challenge was overcoming communication difficulties and lack of... (Review)
Review
Polysomnography provided a means to objectively study sleep. Initial challenges were technical; the next challenge was overcoming communication difficulties and lack of standardization. The new specialty, sleep medicine, created a huge demand for laboratory polysomnography. By the early 2000s, home sleep testing and treatment devices made inroads into clinical sleep practice. The economic consequence was shrinking demand for clinical laboratory polysomnography. Therefore, polysomnography must now find new directions, approaches, and purpose. Engineering challenges remain, and the "new" polysomnography needs to revisit some of the original questions about sleep, including what constitutes optimal sleep quantity, timing, and quality.
Topics: Humans; Polysomnography; Sleep Wake Disorders
PubMed: 28118865
DOI: 10.1016/j.jsmc.2016.07.002 -
Technology and Health Care : Official... Oct 1997Polysomnography refers to the continuous monitoring of multiple neurophysiological and cardiorespiratory variables, usually over the course of a night, to study normal... (Review)
Review
Polysomnography refers to the continuous monitoring of multiple neurophysiological and cardiorespiratory variables, usually over the course of a night, to study normal and disturbed sleep. Electroencephalographic, electrooculographic and electromyographic channels provide the basis for staging the recording into successive epochs of wakefulness and various non-Rapid-Eye-Movement (REM) and REM sleep. Detection of airflow at the nose and mouth by means of thermistors, and analysis of breathing patterns recorded from sensors placed around the ribcage and abdomen, sound recordings, the electrocardiogram and the combined application of several other measurement techniques allow the assessment of normal and abnormal physiological events in relation to sleep structure. Polysomnography has an important role in the diagnosis of disorders of sleep and wakefulness as well as in the assessment of treatment effects and in scientific investigations. Developments in digital signal processing have contributed to its widespread application in clinical practice and research.
Topics: Humans; Polysomnography; Signal Processing, Computer-Assisted; Sleep Stages; Sleep Wake Disorders; Terminology as Topic
PubMed: 9429270
DOI: No ID Found -
Clinical Neurophysiology : Official... Sep 2000Seizures are one of the most frequent problems in the neonatal period, and are frequently associated with high mortality and morbidity rates. On the other hand, neonatal... (Review)
Review
Seizures are one of the most frequent problems in the neonatal period, and are frequently associated with high mortality and morbidity rates. On the other hand, neonatal seizures may represent a first or even the only sign of central nervous system dysfunction. However, establishing the diagnosis of neonatal seizures poses several problems, and clinical observation is not sufficient in many cases. Neonatal polysomnography is a valuable tool both in the diagnostic and in the prognostic assessment of neonatal seizures. The present text reviews some technical aspects related to neonatal polysomnographies, and its usefulness in the area of suspected neonatal seizures. Moreover, some questions are raised regarding rhythmic discharges and their significance as a possible ictal and interictal epileptic pattern in the neonate.
Topics: Brain; Electroencephalography; Epilepsy; Humans; Infant, Newborn; Polysomnography
PubMed: 10996558
DOI: 10.1016/s1388-2457(00)00405-3 -
Journal of Clinical Sleep Medicine :... Mar 2019Polysomnography (PSG) is increasingly used in the assessment of infants. Newborn PSG reference values based on recent standardization are not available. This study...
STUDY OBJECTIVES
Polysomnography (PSG) is increasingly used in the assessment of infants. Newborn PSG reference values based on recent standardization are not available. This study provides reference values for PSG variables in healthy newborn infants.
METHODS
Cross-sectional study of normal term newborn infants using standardized PSG collection and American Academy of Sleep Medicine interpretation criteria.
RESULTS
Thirty infants born between 37 and 42 weeks gestation underwent PSG testing before 30 days of age (mean 19.6 days). The infants had a mean sleep efficiency of 71% with average proportions of transitional, NREM and REM sleep estimated at 16.1%, 43.3% and 40.6% respectively. Mean arousal index was 14.7 events/h with respiratory arousal index of 1.2 events/h. Mean apnea-hypopnea index (AHI) was 14.9 events/h. Central, obstructive, and mixed apnea indices were 5.4, 2.3, and 1.2 events/h respectively. Mean oxygen saturation in sleep was 97.9% with a nadir of 84.4%. Mean end tidal CO was 35.4 mmHg with an average of 6.2% of sleep time spent above end-tidal CO 45 mmHg and 0.6% above 50 mmHg.
CONCLUSIONS
The sleep efficiency was significantly lower and the AHI was significantly higher compared to healthy children older than 1 year. The AHI was also higher than reported in healthy infants older than 1 month. These findings suggest current severity classifications of sleep apnea may not apply to newborn infants.
Topics: Cross-Sectional Studies; Female; Humans; Infant, Newborn; Male; Oxygen Consumption; Polysomnography; Reference Values; Sleep; Sleep Stages; Sleep, REM
PubMed: 30853051
DOI: 10.5664/jcsm.7670 -
Respiratory Care Sep 2010Polysomnography studies are an essential tool for the sleep physician and aid in the diagnosis and treatment of sleep disorders. Polysomnography refers to the recording,... (Review)
Review
Polysomnography studies are an essential tool for the sleep physician and aid in the diagnosis and treatment of sleep disorders. Polysomnography refers to the recording, analysis, and interpretation of multiple physiologic signals collected simultaneously. Rapid advancements in technology have transformed the field from a time when analog studies were collected on paper to computer-assisted collection of digitally transformed studies. Sleep clinicians, whether physicians, respiratory therapists, or sleep technologists, must therefore have an understanding of a broad array of principles underlying the collection of the various signals. In addition, an understanding of basic technical rules in the evaluation of polysomnography studies is necessary for both the scoring and interpretation of such studies. The American Academy of Sleep Medicine published a new manual for the scoring of sleep and associated events in 2007. These changes included modifications to the visual scoring of sleep, the scoring of sleep-disordered breathing events, and movement disorders during sleep. A few early studies have evaluated the effects of the changes in scoring guidelines to the previous Rechtschaffen and Kales (R&K) rules for sleep and the American Academy of Sleep Medicine rules for respiratory events. Some controversy regarding the scoring of respiratory events continues to exist and requires further studies to be performed.
Topics: Diagnosis, Differential; Humans; Polysomnography; Sleep Wake Disorders
PubMed: 20800000
DOI: No ID Found -
Alcoholism, Clinical and Experimental... Apr 2013This review provides a qualitative assessment of all known scientific studies on the impact of alcohol ingestion on nocturnal sleep in healthy volunteers. At all... (Review)
Review
This review provides a qualitative assessment of all known scientific studies on the impact of alcohol ingestion on nocturnal sleep in healthy volunteers. At all dosages, alcohol causes a reduction in sleep onset latency, a more consolidated first half sleep and an increase in sleep disruption in the second half of sleep. The effects on rapid eye movement (REM) sleep in the first half of sleep appear to be dose related with low and moderate doses showing no clear trend on REM sleep in the first half of the night whereas at high doses, REM sleep reduction in the first part of sleep is significant. Total night REM sleep percentage is decreased in the majority of studies at moderate and high doses with no clear trend apparent at low doses. The onset of the first REM sleep period is significantly delayed at all doses and appears to be the most recognizable effect of alcohol on REM sleep followed by the reduction in total night REM sleep. The majority of studies, across dose, age and gender, confirm an increase in slow wave sleep (SWS) in the first half of the night relative to baseline values. The impact of alcohol on SWS in the first half of night appears to be more robust than the effect on REM sleep and does not appear to be an epiphenomenon REM sleep reduction. Total night SWS is increased at high alcohol doses across gender and age groups.
Topics: Alcohol Drinking; Animals; Ethanol; Humans; Polysomnography; Sleep Stages; Sleep, REM
PubMed: 23347102
DOI: 10.1111/acer.12006 -
Journal of Clinical Neurophysiology :... Apr 2002Recent advances in the computing power and storage devices have made computer-based recording of polysomnograms (PSGs) very attractive. Digital PSGs offer the... (Review)
Review
Recent advances in the computing power and storage devices have made computer-based recording of polysomnograms (PSGs) very attractive. Digital PSGs offer the possibility of automating many tedious and time-consuming tasks of identifying sleep related events. Automation not only alleviates these laborious tasks, but also introduces a measure of objectivity in the scoring of various discrete events. In this paper we briefly review some automatic methods that have been previously developed by the authors. Automatic sleep staging methods is emphasized with some illustrative results on inter-scorer variations. We also discuss the leg movement event, respiratory event, sleep spindle and rapid-eye-movement detection methods.
Topics: Computers; Humans; Monitoring, Physiologic; Polysomnography; Sleep Stages
PubMed: 11997724
DOI: 10.1097/00004691-200203000-00004 -
Journal of Clinical Sleep Medicine :... Nov 2013Sleep hygiene recommendations are widely disseminated despite the fact that few systematic studies have investigated the empirical bases of sleep hygiene in the home... (Randomized Controlled Trial)
Randomized Controlled Trial
STUDY OBJECTIVE
Sleep hygiene recommendations are widely disseminated despite the fact that few systematic studies have investigated the empirical bases of sleep hygiene in the home environment. For example, studies have yet to investigate the relative effects of a given dose of caffeine administered at different times of day on subsequent sleep.
METHODS
This study compared the potential sleep disruptive effects of a fixed dose of caffeine (400 mg) administered at 0, 3, and 6 hours prior to habitual bedtime relative to a placebo on self-reported sleep in the home. Sleep disturbance was also monitored objectively using a validated portable sleep monitor.
RESULTS
Results demonstrated a moderate dose of caffeine at bedtime, 3 hours prior to bedtime, or 6 hours prior to bedtime each have significant effects on sleep disturbance relative to placebo (p < 0.05 for all).
CONCLUSION
The magnitude of reduction in total sleep time suggests that caffeine taken 6 hours before bedtime has important disruptive effects on sleep and provides empirical support for sleep hygiene recommendations to refrain from substantial caffeine use for a minimum of 6 hours prior to bedtime.
Topics: Adult; Analysis of Variance; Caffeine; Double-Blind Method; Female; Humans; Male; Polysomnography; Sleep; Time Factors; Wakefulness
PubMed: 24235903
DOI: 10.5664/jcsm.3170