AASM指南分析课件.pptVIP

* * * * * * * * * * * * * * * * * * * New EEG montages including frontal derivations, combined with the existing central and occipital derivations, are recommended. The frontal derivations were recommended for clearer identification and maximal occurrence of K-complexes and slow wave activity. EOG placement has been slightly revised as well as an alternative recommendation given. The electrode placement for EMG is now clearly defined, which was not in the previous RK manual; three electrodes, including one mental and two submental electrodes, are recommended. For the electrocardiograph, lead II placement is recommended. * * * * * * * * * * * * * * * SCORING OF SLEEP STAGES The terminology has slightly changed with wake now being referred to as stage W, and stages N1, N2, and N3 referring to the old NREM stages 1, 2, and 3; REM should now be labeled stage R. Stage N3 represents slow wave sleep and replaces the RK nomenclature of stage 3 and stage 4 sleep. Each stage now includes more detailed definitions and rules as well as procedural notes (figures are included in the manual to give some examples of the rules). The previous 3 minute rule has now been abolished; therefore, the biggest impact will be noticed in the scoring of N2. N2 sleep can be scored as soon as one or more K-complexes unassociated with arousal or one or more trains of sleep spindle occur in the first half of the epoch or the last half of the previous epoch. Major body movements are now either scored as stage W (if more than 15 seconds of alpha is present for any part of the epoch or if an epoch of stage W precedes or follows the movement) or scored as the same stage as the following epoch. * * * * * Arousal scoring should incorporate information form the occipital and central derviations Scoring of arousal can be improved by getting information from the respiratory events and / or additional EEG channels. * * * Classification of Arrhythmias Arrhythmias may be divided into narrow complex