The Polysomnogram Assay: A Method to Represent the Overnight Polysomnogram in a Condensed Format

We present the polysomnogram assay (PSGA), a new representation format for the polysomnogram (PSG), designed to assist in the interpretation of overnight PSG studies. The technique condenses the PSG record by a factor of 30 while preserving the ability to portray PSG features of diagnostic relevance, including sleep architecture, arousals, movement, leg jerks, cyclic alternating pattern, and increased breathing effort. The PSGA patterns associated with these events are described and illustrated by examples. The new format considerably reduces the effort required to evaluate sleep quality and continuity, making it more practicable for the polysomnographer to interpret the entire overnight PSG study. The compressed time scale also facilitates analysis of relatively long PSG episodes and allows assessment of signal activity surrounding critical PSG events. The PSGA appears capable of improving identification of arousals, leg jerks, and upper airway resistance, and may be especially amenable for automatic analysis of PSG data.

[1]  J E Earis,et al.  Arousal responses from apneic events during non-rapid-eye-movement sleep. , 1995, American journal of respiratory and critical care medicine.

[2]  C J Griffiths,et al.  Interobserver variability in recognizing arousal in respiratory sleep disorders. , 1998, American journal of respiratory and critical care medicine.

[3]  J. Stradling.  Handbook of Sleep-Related Breathing Disorders , 1993 .

[4]  E. Wolpert.  A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects. , 1969 .

[5]  C Guilleminault,et al.  A cause of excessive daytime sleepiness. The upper airway resistance syndrome. , 1993, Chest.

[6]  N J Douglas,et al.  Factors impairing daytime performance in patients with sleep apnea/hypopnea syndrome. , 1992, Archives of internal medicine.

[7]  C. Guilleminault,et al.  EEG arousals: scoring rules and examples: a preliminary report from the Sleep Disorders Atlas Task Force of the American Sleep Disorders Association. , 1992, Sleep.

[8]  J. Stradling,et al.  Sleep fragmentation indices as predictors of daytime sleepiness and nCPAP response in obstructive sleep apnea. , 1998, American journal of respiratory and critical care medicine.

[9]  The Upper Airway Resistance Syndrome , 1993 .

[10]  T. Pedley.  Current Practice of Clinical Electroenceph‐alography , 1980, Neurology.

[11]  L Parrino,et al.  Polysomnographic analysis of arousal responses in obstructive sleep apnea syndrome by means of the cyclic alternating pattern. , 1996, Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society.

[12]  A Bartolo,et al.  Analysis of diaphragm EMG signals: comparison of gating vs. subtraction for removal of ECG contamination. , 1996, Journal of applied physiology.

[13]  Ernst Fernando Lopes Da Silva Niedermeyer,et al.  Electroencephalography, basic principles, clinical applications, and related fields , 1982 .

[14]  B. Clymer,et al.  Automatic on-line detection of apneas and hypopneas , 1997, Proceedings of the 19th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. 'Magnificent Milestones and Emerging Opportunities in Medical Engineering' (Cat. No.97CH36136).