V 2.2 of the American Academy of Sleep Medicine (AASM) Manual for the Scoring of Sleep and Associated Events was released on July 1, 2015. The Scoring Manual Editorial Board (previously the Scoring Manual Committee) would like to call attention to the most important changes. As discussed below, there are two new major chapters providing rules for the staging of infant sleep and scoring respiratory events in home sleep apnea testing (HSAT) studies. The new chapters were approved by the AASM Board of Directors to fi ll two obvious gaps in the Scoring Manual. The Scoring Manual Editorial Board would like to emphasize that any changes in the manual are instituted after long deliberation and consultation with area content experts. Version 2.2 of the Scoring Manual, for the fi rst time, includes rules for scoring sleep studies in term infants less than two months of age. This milestone acknowledges the importance of studying sleep across the lifespan, beginning with our youngest patients. The new scoring rules address sleep staging in infants and are based on the classic infant scoring rules of Anders et al.1 Development of these new rules benefi tted from expert consultation from Madeleine Grigg-Damberger, MD, and Mark Scher, MD. One important difference between the current manual and Anders is that sleep is now classifi ed into three stages: REM, NREM and transitional, as compared to the Anders classifi cation of active, quiet and indeterminate sleep. This new classifi cation was based on the physiologic similarities between active and REM sleep, and quiet and NREM sleep. Further, it was realized that young infants have stages of sleep that manifest elements of both REM and NREM sleep; hence, the term “transitional” rather than “indeterminate.” Note that respiratory events in infants should be scored using the standard AASM pediatric scoring criteria. Version 2.2 of the AASM Scoring Manual now also includes scoring rules for adult Home Sleep Apnea Testing (HSAT; chapter IX). The foundation for the development of these rules includes the work of the 2010 AASM Out-of-Center Task Force who developed the SCOPER (Sleep, Cardiovascular, Oximetry, Position, Effort, Respiratory) classifi cation system.2 This classifi cation system systematically evaluated available technology and evidence for diagnosing obstructive sleep apnea using portable devices. These new HSAT scoring rules allow for standardization of scoring and reporting data generated from HSAT AASM Scoring Manual Version 2.2 Updates: New Chapters for Scoring Infant Sleep Staging and Home Sleep Apnea Testing Richard B. Berry, MD1; Charlene E. Gamaldo, MD2; Susan M. Harding, MD3; Rita Brooks, MEd, RST, RPSGT4; Robin M. Lloyd, MD5; Bradley V. Vaughn, MD6; Carole L. Marcus, MBBCh7 1University of Florida, Gainesville, FL; 2Johns Hopkins University, Baltimore, MD; 3University of Alabama, Birmingham, AL; 4Capital Health, Hamilton, NJ; 5Mayo Clinic, Rochester, MN; 6University of North Carolina, Chapel Hill, NC; 7Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA