REM SCORING of PLM

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REM SCORING of PLM

Postby Lonelynights » Fri Apr 22, 2016 10:29 am

I work in a lab that does not keep up to date on new scoring rules (when I started in 2011 they still scored sleep onset at 3rd consecutive epoch of sleep ) and has the misfortune of having an incredible lazy, very strongly opinionated lead scoring tech.

We have been told recently, if there are no other incidents of leg movements, not to score PLM in REM. That some people " just move their legs while they dream"
I have not been able to find anything to confirm this information.


ALSO
Respiratory events that meet scoring criteria but clearly start during an arousal. Scoreable or not?
We were told if the epoch is scored as sleep the event counts even if starts in an arousal.
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Re: REM SCORING of PLM

Postby StuKing » Tue Apr 26, 2016 4:00 am

Shame when you feel like you're pushing uphill.

The AASM rules (current and all the way back to at least v2.0) do not mention any rules regarding sleep stages for marking limb movements, just their duration and amplitude (and then frequency for scoring PLMS). According to the rules, if the limb movements are present, they should be scored regardless of sleep stage. Same goes for PLMS.

For REM, the rules for REM Sleep Behavior Disorder can be applied (particularly transient muscle activity if the limb movements qualify), but there is a note that:
Transient muscle activity and occasional accompanying visible twitching of small muscle groups are a normal phenomenon seen in REM sleep. When larger muscle groups are involved, this activity is not associated with large, overt muscular activity acting across large joints. When smaller muscle groups are involved, the movement often involves the distal muscles of the hands and face or the corners of the mouth. Transient muscle activity may be excessive in RBD.


If the lab is accredited then it is a pretty serious breach to not keep up-to-date; the rules MUST be applied by October of the year they are released. It doesn't matter if the lead tech thinks the limb movements should be scored or not, and frankly it doesn't really matter if they're right or not. The rules are the rules, and for the purpose of standardisation and reproducibility they should be followed.
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Re: REM SCORING of PLM

Postby Lonelynights » Wed Apr 27, 2016 7:01 am

Thank you very much.

Any opinion on the respitory event scoring?
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