The AASM Manual

for the Scoring of Sleep

Associated
and Associated Events
RULES, TERMINOLOGY AND TECHNICAL SPECIFICATIONS

VERSION 2.5

Richard B. Berry, MD (Chair); Claude L. Albertario, RST, RPSGT; Susan M. Harding, MD;
Robin M. Lloyd, MD; David T. Plante, MD; Stuart F. Quan, MD; Matthew M. Troester, DO;
Bradley V. Vaughn, MD; for the American Academy of Sleep Medicine

A AS D¡V American Academy of

> 0)0) IV ÍÁ SLEEP MEDICINE”

Ali Content O 2018 American Academy of Sleep Medicine AASM Scoring Manual Version 2.5 1
 605361, U.5.A,
2013 American Academy of Sleep Medicine, 2510 North Frontage Road, Darien, IL 60561,
Copyright O 2018 U.S.A,

Yearly subscriptions to the online manual are available at www.aasm.org.

reserved, Unauthorized reproduction or transmission of this manual or any portion thereof in any
All rights reserved.
form or by any means, mechanical or electronic, is strictly prohibited.

Correspondence regarding copyright permissions should be directed to the American Academy of Sleep
U,S.A. Translations to other languages must be
1L 60561, U.S.A.
Medicine, 2510 North Frontage Road, Darien, IL
U.S.A,
authorized by the American Academy of Sleep Medicine, U.S.A.

Recommended Citation:
al.; for the American Academy of Sleep Medicine. The AASM
Berry RB, Albertario CL, Harding SM, et al;
Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications.
2.5, Darien, IL: American Academy of Sleep Medicine; 2018.
Version 2.5.

2 —AASM Scoring Manual Version 2.5

AASM Sleep Medicine
All Content O 2018 American Academy of Steep
Alí
Table of Contents

Contributors 4

Dedication 6

I. User Guide
Guide 7

Polysomnography
I1. Parameters to be Reported for Polysomnography
Il. 8

111. Technical and Digital Specifications

TT. 72

IV. Sleep Staging Rules

Part 1: Rules for Adults 77
17
Part 2: Rules for Children 33
Part 3: Rules for Infants 37

Y, Arousal Rule
V. 46

VI. Cardiac Rules 47

VII. Movement Rules 49

VIII. Respiratory Rules

Part 1: Rules for Adults 56

Part 2: Rules for Children 62

IX, Home Sleep Apnea Testing (HSAT) Rules for Adults

IX.
Part 1: HSAT Utilizing Respiratory Flow and/or Effort Parameters 66
Part 2: HSAT Utilizing Peripheral Arterial Tonometry (PAT) 72

X. Development Process 75

XI. Procedural Notes 76

XII. Glossary of Terms 88

Contributors

DIGITAL
Editors Task Forces Thomas Penzel, PhD,
PAD, Chair
of Medicine,
University Hospital, Department ef
VERSION
VERSION 2.5
2.5 (2018)
(2018) FIRST EDITION (2007-2011) Germany
Steep Laboratory, Marburg, German

Richard B. Berry, MD, Chair Max Hirshkowitz, PhD, Co-Chair

AROUSAL end VANMC,
Bavlor College of Medicine and VANC,
Claude L. Albertario, RST, RPSGT
Michael H. Bonnet, PhD, Chair
Michae) Houston, TX
TN
Harding. MD
Susan M. Harding, Wright
Wrighi State University, Davton,
Davion. OH
Robin M.
M, Lloyd, MD Nic Butkov, RPSGT
Doghramji, MD
Karl Doghraraji, School! Polvysomnaography, Medford, OR
School of Clinical Polysomuographiy,
David T. Plante, MD
Thomas Jefferson University, Philadelphia, PA
Stuart F. Quan, MD Ronald D. Chervin, MD, MS
Matthew M. Troester, DO Timothy Roechrs,
Rochrs, PhD University of Michigan, Anm Arbor, Mi
Arm Arbar,
Siete University, Detroit, Mi
Wayne State MI
Y. Vaughn, MD
Bradley V. Meir Kryger, MD
Phi, Stalí
Sherens M, Thomas, PhD,
Sherene Staff Stephen Sheldon, DO, FAAP af Manitoba, Winnipeg, MB Canada
University of
Children's Memorial Hospital, Chicago, IL
HL
VERSION (2057)
2.4 (2017) PaD, RPSGT
Clete A. Kushida, MD, PhD,
Edward J.J, Stepanski, PhD Stanford University, Stanford, Cd
CA
Richard B. Berry, MD, Chair Cemer, Chicago, IL
Rush University Medical Center, 1L
Rita Brooks, MEd, RST, RPSGT Beih A. Malow, MD, MS
Beth
Choerdene E. Gamaldo, MD
Charlene
MID
Arthur S. Walters, MD Universitr. Nashville, TN
Vanderbilt University,
NJ
NI Nenroscience
Neuroscience Institute
institute at JFK Medical Center,
Susan M. Harding, MD Edisom, NJ
Edison, Micharci H.H, Silber, MBCHB
Michael MBChB
Robin M. Lloyd, MD Alavo Clinic
Mayo Clínic College of Medicine, Rochester, MN
S, Wise, MD
Merrill S.
Stuart F. Quan, MD Michae) V, Vitello, PhD
Michael
Healibicare Sleep Disorders Center,
Merhadist Healthcare
Methodist
Troester, DO
Matthew M, Froester, Meniphis, TN
Memphis, University of Washington, Wet
Seaule, Wa
Waskhingron, Seattle,
Bradley Y. Vaughn, MD
Andrew L. Chesson Jr, MD Chessan Jr, MD
Andrew L. Chesson
2.0,2-2.3 (2013-2016)
VERSION 2.0.2—-2.3 (2013-2016) Sciences Center in Shreveport,
LSU Health Sclences LSU Comer in Shreveport,
Heolth Sciences Center
£LSU Health Shrevepor:,
Shreveport, LA Shreveport. LA
Shreveport,
B, Berry, MD
Richard B.
Rita Brooks, MEd, RST, RPSGT GERIATRIC
CARDIAC
Charlene E, Gamaldo, MD
Sean M. Caples, DO, Chair Ancoli-Isracl, PhD, Chair
Sonia Ancoli-Israci, Choir
Susan M. Harding, MD CA
Coliforia, San Diego, Ca
Untversiv of Califorma,
University
ef Medicine, Rochester, MN
Clínic College of
Mayo Clinic
Robin M. Lloyd, MD
Virend K. Somers, MD, PhD, Co-Chair
Co-Chaís PhD
Donald L. Bliwise, PHD
Carole L. Marcus, MBBCh Emorv
Emory Uinversity
University Medical School.
School, Atlanta, GA
Ga
uf Medicine, Rochester, MN
Alavo Clinic College of
Mayo
Bradley Y. Vaughn, MD
Michael E. Adams, Research Associate Susan Redline,
Redlíne, MD, MPH
2.0—2.0,1 (2012-2013)
VERSION 2.0-—2.0.1 Kinysport, TN
Vallev Medical Center, Kingsport,
Holston Valley Western Reserve University, Cleveland, OH
Case Westera
Richard B. Berry.
Berry, MD Edward Stepanski, PhD
William G. Cotts, MD
Rita Brooks, MEd, RST, RPSGT Universitr, Chicago, IL
Northwestern University,
Nortiwestern TL Rush University
Umversin: Medical Center, Chicago,
Chicago. IL
TL
Charlene E.E, Gamaldo, MD
Parvin Dorastkar,
Dorostkar, MD Michael Y. Vitiello,
Vitiello, PhD
M., Harding, MD
Susan M. University of Washington, Seattle, WA
Rainbow Babies and Children's Hospital,
Carole L. Marcus, MBBCh Cleveland, OH
Timothy I. Morgenthaler, MD
Bradley V.Y. Vaughn, MD
Thomas Kara, MD MIN
Mayo Clinic College of Medicine, Rochester, MN
FIRST EDITION (2007-2011) Medicine, Rochester, MN
Mayo Clinic College of Medicine.
iber, MD
Conrad Jber,
MOVEMENTS
Timothy 1.h. Morgenthaler, MD
Ancoli-Israel, PhD
Sonia Ancoli-1sracl, Mavo Clinic College of
Mayo Medichie, Rochester, MN
af Medicine, Arthur S, Walters, MD, Chair
JFK Medical Center, Edison, NJ
NS
Andrew L. Chesson Jr, MD Carol L. Rosen, MD
Siuart £.F, Quan, MD
Stuart ard Children's Hospital,
Rainbow Babies and Richard P. Allen, PHD
PAD
Cleveland, OH Jolms Hopkins University, Baltimore, MD
Johws MO

Consultants Stepanski, PhD

Edward J. Siepanski, Donald L. Bliwise, PhD
1
Rush University Medical Center, Chicago, IL Emory Schaol, Atlanta, GA
Universitv Medical School,
Emorv University

VERSION 2.2 (2014-2015) Win K. Shen, MD Sudhansu Chokroverty, MD, FRCP

Mavo AIN
Mayo Clinic College of Medicine, Rochester, AN NY Neuroscience
NJ Jastitte at
Nentroscicnce Institute FEK Medical Center,
ar JFK
INFANT SLEEP STAGING Kalyanam Shivkumar, MD
Edison, NJ
NI

Madeleine Grigg-Damberger, MD School of Medicine at UCLA,

David Geffen Suhool Wayne A. Hening, MD, PhD
University af
of New Mexico Sehoal of Medicine,
Alexico School Los Angeles, CA
Ca UMDNJ - RW Johnson Medical School,
RI Johnson Non
Sehoot, New
Albuquerque, NM Brunswick,
Brsmswick, NJNI
Conrad Iber,
1ber, MD
Mark S. Scher, MD Hennepin County Medical Center and Universitr
University Clete A. Kushida, MD, PhD, RPSGT
Case Western Reserve University, Cleveland, OH of Minnesota Medical School, Minneapolis, MNMIN Sranford Stanford, CA
Siaunford University, Sianford

(ABNA Amarirar
AASM Scoring Manual Version 2.5 Content Q 2018 American Academy of Sleep Madicine
Ail Con
Gilles Lavigne,
Gilles DMD, PhD,
Lavigne, DMD, FRCD
PhD, FROD Vishesh K. Kapur, MD, MPH
Universite de Montreal Sleep Disorder Laboratory,
Universtte UIVIP Medicine ef
Afedicine Sleep Center, University of Acknowledgements
Coemr Hospital, Montreal, QC Canada
Sacre Coeur Washington,
Washingron, Seattle,
Seasste, WA

Picehictti, MD
Daniel Picchietti, Rohí Budhiraja, MD
Rohit The American Academy of Slecp
Tlw Slexp Medicine
iHinais, Urbana, 1L
Untversiv of Mlinois,
Universitv IL Southern Arizona VA Systeín, Sonthern
Healthcare System,
VÁ Healtlicare Southern acknowledpes the 2017-2018 Board of Directors
acknowledges
Arizona, Tucson, AZ that served over the course of this project and
Ancoli-Israel, PhD
Sonia Ancoli-[srael, provided direction and support:
Califorma, San Diego, CA
University of Califoria, Cál Susan Redline, MD, MPH M. Rosen, MD, MS
blene M,
llene
Israci
Bcih Israel
Brigham and Women's Hospital, Beth
Douglas Kirsch, MD
Deaconess Medical Center and Harvard Medical
PEDIATRIC School, Boston, MA Ronald D,D. Chervin, MID,
MD, MS
Madelcine Grigg-Damberger, MD, Chair Kelly A. Carden, MD, MBA
University of New Mexico
Mexteo School
Sehoal of Medicine, VISUAL (SLEEP STAGING) Nisha Aurora, MD
R. Nisho
eibrquerque. NM
Albuquerque, Michael H. David Kristo, MD
Michael H, Silber, MBChB, Chair
David Gazal,
Goza!, MD, Co-Chair Clínic College of Medicine, Rochester, MN
Mavo Clinic MIN Raman Malhotra, MD
University of
University of Louisville, Lomisville,
Louisville, KY Jennifer Martin, PhD
Ancoli-Isracl, PhD
Sonia Ancoli-Israel,
University of California, San Diego, CA
Umiversite Eric Olson, MD
Carole L. Marcus, MBBCh
of Pennsylvania, Philadelphia, Pa
Universitr of
University PA Kannan Ramar, MD
Michael H. Bonnet, PhD
PHD
Carol Rosen, MD
Weight State
Wrighi Srate University,
Universin, Dayton,
Dayion, OH
Timothy [. Morgenthaler, MD James Rowley, MD
Afayo nf Medicine, Rochester, MN
Mayo Clinic College of Sudhansu Chokroverty, MD, FRCP Ven Hol
Steve Van Hout
NJ Neuroscience Institute
institute at JFK
JFK Medical Center, Exccitive Director
Executive
Carol L. Rosen, MD
Reinbon Babies and Children's Hospital,
Rainbow Edison, NJ
Alí scoring schematics that provide illustration of
All
Of
Cleveland, OH Grige-Damberger, MD
Madeleine Grige-Damberper, slecp staging, respiratory and movement scoring
stagine, respicatory
University
Universitv af
of New Mexico School
Sehool of Medicine, rules were provided by Richard B. Berry, MD.
rulos
Stephen Sheldon, DO, FAAP
Albuquerque, NM
Children's Memorial Hospital, Chicago, IL
Childrer's
Hirshikowitz, PhD
Max Hirshkowitz,
Stuart F. Quan, MD
Baytar College of
Bavlor af Medicine and VAMC,
VAMC.
Brighant end Women's Hospital and
Brigham and und Harvard
Housion, TX
Houston, TN
Medical School, Boston, MA
Sheldon Kapen, MD
RESPIRATORY Wavne Srare
State University Medical
Medical School and
FVAMC, Detroit, MI
Chair
Richard B. Berry, MD, Chawr
ef Florida Health Science Center,
University of Sharon Keenan, PhD, ABSM, RPSGT, REEGT
Guinsville,
Gainsville, FL Inc . Pala
The School for Sleep Medicine, Inc., Also, Cal
Palo Alio, CA

Carole L,
L. Marcus, MBBCh Meir Kryger, MD
Pal
Pennsyivania, Philadelphia, PA
University of Pennsvivanta, University of Manitoba.
Universitv Manitoba, Winnipeg. MB Canada
Winripeg. MB

Sairam Parthasarathy, MD Thomas Penzel, PhD

oud University of Arizona, Tucson, AZ
SAVAHCS and University Hospital, Department of Medicine,
Universitv
Sleep Laboratory, Marburg. German
Marburg, Germanv
Conrad Iber, MD
Hennepin Comity
County Medical Center and University Mark Pressman, PhD
of Minnesota Medical School, Minneapolis, MN
Wvimewvod. PA
Lankenau and Paoli Hospitals, Wvimewood.
Conrad Iber, MD
Mebra, MD, MS
Reena Mehra,
Cormnty Medical Center and University
Hennepin County
Hernepin
Case Western Reserve University, Cleveland, OH
of Minnesota
Minnesora Medical School,
School. MN
Daniel J.J, Gottlicb,
Gottlieb, MD
VA Boston Healthcare System and Boston
Umversitv School of Medicine, Boston, MA

Strohi, MD
Kingman Stroh!l,
Case Western Reserve University, Cleveland, OH

Stuart F. Quan, MD
Woncws Hospital and Harvard
Brigham and Women's
MÁ
Afedical School, Boston, MA
Medical

Sally L. Davidson Ward, MD

Children's Hospital of Los Angeles, Keck School of
Universiv of Southern California. Los
Medicine, University
emgeles, CA
Angeles,

David Gozal, MD
Corner Children's Hospital and Universitv of
Chicago, Chicago, IL
1L

Sleep Medicine
Al Content O 2018 American Academy of Sieep
All AASM Scoring Manual Version 2.5 5
 Dedication

The Scoring Manual Editorial Board acknowledges the invaluable

service of our colleague and friend, Carole L. Marcus, MBBCh,

who served on this Board from 2012-2016.

6 AASM Scoring Manual Version 2.5

|. User Guide

Organization of the Manual

The AASM Manual for the Scoring of Sleep and Associated Evenis Events is designed to guide users through the technical aspects of
conducting routine polysomnography (PSG) testing as well as the analytic scoring and interpretation of PSG results. results, The rules
for PSG testing and scoring are divided over seven chapters (H-VIID
(H-VI1II) of the manual. Chapter 11 specifies all of the parameters
that should be reported in a routine PSG test. test, Chapter 111 details the digital and filter settings that are recommended for routine
PSG recording. Chapters 1V-VIII[V-VII! provide additional technical specifications as well as scoring rules for the major categories
of testing: sleep staging, arousal, cardiac, movement, and respiratory. Chapter 1X IX provides technical specifications and scoring
rules for home sleep apnea testing including those utilizing respiratory flow and/or effort and those utilizing peripheral arterial
tonometry (PAT). Chapter X (Development Process) details the process by which the rules were developed. An outline of the
evidence level and decision-making process for each rule may be found in chapter XI (Procedural Lastiy, chapter XII is
Notes). Lastly,
a glossary of the terminology used throughout the manual.

While the rules in most chapters apply to patients of all ages, rules for adult and pediatric populations are separated in chapters
age»specific differences in testing and scoring.
1V (Sleep Staging Rules) and VIII (Respiratory Rules) due to critical age-specific

The rules within each chapter are organized into categories designated by an upper case letter. The rules themselves are num-
letters.
thal are identified by lower case letters,
bered and may have several components that

IN EACH SECTION, ALONG WITH THE RULES, YOU WILL NOTICE:

The type of rule:

RECOMMENDEO|
RECOMMENDED. — These rules are recommended for the routine scoring of in-laboratory
polysomnography or home sleep apnea testing.

ACCEPTABLE
ACCEPTABLE These are rules that may be used as alternatives to the recommended rules at the
discretion of the clinician or investigator,
investigator.

OPTIONAL These are suggested rules for uncommonly encountered events, events not known to
decision.
have physiologic significance or events for which there was no consensus decision,
Scoring may be performed at the discretion of the clinician or investigator.

ofaa category in order to provide additional information that is

Notes: If applicable, notes are positioned alat the end of
(ex.>'>*),
critical for carrying out the rules. Rules are followed by superscripts that signify the corresponding note (ex.*!**),

Sleep Facility Accreditation

AASM sleep facility accreditation requires compliance with all of the rules, definitions, and notes in this manual. According
to the AASM, rules specified to be recommended, acceptable, or optional are all acceptable methods for scoring. Based
on the discretion of the clinician or investigator, a specific center or laboratory may use the acceptable rule in place of the
acereditation. Optional rules may be followed in addition to the recommended and
recommended rule without any risk to accreditation.
acereditation. For further information please contact the accreditation department at the
acceptable rules without any risk to accreditation.
AASM (acereditationíJansm.org).
(accreditation(Vaasm.org).

Al Content 18 American Academy of Sleep Me AASM Scoring Manual Version 2.5 7

Il. Parameters to be Reported for Polysomnography
ll.
Recommended parameters must be reported. Optional parameters may be monitored at the
discretion of the clinician or investigator and if monitored, should be reported.

A. General Parameters

1. Electroencephalogram
Electroencecphalogram (EEG) derivations RECOMMENDED

Electroaculogram (EOG) derivations

2. Electrooculogram RECOMMENDED

3. Chin electromyogram (EMG) RECOMMENDED

4. Leg electromyogram (EMG) RECOMMENDED

5. Airflow signals RECOMMENDED

6. Respiratory effort signals RECOMMENDED

7. Oxygen saturation RECOMMENDED

8. Body position RECOMMENDED

9, Electrocardiogram (ECG) RECOMMEND ED

RECOMMENDED

B. Sleep Scoring Data

1. Lights out clock time (hbr:min)

(hr:min) RECOMMENDED

2. Lights on elock
clock time (hr:min) RECOMMENDED

sicep time (TST; time spent in

3, Total sleep ín N1
NJ + N2 + N3 + R, in min) RECOMMENDED

4, Total recording time (TRT; “lights out” to “lights on” in min)

4. RECOMMENDED
RECOMMENDED

5. Sleep latency (SL; lights out to first epoch of any sleep in min) RECOMMENDED

6. Stage R latency (sleep Bhrst epoch of stage R in min)

(sicep onset to first RECOMMENDED

slecp onset (WASO; TRT -— SL —— TST, in min)

7. Wake after sleep RECOMMENDED

TRT x 100)
8. Percent sleep efficiency (TST //TRT RECOMMENDED

9, Time in each stage (in min) RECOMMENDED

TST in cach stage (time in each stage

10. Percent of TST TST) x 100 RECOMMENDED

iime out of bed. Time with the patient

afler sleep onset includes all wake activity, including time
Note 1.|. Wake after
should be scored as stage W. Brief episodes of sleep during this
disconnected from the recording equipment shoutd
time, if they occur, are not considered significant for the stage scoring summary.
C. Arousal Events

1. Number of arousals RECOMMENDED

RECOMMENDED

2. Arousal index (Arl; number of arousals x 60 / TST) RECOMMENDED

RECOMMENDED

D. Cardiac Events

1. Average heart rate during sleep RECOMMENDED

RECOMMENDED

2.2, Highest heart rate during slecp

stecp RECOMMENDED
RECOMMENDED

3. Highest heart rate during recording RECOMMENDED

RECOMMENDED

4. Occurrence of bradycardia (if observed); report lowest heart rate RECOMMENDED

RECOMMENDED

Occurrence of asystole (if observed); report longest pause

5. Oceurrence RECOMMENDED
RECOMMENDED

6. Occurrence
Occurrenee of sinus
sinus tachycardia
tachycardía during sicep
slecp (if observed); report highest heart rate RECOMMENDED
RECOMMENDED

narraw complex tachycardia (if observed); report highest heart rate

7. Occurrence of narrow RECOMMENDED
RECOMMENDED

8. Occurrence of wide complex tachycardia (if observed); report highest heart rate RECOMMENDED
RECOMMENDED

9. Occurrence of atrial fibrillation (if

(¡fobserved);
observed); report average heart rate RECOMMENDED

Occurrence of other arrhythmias (if observed); list arrhythmia

10. Oceurrence RECOMMENDED

E. Movement Events

sleep (PLMS)
1. Number of periodic limb movements of slecp RECOMMENDED
RECOMMENDED

2. Number of periodic limb movements of sleep (PLMS) with arousals RECOMMENDED

RECOMMENDED

3. PLMS index (PLMSI; PLMS x 60 / TST) RECOMMENDED

RECOMMENDED

(PLMSA rf; PLMS with arousals x 60 / TST)

4.4, PLMS arousal index (PLMSArl; RECOMMENDED
RECOMMENDED

1t O 2018 8 Am
American A dicine AASM Scoring Manual Version 2.5 9
 Events”
F. Respiratory Events*

apricas
1. Number of obstructive apneas RECOMMENDED

2. Number of mixed apneas RECOMMENDED

3. Number of central apneas RECOMMENDED

4.4, Number of hypopneas RECOMMENDED

obstructiva hypopneas
5.5, Number of obstructive OPTIONAL

6. Number of central hypopneas OPTIONAL

7. Number of apneas + hypopneas RECOMMENDED

8. Apnea index (Al; (% obstructive apneas + % central apneas + $ mixed apneas) x 60 1/ TST) RECOMMENDED

9,9. Hypopnea index (HI; +% hypopneas x 60 //TST)

TST) RECOMMENDED

Apnea-hypopnea
10, Apnea-hypopne a index (AH1; (+f apneas ++ hypopneas) x 60 / TST)
(AH 1; (++ RECOMMENDED

apnea-hypopuea index (OA HI; ($ obstructive apneas +

11. Obstructive apnea-hypopnea mixed apneas + OL
hypopricas) x 60 //TST)
Hfi obstructive hypopneas) TST) SOI

+% central hypopneas) x 60 / TST)

12. Central apnea-hypopnea index (CAHI; (*(+f central apneas ++ OPTIONAL

cfiort-related arousals (RERASs)

13. Number of respiratory effort-related OPTIONAL

14. Respiratory effort-related arousal index (RERA index; f of RERAs x 60 TST)

TST) grDONAS
OPTIONAL

+ 4 RERAs) x 60
15. Respiratory disturbance index (RDI; (*(+ apneas +++ hypopneas ++ TST) OPTIONAL

24% *%*
16. Number of oxygen desaturations >3% or >4% OPTIONAL

17. Oxygen desaturation index >3% >3% or 24%

>23% or 24% (ODI; %4 oxygen desaturations 23% 60.
4% x 60 TST) OPTIONAL

18, Arterial oxygen saturation, mean value

18. RECOMMENDED
RECOMMENOKO

slecp“
19. Minimum oxygen saturation during slecp* RECOMMENDED

20. Occurrence of hypoventilation during diagnostic study Y**

Adults
Adults OPTIONAL

Children RECOMMENDED

21. Occurrence of hypoventilation during PAP titration *

Adults OPTIONAL

Children OPTIONAL

22, Occurrence of Cheyne-Stokes breathing in adults Y**

22. RECOMMENDED

10 AASM Scoring Manual Version 2.5