AASM Membership Sections Newsletter Issue #3
19
to make appropriate changes and also instructing
the bed partner to sleep elsewhere until the RBD is
under control.
Miscellaneous - REM Sleep Without Atonia
Sustained Tonic Activity
in the chin EMG during
REM: defined as an epoch of REM with at least 50%
of duration with chin amplitude greater than the
minimum amplitude in NREM.
Excessive Transient Muscle Activity (TMA)
during
REM sleep in the chin or limb EMG: In a 30 sec ep-
och divided in 10 sequential 3 second mini-epochs,
at least 5 (50%) of the mini epochs should have bursts
of TMA. The bursts of transient activity are 0.1 to
0.5
sec in duration and at least 4 times as high as the
back ground EMG activity.
Note: For ICSD-2 Diagnosis, Dream Enacting
Behavior can be from PSG/Video or History
Channel Key List
•
E1, left outer canthus eye electrode
•
E2, right outer canthus eye electrode
•
M1, left mastoid electrode location
•
M2, right mastoid electrode location
•
C3, left central electroencephalography (EEG)
electrodes
•
C4, right central occipital electroencephalography
electrode
•
Standard electrocardiogram (EKG) lead
•
Electromyographic (EMG) electrodes, LAT1-
LAT2 and RAT1-RAT2, left and respectively right
lower limbs electromyography electrodes
•
Chin EMG
•
SNORE, snore sensor sound
•
CFLO, mask flow-of CPAP
•
CHEST, chest walls motion effort
•
ABD, abdominal walls motion effort
•
SpO2, percent oxygen saturation by pulse
oximetry
Questions for Thought
1.
Why do you think this patient did not remember
his dream?
2.
Is it possible that the patient may have had RBD
due to previous suboptimal titration pressure or
due to on going titration?
3.
If any ENT surgical intervention was subsequent-
ly done, and the patients breathing improved to
tolerate CPAP, would the RBD improve?
References Cited
1.
International Classification of Sleep Disorders,
2
nd edn.: Diagnostic and Coding Manual. West-
chester, Illinois: American Academy of Sleep
Medicine, 2005.
Figure 4
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