AASM Membership Sections Newsletter Issue #2
Childhood Sleep Disorders and
Sanjeev Kothare, MD
Lynne Dâ€™Andrea, MD
Sejal Jain, MD
Indra Narang, MD
represents another advance in the unification and evolution of
higher standards for the practice of sleep medicine with the addition of
Manual for the Scoring of Sleep and Associated Events: Rules,
Terminology and Technical Specifications
from the American Academy of
Sleep Medicine (AASM). The current manual is an online exclusive avail-
The manual was released in the
fall of 2012, and AASM accredited centers must adhere to these updated
rules by no later than October 1, 2013.
As providers of care to a population of patients from one day old till
birthday, pediatric sleep medicine providers require a unique
mastery of both adult and pediatric sleep medicine skills. Understanding
subtle scoring differences between these two diverse ends of our patient
population is crucial to our ability to make the best recommendations.
In the updated manual, ages for which pediatric scoring (both visual
and respiratory rules) should be used remains unchanged: 2 months
to <18 years (recommendation), but an individual sleep specialist can
choose to score children â‰¥ 13 years of age using the adult criteria.
For infants less than two months of age, providers are directed to the
Pediatric Task Force paper: Grigg-Damberger M, Gozal D, Marcus CL,
Quan SF, Rosen CL, Chervin RD, Wise M, Picchietti DL, Sheldon SH,
Iber C. The visual scoring of sleep and arousal in infants and children.
J Clin Sleep Med 2007;3:201-40. For infants > two months of age with
indeterminate epochs of sleep, just as in the 2007 manual, the 2012 rules
allow for scoring of simply stage N in certain circumstances.
The Scoring Manual Committee has developed a detailed outline of
the differences between the 2007 version of the scoring manual and the
latest version. Individuals who purchase Version 2.0 of the scoring manu-
al can access this outline at
mend you view this document to ensure you are complying with the most
current scoring rules.
vs. 2012 - Changes to the Scoring Manual