Nouvelles règles pour scorer les événements respiratoires du sommeil chez l'adulte : rapport de l'American Academy of Sleep Medicine 2013

In 2012 the American Academy of Sleep Medicine (AASM) Sleep Apnea Definitions Task Force reviewed the rules for scoring respiratory events. The new rules are published online with regular updates as necessary. The last version dates at September 2013. The goals were to clarify and simplify the scoring rules, to review evidence for new monitoring technologies relevant to the scoring rules, and to strive for greater concordance between adult and pediatric rules. In summary, the following rules are recommended for adults: apnea is scored when there is a drop in the flow signal by ≥90% using an oronasal thermal sensor (diagnostic study) or PAP device flow (titration study), for ≥10 seconds; hypopnea is scored when there is a drop in the flow signal by ≥30% using nasal pressure (diagnostic study) or PAP device flow (titration study), for ≥10 seconds in association with either ≥3% arterial oxygen desaturation or an arousal; Cheyne-Stokes breathing is scored when there are episodes of ≥3 consecutive central apneas and/or central hypopneas separated by a crescendo and decrescendo change in breathing amplitude with a cycle length of at least 40 seconds, and there are ≥5 central apneas and/or central hypopneas index over a minimum of 2 hours of monitoring; sleep hypoventilation is scored when the PCO2 is >55 mmHg for ≥10 minutes or when there is an increase in the PCO2 ≥10 mmHg to a value >50 mmHg for ≥10 minutes.