S1-2 The clinical and polysomnographic features relevance of idiopathic REM sleep behavior disorders

Abstract

For a long time has Rechtschaffen and Kales (R&K) manual been considered as the sleep community’s bible for sleep scoring. This manual was published in 1968, intending to achieve the consensus among a small number of sleep researchers. However, it survived following 40 years as the essential manual for clinicians and sleep technologists due to its powerful utility. One of the characteristics of R&K scoring criteria is that it is based on epoch-by-epoch sleep staging. Later in 1970s when the concept of sleep apnea syndrome (SAS) was introduced, scoring respiratory events became essential. With the recognition of SAS, sleep gained the status as a clinical subject, which involved treating patients for having a good sleep. As a result, scoring criteria of EEG arousals and periodic leg movements were developed by the American Sleep Disorders Association in early 1990s for more extensive evaluation of sleep quality and sleep-related phenomena. These criteria basically formulated the rules to count defined events, and were incorporated in sleep staging of the R&K manual, which made it difficult for beginners to master them without proper on-the-job training. In 2007, American Academy of Sleep Medicine (AASM) completed a new manual for the scoring of sleep and associated events including cardiac, movement, and respiratory events. Although there has been a controversy on the use of this manual, it should be valued as the first attempt to unite all the measurements necessary for sleep scoring through reviewing numerous articles in pursuit of validity or reliability of measures. However, one thing we should bear in mind is that the AASM manual was developed with the purpose to provide a guideline for AASM accredited sleep disorders centers. Therefore, we should not be bound by it for scientific purpose, and make every effort to introduce more refined methods in the future.