title: Normative values of polysomnographic parameters in childhood and adolescence: arousal events.
abstract: OBJECTIVE
  This study focused on differences in arousals during sleep, using the arousal rules of the American Academy of Sleep Medicine, by gender, age, and maturity in healthy children.
  
  
  METHODS
  One-night polysomnography was performed on 209 healthy German children (age 1-18 years) at their habitual bedtimes in 16 laboratories. Subjects were grouped by gender (112 females, 97 males), age, and Tanner stage.
  
  
  RESULTS
  Normative values of arousal events in sleep are presented, including indexes of spontaneous and respiratory arousals, total electroencephalogram (EEG) arousals, phasic increase in submental electromyogram (EMG) in stage R, and leg movements. With increasing age, a decrease was seen in: EEG arousal index ≥1-2.9 s, EEG arousal index ≥3 s, index of total EEG arousals, index of respiratory arousals, chin EMG enhancement in stage R ≥1-2.9 and ≥3 s, index of total leg movements, and leg movements with EEG arousals (p<0.05). Only spontaneous arousals showed no association with age. There was a significant negative correlation between Tanner stage and arousals ≥1-2.9 s, respiratory arousals, leg movements, and leg movements with arousals (p<0.05). Only arousals ≥3 s and total leg movements showed gender differences (p<0.05).
  
  
  CONCLUSIONS
  For the diagnosis of pediatric sleep disturbances, the given arousal data enable estimation of the degree of deviation from normal findings for age and maturity. There is need for further research on, and further discussion of, the arousal rules of the American Academy of Sleep Medicine.
authors.affiliation: Zentrum für Schlaf- und Beatmungsmedizin, Robert-Koch-Krankenhaus Apolda GmbH, Apolda, Germany. sl@rkk-apolda.de
authors.forename: Sabine
authors.initials: S
authors.lastname: Scholle
authors.forename: Alfred
authors.initials: A
authors.lastname: Wiater
authors.forename: Hans Christoph
authors.initials: HC
authors.lastname: Scholle
mesh_terms: D000293:Adolescent; D041923:Adolescent Development / Q000502:physiology; D000367:Age Factors; D001143:Arousal / Q000502:physiology*; D002540:Cerebral Cortex / Q000502:physiology; D002648:Child; D002657:Child Development / Q000502:physiology; D002675:Child, Preschool; D004569:Electroencephalography / Q000592:standards*; D005260:Female; D006801:Humans; D007223:Infant; D007866:Leg / Q000502:physiology; D008297:Male; D009068:Movement / Q000502:physiology; D017286:Polysomnography / Q000379:methods / Q000592:standards*; D011446:Prospective Studies; D012016:Reference Values; D012737:Sex Factors; D012890:Sleep / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000175:diagnosis*; D011795:Surveys and Questionnaires / Q000592:standards