title: Sleep and Respiration in 100 Healthy Caucasian Sleepers--A Polysomnographic Study According to American Academy of Sleep Medicine Standards.
abstract: OBJECTIVE
  Despite differences between American Academy of Sleep Medicine (AASM) and Rechtschaffen and Kales scoring criteria, normative values following the current AASM criteria are lacking. We investigated sleep and respiratory variables in healthy adults over the lifespan, and established polysomnographic normative values according to current standards.
  
  
  METHODS
  Prospective polysomnographic investigation.
  
  
  METHODS
  Academic referral hospital sleep laboratory.
  
  
  METHODS
  One hundred healthy sleepers aged 19-77 y were selected from a representative population sample by a two-step screening.
  
  
  METHODS
  N/A.
  
  
  RESULTS
  All subjects underwent one full-night polysomnography. Sleep and arousals were scored according to AASM standards. Respiration was scored according to AASM 2007 and 2012 criteria in order to compare both methods. Percentile curves showed age-related differences in sleep architecture: a decrease was found for sleep efficiency [≤ 30 y: 87.0 (71.9-94.1)% versus > 60 y: 79.7 (44.5-90.9)%], total sleep time [≤ 30 y: 413.5 (345.6-451.9) min versus > 60 y: 378.3 (216.0-440.0) min], the percentages of N3 [≤ 30 y 20.7 (15.2-37.5)% versus > 60 y: 14.9 (2.4-35.6)%] and rapid eye movement sleep [≤ 30 y 15.5 (7.5-23.6)% versus. > 60 y: 10.3 (1.9-21.9)%], whereas the percentage of wake time after sleep onset increased with age [≤ 30 y 6.0 (1.9-22.8)% versus > 60 y: 15.2 (6.3-48.7)%]. The apnea-hypopnea index (AHI) was higher when applying the AASM 2012 criteria [AHI AASM 2007 0.7 (0.0-21.5)/h versus 2012: 1.7 (0.0-25)/h; P < 0.001]. Eight percent of subjects had an AHI > 15/h.
  
  
  CONCLUSIONS
  This study provides normative data on sleep macrostructure, microstructure, and respiration in adults following AASM standards. Furthermore, we demonstrated that respiration scoring according to AASM 2012 results in higher AHIs, and challenge the use of age-independent respiratory cutoff values.
authors.affiliation: Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Mitterling
authors.affiliation: Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Birgit
authors.initials: B
authors.lastname: Högl
authors.affiliation: Department of Neurology, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.
authors.forename: Suzana Veiga
authors.initials: SV
authors.lastname: Schönwald
authors.affiliation: Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Heinz
authors.initials: H
authors.lastname: Hackner
authors.affiliation: Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: David
authors.initials: D
authors.lastname: Gabelia
authors.affiliation: Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Marlene
authors.initials: M
authors.lastname: Biermayr
authors.affiliation: Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Birgit
authors.initials: B
authors.lastname: Frauscher
mesh_terms: D000047:Academies and Institutes; D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology; D001143:Arousal / Q000502:physiology; D005260:Female; D006262:Health; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000592:standards*; D011446:Prospective Studies; D012016:Reference Values; D012119:Respiration; D012890:Sleep / Q000502:physiology*; D056508:Sleep Medicine Specialty / Q000592:standards*; D012895:Sleep, REM / Q000502:physiology; D014481:United States; D014851:Wakefulness / Q000502:physiology; D044465:White People; D055815:Young Adult
keywords: gender; normative; polysomnography; sleep architecture; sleep disordered breathing