Scoring and Sleep Stage E (D-26 - )

Question 1

What stage is notable for eye movements (SEM)?

Answer 1

N1

Question 2

What stage is notable for K complexes?

Answer 2

N2 (N2 has to have K complexes or sleep spindles. You don’t need both.)

Question 3

What stage is notable for slow waves (Delta waves)?

Answer 3

N3

Question 4

This stage normally occurs 90 min after sleep onset.

Answer 4

REM

Question 5

This stage is notable for low frequency and high amplitude.

Answer 5

N3

Question 6

What stage is notable for sleep spindles?

Answer 6

N2 but may persist into N3

Question 7

What stage is notable for one or more K complexes unassociated with arousal?

Answer 7

N2

Question 8

What marks the end of stage N2? (x3)

Answer 8

Transition to stage W
An arousal
A major body movement followed by slow eye movements and low amplitude mixed frequency EEG without non-arousal associated K complexes. (If no slow eye movements, continue N2)

Question 9

What stages are notable for sleep spindles and K-complexes? (x2)
One stage has larger, wider K complexes and sleep spindles. Which stage?

Answer 9

N2 and N3.

N3 has larger, wider K complexes and sleep spindles.

Question 10

When 20% or more of an epoch contains slow wave activity, score as what stage?

Answer 10

N3

Question 11

At what stage is the chin EMG at the lowest point?

Answer 11

REM

Question 12

What stage is notable for Theta sawtooth waves in EEG?

Answer 12

REM

Question 13

In what phase of sleep to you see “tonic” or Phasic or non-tonic” waveforms? What’s the difference between them?

Answer 13

REM
Tonic is “tame” or smooth
Phasic or Non-Tonic is “Frantic”, or rough and jagged.

Question 14

What stage of sleep is notable for frequency of 0.5 - 2 Hz and an amplitude of 75 uV peak to peak?

Answer 14

N3 (N3 is the only stage that has an amplitude requirement.)

Question 15

What stage of sleep is marked by a low amplitude, mixed frequency activity, usually 4-7 Hz?

Answer 15

N1

Question 16

What stage of sleep is notable for Vertex waves (V waves)?

Answer 16

N1

Question 17

What stage of sleep is referred to as “drowsy sleep” or “Somnolent sleep”?

Answer 17

N1

Question 18

What stage of sleep is notable for parasomnias, such as sleep-talking, bet-wetting, and night terrors?

Answer 18

N3

Question 19

When does most of the REM stage occur?

Answer 19

During the last 1/3 of the night

Question 20

During this stage of sleep, the brain is active but the body is paralyzed.

Answer 20

REM

Question 21

If you see epochs with low amplitude, mixed frequency EEG activity without K complexes, or sleep spindles, score as ___ (stage?)

Answer 21

N2

Question 22

To score as N1, slow eye movements are (required/not required).

Answer 22

Not required

Question 23

What stage is notable for hypnic jerks?

Answer 23

N1 (Hypnic jerks are more commonly seen when the patient is sleep deprived)

Question 24

When bursts of Theta waves are seen with hypnic jerks, what stage is scored?

Answer 24

N1

Question 25

Theta waves are the most common sleep frequency in what stage?

Answer 25

N1

Question 26

This stage is seen in the frontal region.

Answer 26

N3

Question 27

Memorable dreams occur during what stage?

Answer 27

REM

Question 28

In the absence of eye movements for Epochs following one or more epochs of REM, if the EEG continues with low amplitude, mixed frequency without K complexes or sleep spindles and the chin EMG remains low, score as ___ (Stage?)

Answer 28

REM

Question 29

What stage of sleep is notable for transient muscle activity- short, irregular bursts of EMG activity superimposed on low EMG tone?

Answer 29

REM

Question 30

What stage is notable for sleep spindles?

Answer 30

N2

Question 31

What stage is notable for K complexes?

Answer 31

N2

Question 32

What stage is notable for Theta waves that are 4-7.999 Hz?

Answer 32

N1

Question 33

What stage is notable for a decrease in muscular activity?

Answer 33

N2

Question 34

When 20% of slow wave activity is seen in the epoch, score as ___ (stage?)

Answer 34

N3

Question 35

What stage occupies 45-55% of sleep in adults?

Answer 35

N2

Question 36

In what stage is alpha activity replaced by low voltage activity and usually theta waves?

Answer 36

N1

Question 37

What stage comprises 30-35% of sleep in adults?

Answer 37

N3

Question 38

What stage makes up 20-25% of sleep time?

Answer 38

REM

Question 39

What stage is notable for low amplitude, mixed frequency EEG?

Answer 39

REM

Question 40

End scoring Stage R when the patient transitions to __ or __.

Answer 40

W or N3

Question 41

End scoring Stage R when an increase in ___ EMG is seen.

Answer 41

Chin EMG

Question 42

End scoring Stage R when ___ occurs, followed by ___ amplitude, ___ ___ EEG, and ___ eye movements.

Answer 42

An arousal Low amplitude, mixed frequency EEG Slow eye movements.

Question 43

End scoring stage R when ___ ___ ___ is seen, followed by ___ ___ ___ and ___ amplitude, ___ ___ EEG is seen.

Answer 43

Major body movement Slow eye movements Low amplitude, mixed frequency EEG.

Question 44

If the patient is in REM sleep and you see no slow eye movements and the chin EMG remains low, what should you score?

Answer 44

Continue as Stage R

Question 45

If one or more non-arousal K complexes or sleep spindles are present in the first half of the epoch and no rapid eye movement, but chin EMG is still low, what should you score?

Answer 45

N2

Question 46

Arousal rule: When looking at EEG frequency, how do you score arousal?

Answer 46

An abrupt shift of EEG frequency greater than 16 Hz (not spindles) lasting at least 3 seconds with 10 seconds of stable sleep preceding the change.

Question 47

Arousal rule: When the patient is in REM sleep, how do you score an arousal?

Answer 47

A concurrent increase in submental EMG that lasts 1 second.

Question 48

Which stage decreases with age?

Answer 48

N3

Question 49

What are sawtooth waves and what stage of sleep are they found in?

Answer 49

Trains of sharply contoured or triangular, 2-6 Hz waves over central head regions and often (not always) preceding a burst of rapid eye movements. Seen in REM sleep.