Interrater reliability for sleep scoring according to the Rechtschaffen & Kales and the new AASM standard

  title={Interrater reliability for sleep scoring according to the Rechtschaffen \& Kales and the new AASM standard},
  author={Heidi Danker-Hopfe and Peter Anderer and Josef Zeitlhofer and Marion Boeck and Hans Dorn and Georg Gruber and Esther Heller and Erna Loretz and Doris Moser and Silvia Parapatics and Bernd Saletu and Andrea Schmidt and Georg Dorffner},
  journal={Journal of Sleep Research},
Interrater variability of sleep stage scorings has an essential impact not only on the reading of polysomnographic sleep studies (PSGs) for clinical trials but also on the evaluation of patients’ sleep. With the introduction of a new standard for sleep stage scorings (AASM standard) there is a need for studies on interrater reliability (IRR). The SIESTA database resulting from an EU‐funded project provides a large number of studies (n = 72; 56 healthy controls and 16 subjects with different… 
Sleep classification according to AASM and Rechtschaffen & Kales: effects on sleep scoring parameters.
The study shows significant and age-dependent differences between sleep parameters derived from conventional visual sleep scorings on the basis of R&K rules and those based on the new AASM rules.
Process and outcome for international reliability in sleep scoring
Low REM stage scoring agreement exists for narcoleptics and SAHS, indicating the necessity to study sleep stagescoring agreement for a specific sleep disorder.
Inter-scorer reliability of sleep assessment using EEG and EOG recording system in comparison to polysomnography
The results suggest that the sufficient inter-scorer reliability can be obtained with the EEG/EOG recording system based on manual sleep stage scoring in healthy young adults, but the nature of theEEG and EOG recording system can influence the precisions in manually assessing sleep architectures in comparison to PSG.
Exploring scoring methods for research studies: Accuracy and variability of visual and automated sleep scoring
Although visual scoring induces inter‐ and intra‐expert variability, autoscoring methods can cope with intra‐scorer variability, making them a sensible option to reduce exogenous variability and give access to the endogenous variability in the data.
Agreement in computer-assisted manual scoring of polysomnograms across sleep centers.
Experienced scorers at different laboratories have very good agreement in hypopnea and AHI results when good-quality PSGs are scored using AASM-recommended criteria.
Interrater agreement between American and Chinese sleep centers according to the 2014 AASM standard
This study demonstrated the sleep stage scoring agreement of the 2014 AASM manual and explored potential sources of labeling ambiguity and improvement measures were suggested accordingly to help remove ambiguity for scorers and improve scoring reliability at the international level.
Multiple Sleep Latency Test
In the present paper, the assessment of sleepiness in general and the status quo in “Deutsche Gesellschaft für Schlafforschung und Schlafmedizin” (DGSM; German Sleep Society)-accredited sleep
Computer-assisted analysis of polysomnographic recordings improves inter-scorer associated agreement and scoring times
Study Objectives: To evaluate the current levels of human-expert performance and to assess the possible benefits of computer-assisted analysis for the scoring of polysomnographic sleep recordings
Advanced Analysis of Pharmaco-Sleep Data in Humans
Semiautomated approaches to sleep scoring may achieve a reliability close to 1, and for reasons of cost-effectiveness but also reliability, automatic analysis is preferable to visual analysis, however, the validity of the automatic method applied has to be proven.
The AASM Scoring Manual four years later.
  • M. Grigg‐Damberger
  • Medicine, Psychology
    Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
  • 2012
The AASM Sleep Scoring Manual provides a foundation upon which all can build rules and methods which identify the complexity of sleep and its disorders.


Interobserver agreement among sleep scorers from different centers in a large dataset.
The level of agreement in sleep stage assignment varies between scorers, by diagnosis, and by record, and this warrants caution when comparing data scored in separate laboratories.
The visual scoring of sleep in adults.
  • M. Silber, S. Ancoli-Israel, C. Iber
  • Psychology
    Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
  • 2007
The work of the AASM Visual Scoring Task Force is described, including methodology, a literature review and the rationale behind the new rules, which define onset and termination of REM sleep periods and propose alternative measures for non-alpha generating subjects.
A review of sleep EEG patterns. Part I: A compilation of amended rules for their visual recognition according to Rechtschaffen and Kales
SummaryQuestion of the studyThe reliable evaluation of polysomnographic recordings (PSG) is an essential precondition for good clinical practice in sleep medicine. Although the scoring rules of
Percentile reference charts for selected sleep parameters for 20- to 80-Year-Old healthy subjects from the SIESTA database
SummaryQuestion of the studyOne of the aims of the SIESTA project was to establish a normative database of sleep parameters for healthy and sleep-disturbed patients. Reference data for sleep
The scoring of arousal in sleep: reliability, validity, and alternatives.
  • M. Bonnet, K. Doghramji, A. Chesson
  • Psychology, Biology
    Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
  • 2007
It was concluded that the scoring of EEG arousals has added much to the authors' understanding of the sleep process but that significant work on the neurophysiology of arousal needs to be done.
The SIESTA project polygraphic and clinical database
The SIESTA project had two major goals: developing new tools for analyzing computer-based sleep recordings and creating a reference database for sleep-related features. Basically, both goals have
The effect of small differences in electrode position on EOG signals: application to vigilance studies.
The measurement of observer agreement for categorical data.
A general statistical methodology for the analysis of multivariate categorical data arising from observer reliability studies is presented and tests for interobserver bias are presented in terms of first-order marginal homogeneity and measures of interob server agreement are developed as generalized kappa-type statistics.
Automatic detection of the K-complex in sleep electroencephalograms.
The development and application of an electronic system which is capable of automatically detecting the K-complexes, aperiodic waveforms found in sleep electroencephalograms, is described. The system
A simple format for exchange of digitized polygraphic recordings.