Polysomnography Technical Guide

Polysomnography (PSG) Technical Guide Cover

Polysomnography (PSG) Technical Guide Cover

Polisomnografi

Technically Detailed Visual Guide 15-page content and page distribution plan - PSG recording, assembly, sensor, calibration, scoring and quality control

HEADBOX

EEG - EOG - EMG - ECG - Solunum - SpO2

REVISED CONTENT

In this version the previous summary has been expanded: channel layouts, filter/sampling values, impedance limits, calibration steps, artifact management, index formulas and reporting quality control items were given at a technical level.

Kapsam

• Diagnostic nocturnal polysomnography and technical montage approach
• Practical checklists for sleep technician, biomedical, nursing and physician teams
• Field-focused guidance notes for compliance with AASM/AAST-based technical standards

It is a technical guide for educational purposes; Diagnosis, treatment and final report interpretation are made by the authorized physician/sleep specialist. Page 1/15

The guide is planned to be 15 pages. First the clinical purpose of the test, then the technical setu

Polysomnography (PSG) Technical Guide Contents and page distribution Contents and Page Distribution Plan The guide is planned to be 15 pages. First the clinical purpose of the test, then the technical setup, channel/sensor parameters, It proceeds in the order of calibration, night monitoring, scoring and quality control. Each page is like an independent educational card

okunabilir.

Page Section Technical focus

1 Cover and scope Guide purpose, technical detail scope, visual scheme 2 Contents Page distribution and usage logic 3 What is PSG, what does it measure? Test types, basic channels, indication-basic decision distinction 4 Laboratory and patient preparation Room, security, consent, pre-test control, contraindication/risk management

5 Recording system and signal chain Sensor-headbox-amplifier-A/D-filtering-data archive 6 Electrode and sensor placement EEG 10-20, EOG, chin EMG, leg EMG, ECG electrodes 7 Respiratory channels Nasal pressure, thermistor, RIP belts, SpO2, CO2, body position 8 Mounting, filtering and sampling Channel variants, sensitivity, HFF/LFF, sample rates

9 Calibration and biocalibration Impedance, amplifier, DC device, physiological calibration steps 10 Technical monitoring during recording Artifact sources, correction logic, annotation disciplines 11 Sleep stages and arousal 30 sec epoch, W-N1-N2-N3-R, arousal technical criteria 12 Respiratory events and indices Apnea, hypopnea, RERA, AHI, RDI, ODI, T90, PLMI formulas

13 PAP titration and split-night CPAP/BPAP/ASV concepts, titration steps, mask leaks 14 Reporting and quality management Minimum report fields, maintenance, backup, quality indicators 15 Technical checklist and bibliography Application checklist, sources, endnotes

KULLANIM UYARISI

Technical note: The numerical thresholds in the guide are for educational purposes. Laboratory protocol, instrument manufacturer, and applicable AASM Scoring Manual It must be verified with its version.

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Polysomnography (PSG) Technical Guide What is PSG and what does it measure?

Polysomnography (PSG) Technical Guide What is PSG and what does it measure?

• Polysomnography: technical definition and measurement rationale

Polysomnography (PSG), brain activity during sleep,

eye movements, muscle tone, cardiac rhythm, breathing Patient Sensor Headbox PS

flow, respiratory effort, oxygenation, snoring, body

recording position and behavioral observation synchronously

It is a multi-channel physiological data collection process. Purpose not just counting apnea; Basic channels with sleep architecture To show the time relationship of events.

PSG tipleri

What does the channel provide? Technical commentary

Diagnostic PSG: Sleep and EEG with baseline montage throughout the night Sleep stage, arousal Lowaccurate reference impedance conditionand assessing respiratory disorders.

EOG Eye movement, REM/N1 E1/E2 symmetry amplitude

Split-night PSG: The first part is diagnostic, important for differentiation if the criteria are met

PAP titration on the same night. Chin EMG Muscle tone, REM atonia EMG filter as well as EEG

should not be low

Titration PSG: pressure like CPAP/BPAP/ASV

Controlled adjustment of supports. Leg EMG Periodic extremity Right/left separate channel preference

hareketi edilir

Extended PSG: Seizure, parasomnia or movement Airflow Apnea/hypopnea/RERA Thermal + nasal pressure

Additional EEG/EMG/video montage in case of suspected disorder. considered together

Separation of clinical decision and technical record

RIP effort Thoracic/abdominal effort Obstructive-central

critical in distinguishing

The technician's job is to provide quality and interpretable data

SpO2 Desaturation and Average time and

is to produce. Diagnosis is made by clinical history and examination of events to check for hypoxemia artifact It is determined together with the interpretation of the doctor. Video/audio Behavior and security Synchronized with PSG data

should

PRACTICAL COMMENT

Standard PSG correlates physiological events with sleep stage. For example, the same respiratory event occurs in NREM, REM or supine position may have different clinical meaning.

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Polysomnography (PSG) Technical Guide Laboratory and patient preparation

Polysomnography (PSG) Technical Guide Laboratory and patient preparation

• Laboratory infrastructure and patient preparation

Standard night stream

Stage Technical control

Patient admission ID, request, indication, medication list, allergy,

skin integrity, mobility and fall risk

• Preliminary interview and forms 2. Electrode/sensor application

is confirmed.

Room preparation Quiet, dark, safe, accessible room; two

directional intercom; synchronous video/audio; emergency transportation

yolu.

Device control Headbox connection, sufficient electrodes, cable 3. Impedance control 4. Amplifier/DC calibration

durability, spare sensor, consumables,

battery/adapter.

Skin preparation Oily/dirty areas are cleaned; electrode area

prepared by controlled abrasion; patient comfort

korunur. 5. Biyokalibrasyon 6. Lights out

Consent and Video/audio recording, sensors, night call system, Informational toilet and emergency procedure is explained.

Technical risks before work

• Gece teknik izlem 8. Lights on

Ciltte hassasiyet, yara, alerjik bant reaksiyonu veya ciddi If there is a dermatological lesion, electrode application is planned.

Using oxygen, ventilator, PAP or cardiac device

laboratory protocol and physician order in patients

is clarified. 9. Post-calibration 10. Data backup

Camera angle, bed safety in case of parasomnia/seizure suspicion

and additional EEG/EMG channels are planned in advance.

ORTAM

Room and control room layout, uninterrupted access and patient must be designed for safety. Technical room with light/sound insulation It should be separated in a way that does not disturb the patient.

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Polysomnography (PSG) Technical Guide Recording system and signal chain

Polysomnography (PSG) Technical Guide Recording system and signal chain

• PSG recording system: signal chain

Technical quality depends on every link in the chain, starting from the electrode or sensor. Poor skin contact, impedance mismatch, cable movement, improper filtering or insufficient sample rate, incorrect event during scoring may lead to interpretation.

Patient sensor Headbox Differential A/D converter Filter / display Archive and report

amplifier

For each channel: electrode/sensor quality -> impedance/gain -> sampling -> filter -> annotation -> backup

Differential amplification Frequent technical error chains

Since PSG biopotentials are low amplitude, differential Error Appearance Correction amplifier is used.

High Low amplitude, 50/60 Hz Skin preparation and For suppression of common mode noise, electrode impedance parasite electrode reconstruct Their impedances must be low and close to each other. application The higher the CMRR value, the more common environmental noise Cable tension Synchronous artifact with movement Cable slack

the less likely it is to interfere with the recording signal. Technique dropping fixing sources have a CMRR limit of at least 10,000:1 for PSG. Incorrect reference Reverse polarity or Assembly derivativeDigitization and data

beklenmeyen dalga kontrol etme

The A/D converter samples the analog signal; Underspeed Excessive filter Artificial flattening of waves Laboratory standard

return to setting

increases the risk of aliasing.

Loss of sync Event time with video System

Small EEG/EOG variations mismatched clock/synchronization if digital resolution is low looks rougher; At least 12 bit digital control in PSG systems resolution is targeted.

Raw data, event annotations, video/audio sync and report The output should be archived together.

FILTER WARNING

Notch filter: If the 50/60 Hz notch filter is left on constantly in EEG/EOG channels, it may hide the real artifact. notch in EMG channel The filter should be used with caution as it may suppress muscle activity frequencies.

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Polysomnography (PSG) Technical Guide Electrode and sensor placement

Polysomnography (PSG) Technical Guide Electrode and sensor placement

• Electrode and face sensor placement

Fpz

F3 F4

E1 E2

C3 C4

M1 M2

O1 O2

EEG 10-20 placement: F, C, O + mastoid references EOG + nasal pressure/thermal flow + chin EMG

EEG placement ECG and auxiliary sensors

Zones F, C and O are measured using the international 10-20 system; typical Single channel ECG for standard diagnostic PSG in most cases diagnostic PSG variants F4-M1, C4-M1, O2-M1 and are sufficient as a backup; modified Lead II placement rhythm evaluation They are F3-M2, C3-M2, O1-M2. provides.

M1/M2 references intact, all EEG and EOG Snoring microphone/piezo sensor trachea/lateral neck affects your interpretation. If the reference is broken, the transition to the spare mount is fixed in the area where vibrations are best received.

There must be a plan. Body position sensor supine, prone, right/left lateral and EEG and EOG electrode impedance is typically below 5 kOhm in sitting/standing positions with sleep phase and respiratory event and should be kept close between couples. enables pairing.

EOG, jaw and leg EMG

Video and audio recorded behavior, parasomnia, seizure, movement and

verification of technical events such as sensor break

EOG electrodes were placed approximately 1 cm lateral/superior and 1 It helps.

placed symmetrically cm laterally/inferiorly; this placement is conjugated

It provides counterphase deflection in eye movements.

Mental and bilateral submental electrodes for chin EMG used; Clean EMG for discrimination of REM atonia and arousal gerekir.

Anterior tibialis EMG electrodes along the muscle axis,

placed approximately 2-3 cm apart; If right and left are watched separately PLM skorlama daha nettir.

DENGE

Placement rule: Diagnostic capacity as the number of electrodes increases

may increase; However, if comfort decreases, sleep quality may deteriorate.

It is best to select additional targeted channels based on clinical suspicion is the approach.

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Polysomnography (PSG) Technical Guide Respiratory ducts

Polysomnography (PSG) Technical Guide Respiratory ducts

• Respiratory and oxygenation channels

Respiratory channels monitor the airflow reduction pattern, thoracoabdominal effort, and oxygenation outcome at the same time shows on the axis. This triple correlation is the basic technical data in distinguishing obstructive, central and mixed events.

EEG

EOG

EMG

Airflow

Effort

SpO2

Example diagram: decreased airflow + continued effort + SpO2 decrease requires technical correlation.

Airflow measurement

Channel Good signal indicator Favorite

problem Thermistor/thermocouple: Hot-cold air exchange

perceives; Powerful for apnea detection, increases flow magnitude Nasal pressure Round inspiratory-expiratory Cannula

It does not measure quantitatively. shifting waves,

occlusion,

Nasal pressure transducer: Flow through the mouth with the pressure change in the cannula

shows its pattern more precisely; hypopnea, flow limitation and respiration It is valuable to RERA. Thermal flow Synchronous with respiration distinct Sensor

Oral flow: If there is mouth breathing, only nasal pressure misleading deflection through the nose

it could be; Nasal + oral evaluation is important. if it goes away

Effort and gas exchange become flat

Thorax RIP Respiratory rhythmic amplitude Very

RIP belts: Track the movement of the thorax and abdomen separately; loose/very

tight belt

Paradoxical movement is a technical clue in favor of obstruction.

SpO2: Shows the oxygenation effect of events. Average Abdomen RIP Phase information relative to thorax Abdomen

seviyesinin

Devices with a duration of 3 sec or less experience rapid desaturation more accurately.

catches well. selection

CO2: Suspicion of hypoventilation, pediatrics, obesity SpO2 Stable curve compatible with pulse Peripheral

hypoventilation or transcutaneous cold in neuromuscular disease,

veya end-tidal CO2 eklenebilir. hareket,

oje

CO2 Trend values ​​compatible with physiology Calibration

, maske/ka

null

leaks

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Polysomnography (PSG) Technical Guide Mounting, filtering and sampling

Polysomnography (PSG) Technical Guide Mounting, filtering and sampling

• Montage, filter and sampling settings

The table below summarizes an example technical montage for standard diagnostic PSG. Values ​​device manufacturer, should be verified against the country/laboratory standard and applicable scoring guide. The aim is to focus on the physiology of each channel is to reduce artifact by maintaining appropriate bandwidth.

Channel Typical derivative / sensor Sensitivity HFF LFF Sampling EOG sol E1-M2 5-7 uV/mm 35 Hz 0.3 Hz 500 Hz EOG right E2-M2 5-7 uV/mm 35 Hz 0.3 Hz 500 Hz Frontal EEG F4-M1, F3-M2 yedek 5-7 uV/mm 35 Hz 0.3 Hz 500 Hz Santral EEG C4-M1, C3-M2 yedek 5-7 uV/mm 35 Hz 0.3 Hz 500 Hz Oksipital EEG O2-M1, O1-M2 yedek 5-7 uV/mm 35 Hz 0.3 Hz 500 Hz

Chin EMG EMG1-EMG2/EMG3 7-10 uV/mm 100 Hz 10 Hz 500 Hz Bacak EMG LAT1-LAT2, RAT1-RAT2 10 uV/mm 100 Hz 10 Hz 500 Hz ECG ECG1-ECG2 20 uV/mm 70 Hz 0.3 Hz 500 Hz Horlama Mikrofon/piezo 20 uV/mm 100 Hz 10 Hz 500 Hz Nasal pressure Pflow 20 uV/mm 15 Hz DC veya <0.03 Hz 100 Hz Thermal airflow Tflow 20 uV/mm 15 Hz 0.1 Hz 100 Hz

Toraks efor RIP belt 10-100 uV/mm 15 Hz 0.1 Hz 100 Hz Abdomen efor RIP belt 10-100 uV/mm 15 Hz 0.1 Hz 100 Hz SpO2 Pulse oksimetre DC 5 Hz - 25 Hz Position Position sensor - - - 1 Hz

Filter logic Sampling logic

If LFF is chosen too high, slow EEG waves and breathing will occur at least 2 below the highest measured frequency according to the Nyquist principle. trends are disrupted. strict sampling is required.

If HFF is selected too low, 500 Hz imaging and scoring for EMG, snoring and fast EEG components EEG/EOG/EMG/ECG disappears. It is used as a comfortable target for Notch filter should be used as a last option to solve the problem; Unnecessary oversampling on low frequency DC channels first, electrode, cable, grounding and environmental resources increase the data load; The speed is selected according to the physiology of the channel.

should be corrected.

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Polysomnography (PSG) Technical Guide Calibration and biocalibration

Polysomnography (PSG) Technical Guide Calibration and biocalibration

• Calibration: before and after recording starts

PSG calibration is not just to see that the device is working; Reliable scoring throughout the night Required to create a starting reference. Calibrations must be visible and annotated within the record.

Impedance Amplifier DC device Biocalibration Lights out Lights on EEG/EOG/EMG All channels SpO2/CO2/PAP Patient commands Sleep recording Post-control

Biocalibration commands

Calibration Technical purpose

Amplifier Equal amplitude on all channels, correct polarity 30 seconds recording with eyes open and closed.

and the time constant is controlled. Example Up-down and right-left eye movements 5 repetitions.

uygulamada 30 sn boyunca standart DC

signal is passed. Blink 5 reps.

DC device Oximeter, capnograph or PAP pressure Teeth clenching/chewing for at least 5 sec.

physiological minimum-maximum of output

range must correspond to the correct scale. Snoring/hum simulation 5 sec.

Normal breathing, 10 sec breath hold, nose only, mouth only

Impedance usually <5 kOhm for EEG/EOG/ECG, EMG

<10 kOhm is targeted for; couple harmony breathing.

improves quality. Deep breath and slow expiration for 10 seconds.

Left and right foot dorsiflexion 5 repetitions during post-calibration recording of the sensors at the end of the night.

whether it continues to function

documents. Control so that the ECG R wave deflects upward.

WHY IS IT IMPORTANT?

Biocalibration makes it easier to recognize the source of the signal during night recording. For example, EEG artifact with eye movement, jaw EMG With its increase, arousal, airflow sensor direction and leg EMG polarity are verified at this stage.

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Polysomnography (PSG) Technical Guide Technical monitoring during recording

Polysomnography (PSG) Technical Guide Technical monitoring during recording

• Technical monitoring and artifact management during recording

During the night the technician is not a passive spectator; If signal quality decreases, scoring reliability decreases. Intervention The decision should be made with a risk-benefit evaluation in a way that does not unnecessarily disrupt the patient's sleep.

Artifact Possible source Technical discrimination Correction

50/60 Hz interference High impedance, Sinusoidal interference on multiple channels Electrode preparation, cable layout, grounding

socket/device proximity

Motion artifact Cable pulling, position Large deflection simultaneously with video Fix cable loosely, annotation if necessary

change

Sweating artifact Skin conductance and slow drift Low-frequency fluctuation Room temperature, electrode control, over-boost filter EMG Jaw/temporal muscle Fast low-voltage activity on EEG Reassure patient, check electrode location

kontaminasyonu aktivitesi

Loss of airflow Cannula/thermistor slippage There is effort, airflow flattened, video Re-secure sensor; events as technical losses

mark incompatible

SpO2 artifact Movement, low perfusion, Pulse wave distorted, sudden unreal drop Reposition probe, heating/other finger

nail polish

RIP belt loss Loose/tight belt Straight line or reverse phase unexpected Belt position and tension adjustment Video sync Software/camera delay Motion time does not match signal Check system clock/sync

sorunu

Anotasyon disiplini

KORELASYON

Sensor change, toilet, wakefulness, oxygen/PAP change, Critical principle: An event includes both airflow, effort, SpO2 and Mask leakage and technical loss times are clearly marked. EEG should be evaluated together with arousal. Single channel The annotations are clear enough to use in the report and instead of relying on automatic scoring when broken

Must be compatible with clock/time code. technical note should be made.

If the channel failure is permanent, backup lead or alternative

sensor strategy is applied.

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Polysomnography (PSG) Technical Guide Sleep stages and arousal

Polysomnography (PSG) Technical Guide Sleep stages and arousal

• Sleep stages, epoch and arousal scoring logic

Sleep scoring is the division of PSG recording into W, N1, N2, N3 and R phases in consecutive epochs of 30 seconds.

Scoring Manual rules may vary by version; The laboratory report should indicate the rule set used.

Hypnogram: Shows the stage distribution throughout the night after scoring 30-second epochs.

Sleep architecture criteria

Phase Technical signs

Wake Alpha activity, eye blink, high chin EMG, Parameter Formula / meaning behavioral alertness.

TST Total sleep time; of scored sleep epochs

N1 Alpha decay, low amplitude mixed frequency, slow summation.

rolling eye movements.

TRT/TIB Time spent in bed or recorded;

N2 K-complex and/or sleep spindle; It is distinguished from N1 according to the laboratory definition of being more stable.

NREM uyku.

Sleep efficiency TST / time in bed x 100.

N3 Slow wave activity evident; high amplitude

delta activity dominates. Sleep latency Duration from lights out to the first sleep epoch.

REM/R Rapid eye movements, low jaw EMG tone, mixed REM latency From sleep onset to first REM epoch frequency EEG. duration.

Arousal technical logic WASO Awakening period after sleep onset.

Stage percentages Time spent in each stage / TST x 100.

Sudden change in EEG frequency is the main sign; movement or The time relationship with the respiratory event is noted.

Chin EMG increase provides additional information in the interpretation of REM arousal.

Arousal index = toplam arousal / TST(saat). Solunum, bacak It can be classified as movement or spontaneous.

TECHNICAL SCORING

For scoring quality, EEG/EOG/EMG channels should be combined together.

must read. Just looking at the EEG view REM,

It may cause error in distinguishing between N1 and artifact.

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Polysomnography (PSG) Technical Guide Respiratory events and indices

Polysomnography (PSG) Technical Guide Respiratory events and indices

• Respiratory events and index calculations

Respiratory events, degree and duration of airflow reduction along with exertion, oxygen desaturation, and EEG arousal It is interpreted according to the relationship. Different reporting such as hypopnea rule 3% desaturation/arousal or 4% desaturation It may change with its rules; The rule used should be written in the report.

Olay penceresi

Flow

Thorax

Abdomen

SpO2

Arousal

Index formulas

Event Technical description

Apnea Marked/near complete loss of airflow, Index Formula at least 10 sec; depending on effort, obstructive, central or mixed is classified. AHI (Apnea + hypopnea) / TST(hour) Hypopnea Airflow decrease for at least 10 sec; oxygen RDI (Apnea + hypopnea + RERA) / TST(hours)

Rule out desaturation and/or arousal accompaniment

Searched by set. ODI Number of desaturation events / TST(hour) Not fully meeting RERA Apnea/hypopnea criteria, T90 SpO2 < 90% elapsed time / TST x 100

creates arousal with increasing effort/flow limitation

Minimum SpO2 The lowest respiratory sequence observed during the night.

confirmed SpO2

Cheyne-Stokes/Crescendo-decrescendo respiratory and central

PLMI Periodic number of leg movements / TST(hour) periodic event pattern; in a cardiac/neurological context It is important. PLM / TST(clock) associated with PLMAI Arousal AHI adult severity limits with hypoventilation increased CO2 or impaired oxygenation

inadequate outgoing ventilation; CO2 channel

gerekebilir.

Level AHI

Normal/minimal <5/saat

Hafif 5 - <15/saat

Orta 15 - <30/saat

Heavy >=30/hour

RAPOR YORUMU

AHI alone does not indicate full clinical severity. REM relationship, position relationship, desaturation depth/duration, arousal load, symptom and comorbidities should be evaluated together in the report.

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Polysomnography (PSG) Technical Guide PAP titration and split-night

Polysomnography (PSG) Technical Guide PAP titration and split-night

• PAP titration and split-night technical notes

If sufficient obstructive events are observed during diagnostic PSG and the laboratory protocol is appropriate, PAP titration will be started on the same night passable. The purpose of titration is not only to lower the AHI; REM, supine position, oxygenation, arousal and patient konforunu birlikte optimize etmektir.

Diagnostic recording Criteria control Mask application Pressure increase Event/leak monitoring Optimal pressure

Things to monitor during titration

Mode Technical usage logic

CPAP Single constant expiratory/inspiratory positive pressure; Mask leaks: high leak airflow, pressure and arousal disrupts the interpretation of obstructive apnea/hypopnea and reducing snoring; Mask size and band tension are adjusted.

It is frequently used in the first step titration.

Position/REM: Pressure adequacy especially REM and supine

APAP Automatic changing pressure; It should be tested at home, not in the laboratory.

It is common in follow-up, device in PSG titration

The algorithm must be interpreted. Mouth leakage: dryness of the nasal mask, mouth breathing and flow may cause signal degradation.

BPAP IPAP and EPAP are separate; high pressure requirement, in hypoventilation or CPAP intolerance Patient compliance: claustrophobia, pressure intolerance, aerophagia and skin conceivable. pressure is noted.

BPAP-ST Includes respiratory rate backup support; Central Oxygen: If hypoxemia persists apart from PAP deficiency hypoventilation/complex situations are evaluated in accordance with the physician's order/protocol.

requires protocol. Split-night technical benchmark approach

ASV Kompleks/santral olaylarda belirli klinik kriterlerle

used; Safety in conditions such as heart failure Adequate diagnostic data and clear OSA findings in the first episode evaluation is essential. should be.

Sufficient time must remain for titration; otherwise separate night titration provides more accurate data.

The transition time and reason for transition should be clearly stated in the report.

TITRATION PRINCIPLE

In PAP titration, the pressure increase should be gradual; After each change activity, leakage, sleep stage and position together should be monitored. It is not technically sufficient to act solely on the automatic device recommendation.

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Polysomnography (PSG) Technical Guide Reporting and quality management

Polysomnography (PSG) Technical Guide Reporting and quality management

• Reporting, archiving and quality control

Minimum report fields

Patient ID, date, study type, and mount used.

Lights out/on, TST, sleep efficiency, sleep latency, REM latency, WASO.

Preparation

Phase distribution and hypnogram.

Report QC Impedance AHI/RDI/ODI, event types, REM/supine relation, T90 and minimum SpO2.

PSG

Arousal index and associated event types.

Kalitesi

Video notes for suspected PLMI/PLMAI, parasomnia, or seizure.

Skorlama Kalibrasyon

Technical loss times, sensor problems and used

hypopnea/desaturation rule.

Gece izlem

If there is PAP titration, mask type, leakage, pressures,

optimal/recommended pressure and residual events.

Teknik kabul kriterleri

Quality area Technical indicators

Signal quality Impedances, channel recording throughout the night, sufficient sleep time to answer the clinical question, and continuity, sensor breakage percentage. It must have signal quality.

Scoring consistency AASM rule set, second reader/peer review, technical in the report if there is a long-term loss in the main channels automatic score correction recording. The limitation should be clearly stated.

Device maintenance Monthly physical check, annual electrical safety, Video/audio, especially parasomnia, seizure and behavioral calibration and service records. Must be time matched with PSG in events.

Data security Raw EDF/PSG file, video, report and Pediatric, neurological, cardiopulmonary or ventilation Backup storage of annotations. Standard mounting may not be sufficient in supported patients.

Infection control Disposable consumable, reusable

electrode disinfection, skin integrity

takibi.

QUALITY MESSAGE

The technical quality of the report directly affects the reliability of the physician's interpretation. Detailed report generated from poor quality signal, good is less valuable than the plain report generated from the signal.

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Polysomnography (PSG) Technical Guide Technical checklist and bibliography

Polysomnography (PSG) Technical Guide Technical checklist and bibliography

• Teknik kontrol listesi

Bibliography and foundations

Pre-Check

Device Headbox, cable, sensor, camera, intercom and American Academy of Sleep Medicine. The AASM Manual for

software is ready. the Scoring of Sleep and Associated Events: Rules,

Terminology and Technical Specifications, Version 3. AASM,

Patient ID, request, history, consent, security risk and toilet plan ok. 2023.

Electrode 10-20 measurement, skin preparation, accurate references, American Association of Sleep Technologists. Standard spare electrodes are ready. Polysomnography Technical Guideline. Clinical Resources, Technical guide PDF with 2025 access.

Empedans EEG/EOG/ECG <5 kOhm, EMG <10 kOhm

is targeted; couples close. Kapur VK, Auckley DH, Chowdhuri S, et al. Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep

Calibration Amplifier, DC devices and biocalibration

anotasyonlu. Apnea. Journal of Clinical Sleep Medicine.

2017;13(3):479-504.

During Control Malhotra A, Mesarwi O, Pepin JL, Owens RL. Metrics of sleep apnea severity: beyond the apnea-hypopnea index. Sleep.

Signal EEG/EOG/EMG/flow/effort/SpO2 continuity

izlenir. 2021.

Jasper HH. The ten twenty electrode system of the Event Channel correlation for apnea/hypopnea/RERA

kontrol edilir. International Federation. Electroencephalography and

Clinical Neurophysiology. 1958.

Artifact When and why intervention is required

is annotated.

Safety Patient call, risk of falling, cable entanglement and Final technical note Emergency access is monitored.

PAP Leak, pressure, sleep stage, position and PSG technical application are more important than memorizing the standard montage Oxygenation is monitored together. is more. The aim is to keep physiology intact as much as possible is to produce a channeled, synchronous and interpretable recording. Every

Post-Control depends on the laboratory's own device, patient group and current guidelines There must be a written procedure according to the version.

Post Lights on post impedance and calibration

repetition Data Raw recording, video, audio, annotation and report yedeklenir.

Technical note Lost channels, sensor changes and limitations is written.

Report Rule set, indexes, threads, technical limitations

and the comment is divided.

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