This manual is dedicated to the memory of Kathleen Fisher, who served as Chief Polysomnologist for the SHHS Reading Center during its formative period. Kathleen’s skills in polysomnography and quest for excellence were invaluable in the development of a dedicated Reading Center staff. Her input was also invaluable for the development of detailed methods for dealing with the tremendous amount of polysomnographic data that needed to be processed and analyzed. Kathleen embodied an enthusiasm for research, especially related to the goals of understanding the health impact of sleep-disordered breathing. The Reading Center staff was privileged to have benefited from her generosity, kindness and intelligence.
We are deeply indebted to the classic work of Drs. Rechtschaffen and Kales, whose manual of sleep scoring has stood the test of time. We also acknowledge the helpful input of the SHHS Polysomnography Subcommittee (Drs. William Bonekat, Daniel Gottlieb, Conrad Iber, James Kiley, Stuart Quan, David Rapoport, Mark Sanders, and Philip Smith).
Jean Arnold*, Kathleen Fisher, Guang Shen Liao, Rawan Nawabit*, Susan Redline*, Thomas Rosenbalm, Carl Rosenberg*, Joanna Romaniuk*, Nancy Scott*, Sinziana Seicean*, Kingman Strohl*, and Susan Surovec*.
* Current staff
The procedures and scoring rules developed and/or adapted for the Sleep Heart Health Study were done for the purposes of obtaining consistent (reliable), objective data for large numbers of individuals studied with the same equipment in unattended settings for the purposes of developing a large and versatile research database. Records were scored without knowledge of the demographic or clinical history of participants and without any attempt to diagnose clinical disorders. A summary of the ability of these procedures, implemented early in our study, to achieve reliable data can be found in Sleep 21: 749- 758. 1998. Some of the scoring rules are specific to the use of Compumedics software and may need to be modified when using different systems. The recording montage used included: C3/A2 and C4/A1 EEGs; right and left electrooculograms (EOGs); a bipolar submental electromyogram (EMG); thoracic and abdominal excursions (inductive plethysmography bands, not summed); “airflow” (detected by a nasal-oral thermocouple [thermistor used after 2001]), oximetry, ECG and heart rate (using a bipolar ECG lead); body position; and ambient light (on/off, by a light sensor secured to the recording garment).