The AASM Recommended and Acceptable EEG Montages are Comparable for the Staging of Sleep and Scoring of EEG Arousals

Study Objective: To examine the measurement differences in sleep and EEG arousal statistics between the American Academy of Sleep Medicine (AASM) recommended EEG montage (F4-M1, C4-M1, O2-M1) and acceptable EEG montage (Fz-Cz, C4-M1, Oz-Cz). Design: Prospective, blinded, randomized comparison. Setting: Australian clinical sleep laboratory in a tertiary hospital. Patients or Participants: 50 consecutive patients undertaking polysomnography (PSG) for the clinical suspicion of sleep disordered breathing. Interventions: N/A Measurements and Results: Patient EEGs were recorded using both the AASM recommended and acceptable EEG montages during the PSG. Two scorers were used to examine the difference in PSG statistics using the two EEG montages. The scorers analyzed the 50 studies using the two EEG montages. Ten of the studies were scored twice for each montage by each scorer to calculate intra-scorer and interscorer agreement. No statistically significant differences were observed between the PSG statistics of the recommended and acceptable EEG montages. The recommended EEG montage had greater inter-scorer agreement but no difference in intrascorer agreement. Conclusions: This study demonstrates that the two EEG montages endorsed by the AASM Manual produce similar sleep and EEG arousal statistics.