Sleep onset REM period

Under Sleep-onset REM periods (SOREMP) is understood in the sleep medicine during sleep prematurely occurring periods of REM sleep . The REM sleep during this time is the "Sleep Onset REM" (SOREM).

Premature refers to the normal sleep cycle in which the individual sleep stages are run through in a specific sequence. REM sleep a few minutes after falling asleep is noticeable.

Occurrence of SOREM during sleep

The occurrence of SOREMP is a diagnostic criterion for narcolepsy . However, SOREM can also be observed in obstructive sleep apnea and other disorders with a reduced proportion of REM sleep as well as in pent-up sleep deficits. Recovery sleep then leads to the so-called "REM rebound". The other hypersomnias of central nervous origin do not show an increased number of SOREMP.

Detection of SOREM in sleep

Hypnogram with SOREM - this was followed by four minutes of “lying awake” (W) and three minutes of light sleep (N1) immediately followed by REM sleep (R), from which one then woke up briefly. Sleep latency (SL) and REM latency (RL) are also entered

SOREM is determined in the sleep laboratory using polysomnography in the multiple sleep latency test (MSLT).

In the evaluation of the MSLT, in addition to further results, the number of SOREMPs is given. As usual in polysomnography, 30-second epochs are evaluated from the beginning of the respective recording. A SOREMP therefore requires an epoch with more than 15 seconds of REM sleep. The REM latency is the time from the first epoch with sleep to the beginning of the first epoch with REM sleep, regardless of the sleep stages in between and any waking phases.

Problems in diagnosing narcolepsy

According to the guideline in the MSLT, SOREMP are defined as the occurrence of REM sleep after falling asleep with a latency of 10 minutes or less, but according to other international sources as "the first epoch of REM sleep at any point during a period". When evaluating REM sleep parameters, there are differences between guidelines based on the specifications of the American Academy of Sleep Medicine from 2005 and the German guidelines from 2009, which determine the results for REM latency and the number of SOREMP affect. Since there is no generally applicable definition of SOREMP, but the duration of the recording has consequences, negative effects on the diagnosis of narcolepsy and the comparability of research results are possible.

Individual evidence

1. ^ S1 guideline for narcolepsy of the German Society for Neurology (DNG). In: AWMF online (as of 2008).
2. ↑ ^{a b c} S3 guideline for non-restful sleep / sleep disorders of the German Society for Sleep Research and Sleep Medicine (DGSM). In: AWMF online (as of 2009).
3. ↑ ^{a b} Michael R. Littner et al., Standards of Practice Committee of the American Academy of Sleep Medicine: Practice Parameters for Clinical Use of the Multiple Sleep Latency Test and the Maintenance of Wakefulness Test . In: Sleep . Vol. 28, No. 1 , 2005, p. 113-121 , PMID 15700727 (English).
4. ↑ Cornelia Sauter, Heidi Danker-Hopfe: Multiple Sleep Latency Test . In: Somnology . 2013, doi : 10.1007 / s11818-012-0598-1 (English).

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