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By: Rita Brooks on August 14th, 2015

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What’s NEW in the AASM Scoring Manual? How do the new rules affect me?

Sleep Technology Trends | Sleep Technologist Advice


Home Sleep Apnea Testing (HSAT) scoring rules for adults and sleep staging rules for infants 0 to 2 months post term represent significant changes

The newest version (2.2) of the AASM Scoring Manual published on July 1 addresses HSAT for the first time.

Home Sleep Apnea Testing Scoring Rules

New HSAT terminology and definitions

  • Monitoring time (MT) - Total recording time minus periods of artifact and time the patient was awake as 
determined by actigraphy, body position sensor, respiratory pattern, or patient diary. 

  • Respiratory event index (REI)-Total number of respiratory events scored × 60 divided by monitoring time (MT). 

New recording rules/technical and digital specifications for HSAT

  • Device must have FDA approval and a unique identifier
  • Must meet criteria for CPT codes 95800, 95801 or 95806
  • Ability to record oximetry and heart rate
  • Recommended and acceptable airflow and effort sensors
  • Ability to determine monitoring time (MT)
  • The use of peripheral arterial tonometry (PAT) for HSAT

New respiratory event scoring rules for HSAT

  • Based on respiratory effort and/or airflow
  • Utilizing peripheral arterial tonometry (PAT) technology

New reporting rules for HSAT

  • Specifies what must be reported

The scoring manual addresses infant sleep staging for the first time!

Expanded terminology and definitions for infant sleep staging (age 0 to 2 months post term)

  • Stage W (Wakefulness) 

  • Stage N (NREM) - analogous to the previously used terminology of “quiet sleep” 

  • Stage R (REM) - analogous to the previously used terminology of “active sleep” 

  • Stage T (Transitional) - analogous to the previously used terminology of “indeterminate sleep” 

 And brand new scoring rules for scoring infant sleep!

For more information on the AASM Scoring Manual updates read the Summary of Updates in Version 2.2

What does this mean for me and my sleep center?

  • AASM accredited sleep facilities and HSAT programs must implement the new rules by October 1, 2015!
  • You need a new manual!
  • You need to educate your staff on the new scoring rules!
  • You need to update your policies and procedures if you do HSAT and/or perform infant testing!

How can the AAST help me to implement the new scoring rules?

o   Manual is online and accessible via computer, tablet or mobile devices.


Let us know what we can do to assist you with your educational needs!  Providing quality education for our members is a primary focus of the AAST!

*AAST Members - Create an AASM Guest Shopper account. You can then purchase the Scoring Manual at the member price. On the purchase screen, a link next to Subscription Type will ask if you are an AAST Member. When you click this link, you will need to verify your AAST membership using your member number. Once verified, the Subscription Type will say AAST Member and the price will reflect member pricing of $25.

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