As modern medicine gradually improves its understanding of sleep disorders, polysomnography is increasingly applied in various clinical departments such as neurology, respiratory medicine, otolaryngology, dentistry, and psychiatry.As an important tool for clinical practice and research in sleep medicine, the value of polysomnography is increasingly recognized. To further clarify the clinical indications for polysomnography in China, standardize operational procedures, and unify diagnostic terminology and report formats, the Sleep Disorders Professional Committee of the Neurology Branch of the Chinese Medical Doctor Association initiated a discussion with experts from mainland China and Hong Kong, forming the “Expert Committee on the Operational Specifications and Clinical Applications of Polysomnography in Adults”. They conducted in-depth discussions, appropriately referencing foreign norms, and wrote the “Operational Specifications for Polysomnography in Adults and Clinical Application Consensus” based on extensive consultation.
1. Overview
Polysomnography (PSG) is a diagnostic technique that continuously synchronizes the collection, recording, and analysis of multiple physiological parameters and pathological events during sleep using a polysomnograph in a sleep monitoring room. The parameters collected and recorded during polysomnography include electroencephalogram (EEG), electrooculogram (EOG), electromyogram (EMG), electrocardiogram (ECG), oral-nasal airflow, snoring, respiratory movements, pulse oxygen saturation, and body position. Additional parameters such as audiovisual monitoring, esophageal pressure, esophageal pH, transcutaneous or end-tidal carbon dioxide partial pressure, and erectile function can also be added. These parameters are displayed in various forms such as curves, numbers, images, and audiovisual recordings, forming readable and analyzable data known as the polysomnogram (PSG). Polysomnography is a commonly used objective examination for analyzing sleep structure and assessing sleep disorders, serving as a basic tool for clinical practice and research in sleep medicine.
(1) Indications for Polysomnography
1. Sleep-Related Breathing Disorders: (1) Diagnosis of patients with sleep-disordered breathing (SDB), clarifying the types of sleep apnea and hypoventilation events (obstructive/central/mixed) and the classification of sleep-related breathing disorders (obstructive/central), assessing severity and differentiating from other sleep disorders; clarifying sleep-related hypoventilation and hypoxemic disorders; (2) Evaluating the effectiveness of various treatment methods for sleep-related breathing disorders; (3) Re-examination of patients with high suspicion of sleep-related breathing disorders, who tested negative on home sleep apnea monitoring or first PSG; (4) Re-evaluating treatment in patients receiving non-invasive positive pressure ventilation who experience weight changes, poor clinical treatment outcomes, or symptom recurrence; (5) Conducting manual pressure titration prior to non-invasive positive pressure ventilation; (6) Other clinical symptoms and signs suggesting possible sleep-related breathing disorders, such as excessive daytime sleepiness unexplained by primary disease, daytime hypoxemia, erythrocytosis, resistant hypertension, unexplained arrhythmias, nocturnal angina, morning dry mouth, or persistent chronic cough.
2. Excessive Daytime Sleepiness Disorders: (1) Diagnosis, differential diagnosis, and treatment effectiveness evaluation of narcolepsy; (2) Diagnosis and differential diagnosis of idiopathic hypersomnia; (3) Polysomnography should be performed the night before multiple sleep latency tests (MSLT).
3. Parasomnias, Sleep-Related Epilepsy, and Other Nocturnal Events: Clarifying the types of nocturnal events such as parasomnias, sleep-related epilepsy, and movement disorders. Particularly for patients with atypical clinical symptoms, unclear treatment effects, or those posing risks to themselves or others, polysomnography is required.
4. Sleep-Related Movement Disorders: Diagnosis and assessment of periodic limb movement disorder, and differentiation from restless legs syndrome and REM sleep behavior disorder.
5. Insomnia: Mainly used for clinical assessment of insomnia patients with atypical symptoms or poor treatment outcomes, to clarify the presence of subjective insomnia and differentiate from other sleep disorders that affect sleep, such as sleep-related breathing disorders, periodic limb movement disorder, and parasomnias.
6. Circadian Rhythm Sleep-Wake Disorders: Clarifying the patient’s sleep structure and ruling out other sleep disorders. It is recommended to use portable sleep monitoring technologies such as actigraphy to observe circadian rhythm changes.
7. Sleep Disorders Related to Mental Illness: (1) Evaluation of treatment effectiveness for sleep disorders related to mental illness; (2) Excluding sleep-related breathing disorders, restless legs syndrome, and other sleep disorders, as well as drug-related sleep disorders.
(2) Basic Principles and Recommendations for Polysomnography
1. When conducting polysomnography, significant differences in sleep habits among individuals should be fully considered, and appropriate recording start and end times should be selected based on the patient’s daily schedule. The clinical value of interpreting polysomnography reports should also be combined with the patient’s age and underlying diseases for personalized diagnostic analysis. Necessary specialized examinations should also be conducted based on the corresponding clinical examination needs of different departments.
2. It is recommended to use the latest version of the “AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology, and Technical Specifications” for interpreting sleep stages and sleep-related events.
2. Examination Methods and Procedures
(1) Content and Electrode Placement for Polysomnography
Polysomnography routinely records biological electrical signals such as EEG, EOG, EMG, and ECG; physiological signals such as respiratory airflow, chest and abdominal movements, pulse oxygen saturation, and snoring; and external signals such as transcutaneous carbon dioxide and pressure titration-related parameters.
1. The EEG recording electrodes should be placed according to the international “10-20” positioning system standards. The recommended combination for EEG leads is C4-M1, F4-M1, O2-M1; backup leads should use C3-M2, F3-M2, O1-M2; acceptable leads include FZ-CZ, CZ-OZ, C4-M1. The grounding electrode should be placed at or near the Fpz position, and the reference electrode should be placed at the Cz position. If any electrodes malfunction during monitoring, backup electrodes should be placed at Fpz, C3, O1, and M2; Fpz may replace Fz, C3 may replace Cz or C4, O1 may replace Oz, and M2 may replace M1.
2. It is recommended to place the EOG recording electrodes E1 and E2 at 1 cm outward and downward from the outer canthus of the left eye and 1 cm outward and upward from the outer canthus of the right eye. EOG leads should be recorded using E1-M2/E2-M2.
3. The electrodes for chin EMG should be placed 2 cm down from the anterior margin of the mandible, with Chin1 electrode 2 cm to the left of the midline and Chin2 electrode 2 cm to the right of the midline. The reference electrode ChinZ should be placed 1 cm above the midline of the anterior mandible. The recommended leads are Chin1-ChinZ or Chin2-ChinZ.
4. Monitoring of respiratory airflow: It is recommended to use both oral-nasal temperature sensors and nasal pressure sensors to monitor respiratory airflow. The oral-nasal temperature sensor is usually placed above the nostrils and lips.
5. Monitoring of respiratory effort: It is recommended to use a respiratory inductance plethysmography belt to monitor respiratory effort. The chest belt should be placed horizontally near the nipple, and the abdominal belt should be placed at the level of the umbilicus. Intercostal/diaphragm EMG and esophageal pressure can also be used for recording.
6. Monitoring of pulse oxygen saturation: Usually, fingertip or earlobe sensors are used to continuously record pulse oxygen saturation to evaluate the degree and frequency of oxygen saturation reduction. The adult pulse oximeter probe should be placed on the tip of the ring finger and secured properly.
7. Cardiac monitoring: Usually, a single-lead ECG monitoring is applied. The recommended method for placing electrodes is to place the negative electrode below the right clavicle at the intersection with the extended line of the right lower limb, and the positive electrode at the intersection of the 6th and 7th intercostal space with the extended line of the left lower limb. This is mainly used to assess heart rate and arrhythmias.
8. Monitoring of limb movements: Electrodes are usually placed on the midsection of the anterior tibial muscles of both lower limbs, with a distance of 2-3 cm between the two electrodes. Depending on clinical examination needs, upper limb movements can also be monitored simultaneously, placing electrodes on the midsection of the extensor or flexor muscles of both sides, with a distance of 2-3 cm between the two electrodes.
9. Video-audio recording: Video and audio recordings should be synchronized with EEG, EOG, EMG, and other signals to confirm the patient’s position and detect abnormal behaviors and sounds during sleep. Audio can also assist in diagnosing bruxism, sleep talking, snoring, moaning, etc. The snoring sensor should be placed in a suitable position on the neck to capture the strongest signal.
10. Position recording: A three-dimensional accelerometer that records positional changes is usually placed near the midline of the sternum and can display different positions such as supine, prone, left lateral, right lateral, and upright.
11. Other auxiliary monitoring content: Depending on different clinical examination needs, corresponding monitoring modules can be added. For patients with sleep-related breathing disorders, additional monitoring of end-tidal carbon dioxide pressure and transcutaneous carbon dioxide pressure can be added. For patients with parasomnias or epilepsy, continuous video EEG monitoring and additional EEG recording electrodes are recommended, and a 10-second window should be used for analysis. For patients diagnosed and treated for gastroesophageal reflux disease, esophageal pH measurement can be conducted simultaneously. For patients with erectile dysfunction, measuring the tension of the suspensory ligament can reflect the occurrence of erections, the strength of the erection, and the sleep stage.
(2) Technical and Data Specifications for Polysomnography
1. Detect and record electrode impedance: The impedance of the electrodes should be detected and recorded before and after the PSG recording begins and ends. The impedance of EEG, EOG, and chin EMG electrodes should be ≤5 kΩ, and the impedance of lower limb EMG electrodes should preferably be ≤5 kΩ, with ≤10 kΩ being acceptable. If artifacts occur, the electrode impedance should be re-checked.
2. The minimum digital resolution should be 12 bits.
3. Sampling frequency and filtering: Set the sampling frequency and filtering according to the recommendations in the “AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology, and Technical Specifications” (Table 1).
(3) Procedures for Polysomnography
1. Mechanical Calibration: Before monitoring, the sensitivity, polarity, and filtering settings of each amplifier should be calibrated; appropriate signal sampling frequencies should be selected for different leads; and the display should be set to an appropriate resolution. Currently, digital PSG does not require mechanical calibration for each monitoring session, only periodic calibration is needed.
2. Electrode Placement: After accurately measuring and locating according to the aforementioned electrode placement requirements, the electrodes should be sequentially pasted and placed.
3. Biological Calibration: Standardized biological calibration is a necessary part of each sleep monitoring session. By observing the monitored individual performing corresponding actions as instructed, signals can be collected to record basic physiological parameters such as the alpha rhythm in EEG recordings and the amplitude of anterior tibial muscle EMG activity, and to determine whether the electrode placement is accurate and whether the monitoring equipment, sensors, and electrodes are functioning correctly. These instructed actions include closing and opening eyes, moving eyes up and down and side to side, inhaling, exhaling, holding breath, and moving toes (Table 2). Biological calibration should be conducted before and after monitoring.
4. Once stable waveforms are obtained, monitoring can begin. During monitoring, pay attention to observe any abnormal behaviors, actions, and events of the patient, promptly identify and correct any potential signal artifacts, and periodically check impedance.
5. When the patient requests to get up or end the recording, monitoring should be paused or terminated.
6. Analyze the examination results and issue a signed report, which should be reviewed and signed by the physician responsible for the sleep examination.
3. Basis and Basic Rules for Sleep Staging
(1) Basis for Sleep Staging
Polysomnography mainly relies on information recorded from EEG, EOG, and chin EMG to comprehensively judge wakefulness and each stage of sleep.
1. Common Waveforms in EEG Recordings: Recognizing EEG waveforms is an important foundation for sleep staging. In addition to common waveforms such as alpha waves, beta waves, and delta waves in routine EEG monitoring, there are also some specific EEG waveforms that are the main basis or reference for interpreting corresponding sleep stages, including alpha rhythm, low-amplitude mixed frequency waves, vertex waves, sleep spindles, K-complexes, slow waves, and sawtooth waves (Table 3).
2. Common Waveforms in EOG Recordings: (1) Blinks: The conjugate vertical eye movement wave appearing during blinking with open eyes in the waking state at a frequency of 0.5-2.0 Hz.(2) Reading Eye Movements: Conjugate eye movement waves consisting of slow eye movements and subsequent rapid eye movements during reading.(3) Rapid Eye Movements (REM): Conjugate, irregular, steeply peaked eye movement waves, with an initial peak time of <500 ms. Rapid eye movements are characteristic of REM sleep and are also observed when scanning the environment with eyes open in the waking state.(4) Slow Eye Movements (SEM): Conjugate, relatively regular sine wave eye movement waves, with an initial peak time usually >500 ms.
3. Common Waveforms in Chin EMG Recordings: The amplitude of chin EMG is usually higher during waking than during sleep. After entering sleep, the amplitude of chin EMG gradually decreases from N1 to N3 stages, and may already be at a low level in N1, reaching the lowest level during REM sleep.
(2) Basic Rules for Sleep Staging
1. Basic Unit of Sleep Staging: A continuous 30-second PSG recording is called an epoch. An epoch is the smallest unit of sleep staging, and each epoch should be marked as a specific sleep stage. When two or more features of different sleep stages appear within an epoch, the dominant (most prevalent) sleep stage should be used to label that epoch.
2. Marking Sleep Stages: Normal sleep structure is divided into three parts: non-rapid eye movement sleep (NREM), rapid eye movement sleep (REM), and wakefulness. Among them, NREM is further divided into N1, N2, and N3 stages. (1) W Stage: The EEG during wakefulness can show low-amplitude mixed waveforms (beta and alpha waves), and when eyes are closed, alpha rhythm can be recorded in the occipital region, occupying >50% of the epoch. The EOG during wakefulness can show reading eye movements, rapid eye movements, and blinks, while slow eye movements can be recorded when eyes are closed. The amplitude of chin EMG is variable but generally higher than during sleep. (2) N1 Stage: The EEG features low-amplitude mixed frequency waves, occupying >50% of the epoch, and vertex waves may appear. The EOG can show slow eye movements. The amplitude of chin EMG is variable, typically lower than during wakefulness. (3) N2 Stage: The EEG features sleep spindles and K-complexes. The EOG recording usually shows no significant eye movements, but slow eye movements may occasionally appear. The amplitude of chin EMG is variable, usually lower than during wakefulness. (4) N3 Stage: The slow waves occupy ≥20% of the epoch in the EEG. The EOG recording usually shows no eye movements. The amplitude of chin EMG is variable, usually lower than in N2, sometimes approaching the level seen in REM sleep. (5) R Stage: The EEG shows low-amplitude mixed frequency waves, with sawtooth waves possibly appearing. The EOG shows rapid eye movements. The amplitude of chin EMG shows significant reduction, usually the lowest level during the entire recording.
3. Other Situations in Sleep Staging: (1) Major Body Movement (MBM): Due to body movements and EMG artifacts interfering with EEG for more than 50% of an epoch, accurate sleep staging cannot be determined.(2) Arousal: A sudden change in brain wave frequency during sleep causes a transient interruption of sleep continuity, but does not necessarily manifest as wakefulness. In interpreting arousal during NREM sleep, a sudden change in brain wave frequency must be observed, with the appearance of alpha waves, theta waves, or waves with frequency >16 Hz lasting ≥3 seconds, preceded by a stable sleep period lasting ≥10 seconds. In interpreting arousal during REM sleep, both the change in brain wave frequency and an increase in chin EMG must be observed simultaneously, lasting more than 1 second.
4. Abnormal Events During Sleep Staging
(1) Respiratory-Related Events
1. Apnea: The amplitude of the airflow signal from the oral-nasal temperature sensor channel decreases by ≥90% compared to baseline, and the event lasts ≥10 seconds. Based on the presence or absence of respiratory effort during the period of airflow cessation, it is further divided into: (1) Obstructive Apnea: Respiratory effort persists or increases during the period of airflow cessation; (2) Central Apnea: Respiratory effort ceases during the period of airflow cessation; (3) Mixed Apnea: During the initial part of the event, respiratory effort disappears, but then respiratory effort resumes.
2. Decrease in Pulse Oxygen Saturation: Usually defined as an event where pulse oxygen saturation decreases by ≥3% compared to before the respiratory event.
3. Hypoventilation: The amplitude of the airflow signal from the nasal pressure channel decreases by ≥30% compared to baseline, the event lasts ≥10 seconds, and is accompanied by a decrease in pulse oxygen saturation of ≥3% or arousal.
4. Respiratory Effort-Related Arousal (RERA): An event lasting ≥10 seconds characterized by increased respiratory effort or flattened nasal pressure waveform, which causes arousal during sleep and does not meet the criteria for apnea or hypoventilation.
(2) Cardiac-Related Events
1. Sinus Tachycardia: Sinus rhythm during sleep with a heart rate sustained ≥90 beats/min, lasting more than 30 seconds.
2. Sinus Bradycardia: Sinus rhythm during sleep with a heart rate sustained ≤40 beats/min, lasting more than 30 seconds.
3. Cardiac Arrest: Cardiac arrest lasting ≥3 seconds.
4. Wide Complex Tachycardia: At least three consecutive heartbeats with wide QRS complex morphology, lasting ≥120 ms, heart rate >100 beats/min.
5. Narrow Complex Tachycardia: At least three consecutive heartbeats with narrow QRS complex lasting <120 ms, heart rate >100 beats/min.
6. Atrial Fibrillation: Absolute arrhythmia with normal P waves replaced by rapid fibrillation waves of varying size, morphology, and duration.
(3) Abnormal Limb Movement Events
1. Significant Limb Movements: Lasting 0.5-10 seconds, with EMG amplitude increased by >8 μV compared to resting state, starting from the point where EMG amplitude increases >8 μV, and ending when EMG amplitude increases no more than 2 μV compared to resting state.
2. Periodic Limb Movements: At least four consecutive limb movements with an interval of 5-90 seconds between two consecutive movements.
3. Periodic Limb Movements in Sleep (PLMS): Periodic limb movements occurring during sleep.
4. Sustained Muscle Activity During REM Sleep: In one epoch of REM sleep, muscle activity in chin EMG exceeds the minimum amplitude during NREM sleep for more than 50% of the epoch.
5. Intermittent Muscle Activity During REM Sleep: In one epoch of REM sleep, subdivided into smaller epochs of 3 seconds each, where 5 small epochs show intermittent muscle activity lasting 0.1-5.0 seconds, with amplitude exceeding four times the baseline EMG amplitude.
5. Content and Format of Report Writing
(1) Routine Report Content for Polysomnography
1. General Information of the Patient: Including name, gender, contact information, height, weight, blood pressure, body mass index (BMI), neck circumference, waist circumference, etc.
2. General Information of the Examination: Including examination date, purpose of examination, electrode placement method, recorded parameters, basis for interpreting sleep stages and related events, signatures of polysomnography analysis technicians and physicians, etc.
3. Sleep Structure Parameters: (1) Light Out Time (hh:mm): The starting time of sleep monitoring. The time when the lights are turned off and the patient is instructed to start sleeping, usually consistent with the patient’s usual bedtime. (2) Light On Time (hh:mm): The termination time of sleep monitoring. The time when the patient is awake and indicates they are no longer going to sleep. (3) Total Recording Time (TRT) (minutes): The total duration of sleep recording from light out to light on. (4) Sleep Latency (SL) (minutes): The time from light out to the appearance of the first epoch of sleep. (5) Total Sleep Time (TST) (minutes): The total actual sleep time from light out to light on, i.e., the sum of the times of each sleep stage (N1, N2, N3, R). (6) Wake After Sleep Onset (WASO) (minutes): The total duration of all wake times between the first epoch of sleep and the end of recording. (7) REM Latency (minutes): The time from the first epoch of sleep to the appearance of the first epoch of REM sleep. (8) Sleep Efficiency (SE) (%): Total sleep time/total recording time × 100%. (9) Wake Time (W) (minutes): The total wake time during the recording, including sleep latency and wake time after sleep onset. (10) Time in Each Sleep Stage (minutes): Cumulative time for each sleep stage (N1, N2, N3, R). (11) Percentage of Each Sleep Stage (%): The cumulative time of each sleep stage (N1, N2, N3, R) as a percentage of total sleep time. (12) Number of Arousals: The total number of arousals during sleep. (13) Arousal Index (ArI) (times/hour): The number of arousals per unit sleep time, i.e., the number of arousals/total sleep time.
4. EEG Recordings: Describe the baseline EEG waves and whether there are any abnormal EEG activities. If abnormal EEG activities are found during monitoring, describe the sleep stage, whether abnormal seizure symptoms were observed, duration, and whether there were changes in autonomic nervous functions such as heart rate and respiration.
5. Respiratory-Related Event Parameters: (1) Number of Sleep-Related Breathing Events: The total number of apneas, hypoventilation, and RERAs during sleep. (2) Number of Apneas and Hypoventilation: The total number of apneas and hypoventilation during sleep. (3) Number of Apneas: The total number of apneas during sleep, further divided into obstructive, central, and mixed apneas. (4) Number of Hypoventilation Events: The total number of hypoventilation events during sleep. (5) Sleep-Related Breathing Event Index (times/hour): The number of breathing events per unit sleep time, i.e., the total number of apneas, hypoventilation, and RERAs/total sleep time. (6) Longest Apnea Duration and Longest Hypoventilation Duration. (7) Oxygen Desaturation Index (ODI) (times/hour): The number of times oxygen saturation decreases per unit sleep time, i.e., the number of desaturation events/total sleep time. (8) Average Oxygen Saturation and Lowest Oxygen Saturation. (9) Cumulative time with oxygen saturation below 88% or 90%.
6. Cardiac-Related Event Parameters: Changes in heart rate during wakefulness and sleep (maximum heart rate, minimum heart rate, average heart rate), and whether there are arrhythmic events. If tachycardia is present, describe the fastest heart rate during the event; if bradycardia is present, describe the slowest heart rate during the event; if cardiac arrest is present, describe the longest duration of arrest; if atrial fibrillation is present, describe the average heart rate.
7. Abnormal Limb Movement Events::
(1) Number and Index of Periodic Limb Movements During Sleep;
(2) Number and Index of Arousals Related to Periodic Limb Movements.
8. Trend Graphs: Display the different sleep stages, arousals, breathing events, pulse oxygen saturation, and limb movement events during monitoring in a structured graph format.
9. Descriptions from On-Duty Technicians and Analysis Technicians Regarding the Examination Process: Including the patient’s cooperation during the examination, any abnormal activities observed at night and related interventions, changes in the examination environment and equipment, the quality of the polysomnogram, and any special polysomnographic performances.
10. Diagnostic Summary: Describe the overall sleep condition (sleep time, sleep structure), sleep-related breathing events and severity, and any abnormal behaviors or limb movement events present during sleep.
(2) Safety and Precautions for Polysomnography:
The physician in the sleep monitoring room should arrange nursing staff for overnight monitoring based on the examination purpose and specific assessment of the patient’s condition, and in special cases, obtain informed consent and request family accompaniment. Emergency plans should be made for unexpected situations that may arise during monitoring, and sleep physicians and technicians should enhance personnel training to independently handle emergencies. The sleep monitoring room should have a relatively independent space, ensuring a quiet, dark, and comfortable sleep environment, with controllable room temperature, and equipped with basic emergency equipment and protective devices.
Members of the Guidelines/Consensus Development Expert Committee
(Arranged in alphabetical order by surname)
Chen Guihai (Department of Neurology, Chaohu Hospital Affiliated to Anhui Medical University); Chen Kui (Department of Neurology, Beijing Friendship Hospital Affiliated to Capital Medical University); Deng Liying (Department of Neurology, Second Affiliated Hospital of Nanchang University); Fan Yuhua (Department of Neurology, First Affiliated Hospital of Sun Yat-sen University); Gao Dong (Sleep Center, Daping Hospital, Army Medical University); Han Fang (Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital); Han Yanbing (Department of Neurology, First Affiliated Hospital of Kunming Medical University); He Guohua (Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong); Hou Qian (Department of Neurology, People’s Hospital of Qinghai Province); Huang Yan (Department of Neurology, Peking Union Medical College Hospital); Li Qingyun (Department of Respiratory Medicine, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine); Li Yanpeng (Department of Neurology, Changzheng Hospital of Naval Medical University); Liao Yuangao (Department of Neurology, First People’s Hospital of Chenzhou); Lin Hai (Department of Cerebrovascular Disease, Xi’an Traditional Chinese Medicine Hospital); Lin Yongzhong (Department of Neurology, Second Affiliated Hospital of Dalian Medical University); Liu Chunfeng (Department of Neurology, Second Affiliated Hospital of Suzhou University); Liu Chunhong (Department of Neurology, General Hospital of Ningxia Medical University); Liu Ling (Department of Neurology, West China Hospital, Sichuan University); Liu Zhenhua (Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University); Long Xiaoyan (Department of Neurology, Xiangya Hospital, Central South University); Lu Xiaofeng (Department of Oral and Maxillofacial Surgery, Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University); Ma Jianfang (Department of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine); Mao Chengjie (Department of Neurology, Second Affiliated Hospital of Suzhou University); Pan Jiyang (Department of Psychiatry, First Affiliated Hospital of Jinan University); Pan Yujun (Department of Neurology, First Affiliated Hospital of Harbin Medical University); Shang Wei (Department of Neurology, Second Hospital of Shandong University); Shao Hongyuan (Department of Neurology, Shanxi Provincial People’s Hospital); Song Guoying (Editorial Office of Chinese Medical Journal); Tang Jiyou (Department of Neurology, Qianfoshan Hospital Affiliated to Shandong University); Tang Xiangdong (Sleep Medicine Center, West China Hospital, Sichuan University); Wang Guaner (Sleep Center, Peking University International Hospital); Wang Jie (Department of Neurology, First Hospital of Shanxi Medical University); Wang Weiwen (Department of Neurology, General Hospital of Chengdu Military Region); Wang Xiaoyun (Department of Neurology, Drum Tower Hospital of Nanjing University); Wang Yuping (Department of Neurology, Xuanwu Hospital of Capital Medical University); Wang Zan (Department of Neurology, First Hospital of Jilin University); Wu Huijuan (Department of Neurology, Changzheng Hospital of Naval Medical University); Wu Yuncheng (Department of Neurology, First People’s Hospital Affiliated to Shanghai Jiao Tong University); Wu Zhongliang (Department of Neurology, Xijing Hospital, Air Force Medical University); Xiong Yingqiong (Department of Neurology, Jiangxi Provincial People’s Hospital); Su Changjun (Department of Neurology, Tangdu Hospital, Air Force Medical University); Xue Rong (Department of Neurology, Tianjin Medical University General Hospital); Ye Jingying (Department of Otolaryngology, Tsinghua Changgung Hospital); Yin Mei (Department of Neurology, Second Affiliated Hospital of Kunming Medical University); Yin You (Department of Neurology, Changzheng Hospital of Naval Medical University); Yu Huan (Department of Neurology, Huashan Hospital Affiliated to Fudan University); Zhan Shuqin (Department of Neurology, Xuanwu Hospital of Capital Medical University); Zhang Bin (Department of Psychiatry, Southern Medical University Southern Hospital); Zhang Hongju (Department of Neurology, People’s Hospital of Zhengzhou University); Zhang Peng (Department of Neurology, 91st Central Hospital of the PLA); Zhang Yan (Department of Neurology, Third Hospital of Peking University); Zhang Yifan (Department of Neurology, Affiliated Hospital of Guizhou Medical University); Zhang Zhiqiang (Department of Neurology, General Hospital of Lanzhou Military Region); Zhao Zhongxin (Department of Neurology, Changzheng Hospital of Naval Medical University); Zhou Xiaohong (Department of Neurology, Guangdong Provincial People’s Hospital)
Chinese Medical Journal December 2018, Volume 98, Issue 47
Authors: Sleep Disorders Professional Committee of the Neurology Branch of the Chinese Medical Doctor Association, Sleep Disorders Professional Committee of the Chinese Sleep Research Society, Sleep Disorders Group of the Neurology Branch of the Chinese Medical Association (Li Yanpeng, Wang Guaner, Zhao Zhongxin as the main authors)
Neurology Ward 1 Office: 029-33288232
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