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In a sample of multiple sleep latency test naps following nocturnal polysomnograms from a group of 13 patients of varying ages and diagnoses, we compared a computer-derived electroencephalographic (EEG) measure (z-ratio) with standard visual sleep stage scoring. In this clinical population, z-ratio scoring agreed with human scorers approximately 80% of the time when determining sleep versus wake in 30-second epochs. These results show that a single, objectively quantifiable value derived from a single channel of EEG can distinguish between sleep and wakefulness (as defined by Rechtschaffen and Kales) with at least a moderate degree of precision. When refined, the z-ratio method might be of use as the basis for a new sleep scoring system, particularly where an accurate determination of sleep onset is required.

Comparison of a Frequency-based Analysis of Electroencephalograms (Z-ratio) and Visual Scoring on the Multiple Sleep Latency Test