The AASM manual is largely consensus-based and does not meet scientific evidence levels of standard practice parameters. The task force members involved in the consensus did not have an opportunity to review the contents of the manual before its publication. The manual presents a number of technical and practical concerns that remain unresolved Consensus-based recommendations are generally scrutinized, debated, and are eventually either accepted or rejected on the basis of merit and practicality. This was the case with the R and K manual nearly 40 years ago. It seems reasonable to expect the same level of scrutiny of the AASM manual, before the changes are implemented as a new standard. [3] R and K system was useful as it established minimal criteria for staging sleep that efficiently produced comparable and relatively accurate results for the clinician or researcher, among studies, scorers, and sleep laboratories. It allowed for different epoch sizes, but the 30-second epoch continued to provide adequate detail supported by its continued, consistent use in clinical and research practice. Perhaps the old R and K scoring system was good enough!
