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P.128 Quantitative EEG Detects REM Sleep Microstructure

Background: Rapid eye movement sleep (REM) is divided into phasic and tonic microstates. Phasic REM is defined by presence of REMs with reportedly greater antiepileptic effect. We assessed whether quantitative EEG (QEEG) software can detect REM microstates. Methods: We applied artifact reduction and detection trends from QEEG software (Persyst 14) on 18 patients undergoing 30 day-night high density EEG recordings in the epilepsy monitoring unit. We identified phasic REM as 10-second epochs of previously human-scored REM that demonstrated presence of either vertical or horizontal eye movements on the QEEG artifact detection panel. Remaining epochs were identified as tonic REM. Results: Out of 91.2 average minutes of REM (range 24.5-167.5) per recording, a mean of 2.5% (range 0-18.9%) demonstrated eye movements intensive enough for QEEG artifact detection to be identified as phasic REM. On average, only 40% (range 0-500%) of eye movements per recording was flagged as vertical. Conclusions: These findings provide proof-of-concept that QEEG can automatically assess REM microstructure by readily detecting phasic and tonic REM. These findings also confirm that most REMs are horizontal. Having the ability to easily and automatically detect phasic versus tonic REM can help further future studies examining the antiepileptic effect of REM sleep.