# Sleep lab study scoring software that keeps the scorer, the epochs and the physician review on one study

> Sleep lab study scoring is the epoch by epoch reading of a polysomnogram, in which a technologist stages sleep and marks respiratory events so a physician can interpret the study. Medicare treats a sleep study as 6 or more hours of recording with physician review, and requires the laboratory physician to review the entire raw data recording for every patient studied. Scoring is also the least reproducible step: in a study of 70 polysomnograms read by 10 technologists, only 1.5 percent of stage N1 epochs were scored unanimously. Neurobird holds the study, the scorer and the review on one record.

- URL: https://neurobird.com/sleeplab/
- Product: Neurobird Sleep Lab Study Scoring Inspection Tracking Platform
- Niche: sleep lab study scoring
- Buyer: sleep laboratories and diagnostic sleep centers
- Status: in development, open for early access
- Updated: 2026-08-22

## What Neurobird Sleep Lab Study Scoring does

- Hold the scoring queue by study rather than by whoever happens to be logged into the acquisition system
- Attach the scorer's credential and its expiry date to the study they actually read
- Compare a rescore against the original and report the agreement instead of quietly overwriting it
- Record the physician review of the raw recording as an event with a time, not as a signature line

## How it works

1. **Take the study in** The recording, its total time, the order and the referring physician land as one record, so a study that fell short of 6 hours is visible before anyone starts scoring it.
2. **Assign and score** The queue routes by credential and workload, the scorer is stamped on the study, and a second read is stored beside the first rather than on top of it.
3. **Review and release** The interpreting physician's review of the raw data is recorded as its own step, and the report goes out with the scorer, the reviewer and the agreement figures attached to it.

## From the source material

> A sleep study, also known as polysomnography, is a test that measures and records different body functions while you sleep.

Source: MedlinePlus, sleep study, https://medlineplus.gov/lab-tests/sleep-study/

## Industry context

- **6 hours** Recording length Medicare uses to describe a sleep study or polysomnogram, with physician review, interpretation and report, and the laboratory physician must review the entire raw data recording for every patient studied. (source: CMS Article A53019, https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=53019)
- **15 events** Apnea hypopnea index per hour that supports an initial 12 week period of CPAP, or an index of 5 to 14 events per hour with documented sleepiness, cognitive or mood symptoms, hypertension, ischemic heart disease or stroke. (source: CMS NCD 240.4, https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=226)
- **10 seconds** Minimum duration for an apnea. A hypopnea also lasts at least 10 seconds and needs at least a 30 percent reduction in airflow or thoracoabdominal movement together with at least a 4 percent oxygen desaturation. (source: CMS NCD 240.4, https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=226)
- **1.5 percent** Share of stage N1 epochs that received a unanimous score from all six technologists reading the same recordings. For stage N3 the unanimous share was 3.8 percent. (source: J Clin Sleep Med 2018, PMC5786839, https://pmc.ncbi.nlm.nih.gov/articles/PMC5786839/)
- **45.2 percent** Share of epochs scored as stage N1 by one technologist that no other technologist scored as stage N1. The same figure for stage N3 was 40.8 percent. (source: J Clin Sleep Med 2018, PMC5786839, https://pmc.ncbi.nlm.nih.gov/articles/PMC5786839/)
- **70 studies** Polysomnograms scored independently by 10 trained technologists from five academic sleep laboratories. Intraclass correlation with the group average ran from 0.18 to 0.96 depending on stage and scorer. (source: J Clin Sleep Med 2018, PMC5786839, https://pmc.ncbi.nlm.nih.gov/articles/PMC5786839/)

## Pricing

- Single laboratory: $179 per month
- Sleep center: $545 per month
- Multi site group: $1,380 per month

## Questions

### What is sleep lab study scoring?

It is the epoch by epoch reading of a polysomnogram, in which a technologist assigns a sleep stage to each 30 second epoch and marks respiratory events, arousals and limb movements. The interpreting physician then reviews the raw recording and writes the report from the scored data.

### What are the documentation requirements for a Medicare sleep study?

CMS describes a sleep study as 6 or more hours of recording with physician review, interpretation and report. The report has to carry the parameters monitored, start time and duration, total sleep time, sleep efficiency, time in each stage and the respiratory findings, and the laboratory physician must review the entire raw data recording.

### Why does interscorer agreement matter?

Because the numbers on the report depend on who read it. In a published study of 70 polysomnograms read by 10 experienced technologists, only 1.5 percent of stage N1 epochs were scored the same way by everyone, and intraclass correlation with the group average ranged from 0.18 to 0.96.

### Does this replace our acquisition system?

No. The amplifiers, the waveform display and the scoring tool stay where they are. This holds the queue around them: which study went to which scorer, what their credential was, how a rescore compared, and when the physician reviewed the recording.

### Can it track scorer credentials?

Yes, and it ties them to the study rather than to a folder. The payer article names the credentials a scorer must hold, so the useful place to keep them is beside the studies that person actually read.

## Sources

- [CMS Article A53019, polysomnography and sleep studies](https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=53019)
- [CMS NCD 240.4, CPAP therapy for obstructive sleep apnea](https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=226)
- [Reliability of the AASM rules for assessing sleep depth, J Clin Sleep Med](https://pmc.ncbi.nlm.nih.gov/articles/PMC5786839/)
- [42 CFR 410.33, independent diagnostic testing facility](https://www.law.cornell.edu/cfr/text/42/410.33)
- [MedlinePlus, sleep study](https://medlineplus.gov/lab-tests/sleep-study/)
- [NINDS, brain basics: understanding sleep](https://www.ninds.nih.gov/health-information/public-education/brain-basics/brain-basics-understanding-sleep)

## Contact

- office@neurobird.com
- https://neurobird.com/