In sleep laboratories, the REM stage is divided into tonic and phasic components based on the simultaneous recording of other physiological parameters not routinely monitored during EEG acquisitions (7). The other recordings include respiration effort and pulse oximetry, and chin and leg EMG activity. From a strictly EEG perspective, the background rhythm returns to what seems to be a drowsy or wakeful state, with low-voltage theta and alpha frequency activity, and with large, slow lateral eye movements (Fig. 8). This stage of sleep is also rarely encountered in routine EEG. When it is, perhaps ideally, the time from onset of drowsiness to the time of onset of REM should be measured. If it is short (<10 min), then the subject might consider a formal sleep lab referral to rule out narcolepsy.

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