{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:59:05Z","timestamp":1792155545761,"version":"4.4.0"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","award":["2793745"],"award-info":[{"award-number":["2793745"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>The cyclic alternating pattern is a hallmark of the dynamic organisation of non\u2010rapid eye movement sleep, reflecting the brain's oscillatory regulation of arousal and sleep stability. Since the original publication of the rules for scoring the cyclic alternating pattern in 2001, major advances in sleep neurophysiology, signal analysis and international sleep staging standards have necessitated a comprehensive revision. This consensus report by a Taskforce of the European Sleep Research Society presents the updated 2025 Atlas and Rules for the scoring of the cyclic alternating pattern in human sleep. The new guidelines preserve the foundational framework of the cyclic alternating pattern while introducing several critical innovations: (i) expanded definitions and a broader catalogue of Phase A electroencephalographic patterns; (ii) refined onset and offset criteria based on amplitude and frequency shifts, with strict inter\u2010lead concordance requirements; (iii) standardised metrics for the quantification and reporting of the cyclic alternating pattern; (iv) formal guidance for scoring the cyclic alternating pattern in paediatric populations and optional scoring in rapid eye movement sleep; and (v) a technical framework for computerised detection and analysis. These updates align scoring with contemporary sleep staging standards, enhancing precision, reproducibility and applicability across research and clinical contexts.<\/jats:p>","DOI":"10.1111\/jsr.70283","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T09:05:52Z","timestamp":1768986352000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Atlas and Updated Rules for the Scoring of Cyclic Alternating Pattern (\n                    <scp>CAP<\/scp>\n                    ) in Human Sleep. A Consensus Report by a Taskforce of the European Sleep Research Society"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4035-6234","authenticated-orcid":false,"given":"Liborio","family":"Parrino","sequence":"first","affiliation":[{"name":"\u201cMario Giovanni Terzano\u201d Sleep Disorders Center University of Parma  Parma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidur","family":"Gretarsdottir","sequence":"additional","affiliation":[{"name":"Reykjavik University Sleep Institute, School of Technology, Reykjavik University  Reykjavik Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Thomas","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Pulmonary, Critical Care and Sleep, Department of Medicine Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana","family":"Rosenzweig","sequence":"additional","affiliation":[{"name":"Sleep and Brain Plasticity Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London  London UK"},{"name":"Sleep Disorders Centre Guy's and St Thomas' Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2207-1398","authenticated-orcid":false,"given":"Oliviero","family":"Bruni","sequence":"additional","affiliation":[{"name":"Department of Human Neuroscience Sapienza University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulcin Benbir","family":"Senel","sequence":"additional","affiliation":[{"name":"Division of Clinical Neurophysiology, Department of Neurology, Cerrahpasa Faculty of Medicine Istanbul University\u2010Cerrahpasa  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F\u00e1bio","family":"Mendon\u00e7a","sequence":"additional","affiliation":[{"name":"University of Madeira  Funchal Portugal"},{"name":"Interactive Technologies Institute (ITI\/ARDITI\/LARSyS)  Funchal Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio G.","family":"Ravelo Garc\u00eda","sequence":"additional","affiliation":[{"name":"Interactive Technologies Institute (ITI\/ARDITI\/LARSyS)  Funchal Portugal"},{"name":"Institute for Technological Development and Innovation in Communications, Universidad de Las Palmas de Gran Canaria  Las Palmas de Gran Canaria Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erna Sif","family":"Arnard\u00f3ttir","sequence":"additional","affiliation":[{"name":"Reykjavik University Sleep Institute, School of Technology, Reykjavik University  Reykjavik Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Ferri","sequence":"additional","affiliation":[{"name":"Sleep Research Centre Oasi Research Institute\u2010IRCCS  Troina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"e_1_2_20_2_1","volume-title":"The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications, Ver. 2.6","author":"Berry R. 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