Guidelines for the Multiple Sleep Latency Test (MSLT): A Standard Measure of Sleepiness

Carskadon, MA; Dement, William C.; Mitler, Merrill M.; Roth, T.; Westbrook, Philip R.; Keenan, Sharon

doi:10.1093/sleep/9.4.519

Cited by 1,442 publications

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“…The most commonly used clinical EEG measures of sleepiness are the multiple sleep latency test (MSLT) (Carskadon et al, 1986) and the maintenance of wakefulness test (Mitler et al, 1982;Sangal et al, 1992) which both report the mean length of time to sleep onset at multiple time periods. The awake maintenance task is a modification of the maintenance of wakefulness test using only a single 6 min period (Salinsky et al, 1996).…”

Section: Conventional Eeg Measures Of Sleepinessmentioning

confidence: 99%

Vigilance, alertness, or sustained attention: physiological basis and measurement

Oken

Salinsky

Elsas

2006

Clinical Neurophysiology

660

463

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Vigilance is a term with varied definitions but the most common usage is sustained attention or tonic alertness. This usage of vigilance implies both the degree of arousal on the sleep-wake axis and the level of cognitive performance. There are many interacting neural and neurotransmitter systems that affect vigilance. Most studies of vigilance have relied on states where the sleep-wake state is altered, e.g. drowsiness, sleep-deprivation, and CNS-active drugs, but there are factors ranging from psychophysics to motivation that may impact vigilance. While EEG is the most commonly studied physiologic measure of vigilance, various measures of eye movement and of autonomic nervous system activity have also been used. This review paper discusses the underlying neural basis of vigilance and its assessment using physiologic tools. Since, assessment of vigilance requires assessment of cognitive function this aspect is also discussed.

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Section: Conventional Eeg Measures Of Sleepinessmentioning

confidence: 99%

Vigilance, alertness, or sustained attention: physiological basis and measurement

Oken

Salinsky

Elsas

2006

Clinical Neurophysiology

660

463

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“…Only myoclonic jerks were recorded (Record 1, or R1, on Table). Three MSLT were performed, two out of them followed the APSS Committee Guidelines 6 . On first MSLT (R2) an irresistible sleep episode occurred on Nap 3 (patient fall asleep on Sleep SII and remains asleep until the end of MLST; no REM period was present).…”

Section: Casementioning

confidence: 99%

Hypersomnia in Whipple disease: case report

Maia

Marta

Lopes

et al. 2006

Arq. Neuro-Psiquiatr.

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-Whipple disease (WD) is a rare systemic infection caused by Tropheryma whippelii. Neurological involvement has been recognised in 40% of patients, either as initial manifestations or during the course of the disease. We report on a 45 years-old man with WD with initial, persistent and irresistible episodes of daytime somnolence. The patient was HLA-DQB1*0602 positive (genetic marker for narcolepsy). WD diagnosis was suspected on clinical and MRI basis and confirmed by histological and immunohistochemical study of duodenal biopsy. Forty months later all clinical features improved, narcoleptic-like episodes disappeared and cerebral MRI and CSF normalised. Longitudinal neurophysiological studies revealed persistent sleep pattern abnormalities with sleep fragmentation, paucity of slow wave and of REM sleep. The disruption of the hypocretin circuitry in the hypothalamic -diencephalic region triggered by the infection was the probable cause of the hypersomnia and narcopleptic symptoms. WD should be added to the list of causes of secondary hypersomnia.KEY WORDS: Whipple disease, hypersomnia, multiple sleep latency test, HLA (DQB1*0602). Hipersónia na doença de Whipple: relato de casoRESUMO -A doença de Whipple (DW) é infecção sistémica rara causada pelo Tropheryma whippelii. Cerca de 40% dos doentes apresentam envolvimento neurológico, seja como manifestação inicial da doença, seja durante o seu curso. Apresentamos o caso de um homem de 45 anos com doença de DW com episó-dios iniciais, persistentes e irresistíveis de sonolência durante a actividade diurna. O doente era positivo para o HLA-DQB1*0602 (marcador genético de narcolepsia). A suspeita do diagnóstico de DW foi levantada com base na clínica e RM e confirmada por estudo imunocitoquímico do material de biópsia jejunal. Quarenta meses mais tarde, todas as manifestações clínicas melhoraram, os episódios narcolépticos desapareceram, e a RM e o LCR normalizaram. Os estudos neurofisiológicos seriados do sono revelaram alterações persistentes caracterizadas por fragmentação do sono, escassez de ondas lentas e sono REM. A perturbação do circuito da hipocretina na região hipotálamo-diencefálica, causada pela infecção, foi a causa provável da hipersónia num doente geneticamente susceptível. A DW deve ser incluída nas causas de hipersónia secundária. PALAVRAS-CHAVE: doença de Whipple, hipersónia, teste de latências múltiplas, HLA (DQB1*0602).When George H Whipple first described in 1907 the autopsy findings of a case of "intestinal lipodystrophy" no neurological manifestations were reported and pathology of central nervous system (CNS) was not described. Whipple disease (WD) was born. It is now believed that the CNS is the major extra-intestinal site of involvement 1,2 . Data in the literature report a variable frequency of neurological symptomatology of 5-40% with only 5% with exclusive CNS involvement 1-4 . WD is caused by Tropheryma whippelii (TW) and it is generally accepted that both the presence of the bacillus and the host response are responsible for the ...

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“…All patients met criteria for diagnosis of narcolepsy as described in the International Classification of Sleep Disorders 13 and responded to the Epworth Sleep scale (ESS) instrument 14 . Additionally, nocturnal polysomnographic (PSG) records 15,16 and the multiple sleep latency test (MSLT) 17,18 were performed on each patient.…”

Section: Methodsmentioning

confidence: 99%

Correlations between subjective and objective features of nocturnal sleep and excessive diurnal sleepiness in patients with narcolepsy

Jiménez‐Correa

Haro

González

et al. 2009

Arq. Neuro-Psiquiatr.

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-Objective: To determine the correlations between excessive daytime sleepiness (EDS), assessed by the Epworth sleepiness scale (ESS), and the multiple sleep latency test (MSLT) and nocturnal sleep architecture features, clinical symptoms of narcolepsy (CSN) and subjective sleep quality (SSQ) in patients with narcolepsy. Method: Twenty three untreated patients were studied and compared with a matched control group. Diagnosis of narcolepsy was carried out employing a clinical interview, a polysomnographic (PSG) record, and an MSLT. Results: Subjective number of awakenings was the SSQ indicator that best correlated with EDS (ESS and MSLT). Regarding clinical features, diurnal tiredness and sleep paralysis correlated with ESS values. Increase in ESS was related with decrease in total sleep time, SWS, and sleep onset latency. On the other hand, increase in MSLT was related with decrease in SWS. Conclusion: These data suggest that EDS in patients with narcolepsy could be impaired by disturbed nocturnal sleep.KEy WORDS: narcolepsy, clinical symptoms, subjective sleep quality, sleep architecture, Epworth sleepiness scale, multiple sleep latency test, excessive daytime sleepiness. Correlação entre as características objetivas e subjetivas do sono noturno e a hipersonolência diurna em pacientes narcolepticosResumo -Objetivo: Determinar as correlações entre hipersonolência, avaliada pela escala de sonolência Epworth (ESE) e o teste múltiplo de latência do sono (TMLS) com a arquitetura do sono (AS), sintomas e qualidade subjetiva do sono em pacientes narcolepticos. Método: Comparou-se um grupo de vinte e tres pacientes narcolepticos sem tratamento com grupo controle. O diagnóstico de narcolepsia foi realizado por uma entrevista clinica, polissonografia e o TMLS. Resultados: O número subjetivo de despertares foi o indicador com maior relação com a hipersonolência, o cansaço diurno e a paralisia do sono também foi correlacionados com a ESE.O aumento do índice na ESE foi correlacionado com uma diminuição do tempo total do sono, no sono de ondas lentas (SOL) e com a latência para o início do sono. O incremento na TMLS foi relacionado com diminuição do SOL. Conclusão: Os dados sugerem que a hipersonolência diurna em pacientes portadores de narcolepsia pode se correlacionar com as alterações da arquitetura do sono noturno. PALAVRAS-CHAVE: sintoma clínico de narcolepsia, qualidade subjetiva do sono, teste múltiplo de latência do sono, hipersonolência.

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Guidelines for the Multiple Sleep Latency Test (MSLT): A Standard Measure of Sleepiness

Cited by 1,442 publications

References 0 publications

Vigilance, alertness, or sustained attention: physiological basis and measurement

Vigilance, alertness, or sustained attention: physiological basis and measurement

Hypersomnia in Whipple disease: case report

Correlations between subjective and objective features of nocturnal sleep and excessive diurnal sleepiness in patients with narcolepsy

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