According to the AASM (Littner, et al., 2005), repeat MSLT testing may be indicated in the following situations: The MSLT is not routinely indicated in the initial evaluation and diagnosis of obstructive sleep apnea syndrome or in assessment of change following treatment with nasal CPAP (Littner, et al., 2005). The MSLT is not routinely indicated for evaluation of sleepiness in medical and neurological disorders (other than narcolepsy), insomnia, or circadian rhythm disorders. The MSLT may be indicated as part of the evaluation of patients with suspected idiopathic hypersomnia to help differentiate idiopathic hypersomnia from narcolepsy. According to AASM guidelines (Littner, et al., 2005), the MSLT is indicated as part of the evaluation of patients with suspected narcolepsy to confirm the diagnosis. Results may be used to determine the efficacy of therapy for sleep disturbance disorders (such as narcolepsy) or to determine if the inability to stay awake is a public or personal safety concern. The test is routinely performed the day after a nocturnal PSG and evaluates the ability to stay awake for a defined period of time. ![]() The procedure protocol is similar to that of the MSLT, with the exception that an individual is given four nap trials, each trial consisting of a forty minute session in which the an individual attempts to fall asleep. Maintenance of Wakefulness Test (MWT) is a facility based study that is used to measure the ability to stay awake and alert. Parameters necessary for sleep staging (including 1 to 4 channels of EEG, EOG, and chin EMG) are recorded. The MSLT is the better test for demonstration of sleep-onset rapid eye movement (REM) periods, a determination that is important in establishing the diagnosis of narcolepsy. The patient may be instructed to lie down in a dark room, with permission or a suggestion given to sleep (MSLT) or to sit up in a dimly lit room and try to stay awake (maintenance of wakefulness test). The test is typically performed on the night following a polysomnography (PSG where at least six hours of sleep were achieved) in order to rule out other sleep disorders as a cause of excessive daytime sleepiness. Onset of sleep and rapid eye movement, along with heartbeat and chin movements are recorded. During a routine MSLT, an individual is given five nap trials that are separated by two hour intervals: each trial consists of a twenty-minute session in which the individual attempts to fall asleep. The multiple sleep latency test (MSLT) involves multiple trials during a day to objectively assess sleep tendency by measuring the number of minutes it takes the patient to fall asleep. The results of the study are primarily used to confirm the suspected diagnosis of narcolepsy. Multiple Sleep Latency Test (MSLT) is a facility based study that is used to measure levels of daytime sleepiness. ![]() See also CPB 0004 - Obstructive Sleep Apnea in Adults.
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