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Test Protocols
Published in Ravi Gupta, S. R. Pandi Perumal, Ahmed S. BaHammam, Clinical Atlas of Polysomnography, 2018
Ravi Gupta, S. R. Pandi Perumal, Ahmed S. BaHammam
Littner, M. R., Kushida, C., Wise, M., Davila, D. G., Morgenthaler, T., Lee-Chiong, T., et al., (2005). Standards of Practice Committee of the American Academy of Sleep Medicine. Practice parameters for clinical use of the multiple sleep latency test and the maintenance of wakefulness test. Sleep 28(1), 113-121.
A Narcolepsy Patient Role Model
Published in Meeta Goswami, Charles P. Pollak, Felissa L. Cohen, Michael J. Thorpy, Neil B. Kavey, Austin H. Kutscher, Jill C. Crabtree, Psychosocial Aspects of Narcolepsy, 2015
In 1969, just after starting my company and Just before I was married, I first visited the Mayo Clinic in search of narcolepsy treatment. I was directed to a neurologist on the clinic staff who had treated about 4000 narcolepsy patients in 35 years. He retired in 1982, but still maintains a private practice for narcolepsy patients in Rochester, Minnesota. I was diagnosed as having severe narcolepsy, with frequent sleep attacks, cataplexy, and most of the other classic symptoms of narcolepsy. The diagnosis was made after I gave a complete and detailed medical history, followed by a 10-minute pupillography test. That was all. To this day I have never taken a polysomnograph or a sleep study, nor have I had a multiple sleep latency test. I wonder often if these expensive and very inconvenient procedures are really necessary?
Stimulants
Published in Clete A. Kushida, Sleep Deprivation, 2004
John A. Caldwell, J. Lynn Caldwell
Penetar et al. (126,127) examined the efficacy of 150, 300, and 600 mg/70 kg on subjects kept awake for a total of 63.5 hr (caffeine or placebo was administered after 48 hr). After the dose, data were collected on sleep latencies, psy-chomotor performance, subjective sleepiness ratings, mood, and alertness. The 600-mg dose restored sleep latency to approximately 50% of well-rested levels (up from approximately 20%) and continued to exert a positive effect for 3 hr. Throughput on the choice reaction time test was significantly improved for 8 hr by 600 mg of caffeine and for 4 hr by 300 mg of caffeine. Serial addition/subtraction benefited for 3 hr from all three doses. Performance on the logical reasoning task was better after 600 mg and 300 mg than after placebo, and the effect lasted for 12 hr. All three doses returned subjective sleepiness ratings to near baseline levels, but only for 2 hr. Ratings of vigor were improved and ratings of fatigue were attenuated similarly by all three doses and these improvements persisted for 2 hr postdose. Self-ratings of confusion were affected only by the 150-mg dose at the 2-hr postdose point. Kelly et al. (58) failed to support the sleep latency results (collected with standard multiple-sleep-latency-test procedures) or the performance results in a later study that used a 300-mg dose of caffeine across a 64-hr sleep deprivation period (300 mg every 6 hr from 23:20 on the first day through 17:20 on the third day). However, when sleep latencies were collected using a maintenance-of-wakefulness protocol, subjects receiving the caffeine were able to sustain near-baseline levels of alertness whereas placebo subjects were not. Some of the differences between the Penetar et al. (126) and Kelly et al. (58) studies no doubt stem from the fact that one study was designed to restore performance that had already deteriorated, whereas the other study attempted to prevent decrements from ever occurring.
Residual excessive daytime sleepiness in patients treated for obstructive sleep apnea: guidance for assessment, diagnosis, and management
Published in Postgraduate Medicine, 2021
Russell Rosenberg, Paula K. Schweitzer, Joerg Steier, Jean-Louis Pepin
The Multiple Sleep Latency Test (MSLT) and Maintenance of Wakefulness Test (MWT) are the most commonly used objective assessments for characterizing an individual’s ability to fall asleep in a sleep-inducing environment or stay awake while seated in a dark, quiet environment, respectively (Table 2). For both assessments, the outcome of interest is mean sleep onset latency (the average amount of time it takes the patient to fall asleep) as determined by electroencephalography. The MSLT is often used to rule out other sleep disorders as the etiology for EDS, such as narcolepsy. The American Academy of Sleep Medicine (AASM) advises that the MWT should not be used for diagnostic purposes [71]. Instead, it may be useful to evaluate the response to treatment or assess whether an individual’s ability to remain awake poses a public or personal safety risk, such as those employed in public transportation [72].
Bright-light exposure during daytime sleeping affects nocturnal melatonin secretion after simulated night work
Published in Chronobiology International, 2018
Shunsuke Nagashima, Madoka Osawa, Hiroto Matsuyama, Wataru Ohoka, Aemi Ahn, Tomoko Wakamura
The sleep parameters of daytime sleeping in our study, particularly SOL and WASO, did not differ significantly between the light conditions, although many previous studies have indicated that subjective sleepiness was reduced by bright-light exposure during daytime (Phipps-Nelson et al. 2003; Rüger et al. 2006). This may be due to increased homeostatic sleep pressure after simulated night work. Under the bright-light condition, the mean time of SOL for the daytime sleeping was only 3.5 ± 1.5 minutes. This result was very similar to that of a multiple sleep latency test (3.0 ± 2.9 minutes) following one night of total sleep deprivation (Franzen et al. 2008). Thus, with the greater homeostatic sleep pressure due to night work, bright-light exposure during daytime sleeping may have little impact on daytime sleeping after night work.
Factor structure of the Brazilian version of Pediatric Daytime Sleepiness Scale
Published in Chronobiology International, 2018
Geraldo Jose Ferrari Junior, Christopher L Drake, Diego Grasel Barbosa, Rubian Diego Andrade, Diego Augusto Santos Silva, Gomes Felden Érico Pereira
Thus, some evaluative methods were created in order to measure daytime sleepiness. The Multiple Sleep Latency Test (Hauser and Josephson 2015) is the most effective test; however, it is costly and difficult to apply in epidemiological research. An alternative subjective evaluation of daytime sleepiness is the Epworth Sleepiness Scale (ESS) which was developed and designed to measure sleep propensity in a simple and standardized way in adults (Johns 1991). In addition to the abovementioned, the Pediatric Daytime Sleepiness Scale (PDSS) (Drake et al. 2003) is also a quick and easy questionnaire to complete, but different from ESS. The PDSS evaluates the daytime sleepiness of children and adolescents in daily life situations related to sleep habits.