Special Procedures F5-F13

Question 1

What does MSLT stand for?
What does it test for?
When is it done?

Answer 1

Multiple Sleep Latency Test
It is the definitive test for narcolepsy.
About 1.5-3 hrs after a full polysomnography.
(This is to rule out that the sleepiness is due to a bad night’s sleep. A good night’s sleep is documented.)

Question 2

The MSLT consists of a seris of # to # naps, # minutes in duration, and # hours apart.

Answer 2

A series of 4-5 naps, 20 min in duration, 2 hrs apart.

Question 3

When are four naps acceptable to complete the MSLT?

Answer 3

If sleep onset REM occurs in 2 of the 4 naps.

Question 4

After what event is an MSLT not recommended?

The MSLT can’t be used to diagnose narcolepsy if the TST on the prior night study was less than # hours.

Answer 4

After a split-night study

6 hours.

Question 5

To evaluate sleep hygiene, ___ may be required, and it must be done __ prior to the MSLT.

Answer 5

A sleep log, 1 week prior.

Question 6

If you’re going to do MSLTs, there are two skills you need to be really good at. What are they? (x2)

Answer 6

1. Score sleep onset very accurately

2. Score REM onset very accurately.

Question 7

When can you end a nap during an MSLT?

Answer 7

No sleep after 20 min

15 min of continuous sleep onset is monitored.

Question 8

What are the indications for doing an MSLT?

Answer 8

Narcolepsy vs excessive daytime sleepiness vs idiopathic hypersomnia
Evaluate sleepiness
Determine sleep onset REM (SOREM)
(Note: Normal patients take 90 min to enter REM. Nacroleptic patients can have 2 or more REM periods in a nap period.)

Question 9

To detect any drugs that may cause sleepiness, the patient might need to take this test.

Answer 9

Urinalysis

Question 10

What must be done by the patient before and after naps? (Pre and post)

Answer 10

Sleep questionnaire

Question 11

How do you do biocalibrations of the eyes before each nap? (x4)

Answer 11

1. Lie quietly with eyes open for 30 seconds.
2. Close eyes for 30 seconds
3. With eyes and without moving head, look right, then left.
4. Blink eyes 5 times.

Question 12

How do you do biocalibrations of other body parts (not the eyes) before each nap? (x2)
How often do you do calibrations? (x1)

Answer 12

1. Clench or grind teeth tightly together
2. Lie quietly in a comfortable position and try to fall asleep.
3. Repeat before each nap.

Question 13

Which sensors are not required for an MSLT? (x5)

Answer 13

1. Leg leads
2. Intercostal EMG
3. Thermocouple
4. Oximeter
5. Respiratory belts

Question 14

Between naps, the patient must be ___, but not fight the urge to ___.

Answer 14

Must be out of bed

Do not fight the urge to fall asleep. (Sit in a chair reading or relaxing.

Question 15

What information is required to score the MSLT?

Answer 15

Sleep latencies for each nap
Mean sleep latency for entire test
Number of sleep-onset REM periods (SOREM)

Question 16

How do you calculate sleep latency?

How do you calculate REM latency?

Answer 16

Lights out to first epoch of sleep

Lights out to first epoch of REM

Question 17

Interpretation of MSLT scores:

0-5 min:

Answer 17

Severe

Question 18

Interpretation of MSLT scores:

6-10 min:

Answer 18

Troublesome

Question 19

Interpretation of MSLT scores:

11-15 min:

Answer 19

Manageable

Question 20

Interpretation of MSLT scores:

16-20 min: Excellent

Answer 20

Excellent