The Multiple Slep Latency Test分析课件.ppt

The Multiple Sleep Latency Test Objective To assess and diagnose disorders of excessive daytime somnolence. MSLT Protocol Consists of five nap “opportunities” for the patient to sleep; performed at two hour intervals. Initial nap opportunity begins 1.5-3 hours after termination of the polysomnogram. Five vs. Four Naps A shorter four-nap test may be performed but this test is not reliable for the diagnosis of Narcolepsy unless at least two Sleep Onset REM Periods (SOREMPs) have occurred. MSLT Protocol(continued) Must be performed immediately following polysomnography recorded during the individual’s major sleep period. Contraindications The use of the MSLT to support a diagnosis of Narcolepsy is suspect if TST on the prior night sleep is less than 6 hours. The test should not be performed after a split-night study. Sleep logs may be acquired for one week prior to the MSLT to assess sleep-wake schedules (sleep hygiene) Why? To rule out: Sleep Apnea Movement Disorders Circadian Rhythm Disorders Insufficient/Poor Sleep Other sleep disorders Standardization Sleep rooms should be quiet and dark during testing. Room temperature should be set based on patient’s comfort level. Smoking should be stopped at least 30 minutes prior to each nap opportunity. Vigorous physical activity should be avoided during the day and any stimulating activities by the patient should end at least 15 minutes prior to each nap opportunity. Standardization Patients must abstain from any caffeinated beverages and avoid unusual exposures to bright sunlight. A light breakfast is recommended at least 1 hour prior to the first nap. A light lunch is recommended immediately after the termination of the second nap. Medications Stimulants, stimulant-like medications, and REM suppressing medications should be ideally stopped 2 weeks before the MSLT. Use of the patient’s other usual medications (anti-hypertensives, insulin, etc.) should be thoughtfully planned by the sleep clinician before MSLT testing so