Anniss Angela M, Young Alan, O'Driscoll Denise M
Department of Respiratory and Sleep Medicine, Eastern Health, Box Hill, Victoria, Australia.
Eastern Health Clinical School, Monash University, Clayton, Victoria, Australia.
J Clin Sleep Med. 2021 Aug 1;17(8):1571-1578. doi: 10.5664/jcsm.9250.
The Maintenance of Wakefulness Test (MWT) is used to objectively evaluate an individual's ability to remain awake; however, microsleeps are not included in the assessment. We aimed to determine if microsleep data prior to sleep onset assisted in interpretation of ability to maintain wakefulness across a range of typical patient groups.
Forty-eight patients referred for overnight polysomnography and subsequent MWT were included. Patients were divided into 3 groups (treated obstructive sleep apnea [OSA], untreated OSA, or treated idiopathic hypersomnia or narcolepsy) based on prior medical diagnosis. Demographics, clinical characteristics, polysomnography, and MWT variables, including frequency, distribution, duration, and latency of microsleeps were compared between groups.
Microsleeps were observed in MWT trials significantly more frequently in patients with treated idiopathic hypersomnia/narcolepsy over the course of the day (0.34 ± 0.06 vs 0.07 ± 0.02 microsleeps/min; < .001) and in patients with untreated OSA toward the end of the day (0.31 ± 0.06 vs 0.05 ± 0.02 microsleeps/min; < .001) compared to the group with treated OSA. Microsleeps were often observed in series and earlier in patients with treated idiopathic hypersomnia/narcolepsy (10.9 ± 1.6 minutes) and those with untreated OSA (16.2 ± 2.7 minutes) compared to the group with treated OSA (24.9 ± 3.0 minutes; < .05), and, if taken into consideration, would increase the proportion of patients demonstrating inability to maintain wakefulness by 33% and 22%, respectively.
MWT performance varies significantly across patient groups. Microsleep analysis prior to sleep onset may be a more sensitive measure of patient daytime wakefulness than sleep latency alone and should be considered in MWT assessment.
Anniss AM, Young A, O'Driscoll DM. Microsleep assessment enhances interpretation of the Maintenance of Wakefulness Test. . 2021;17(8):1571-1578.
清醒维持测试（MWT）用于客观评估个体保持清醒的能力；然而，微睡眠未包含在评估范围内。我们旨在确定入睡之前的微睡眠数据是否有助于解读一系列典型患者群体维持清醒的能力。
纳入48例因夜间多导睡眠图检查及后续MWT而转诊的患者。根据既往医学诊断，将患者分为3组（治疗的阻塞性睡眠呼吸暂停[OSA]、未治疗的OSA或治疗的特发性嗜睡症或发作性睡病）。比较各组之间的人口统计学、临床特征、多导睡眠图和MWT变量，包括微睡眠的频率、分布、持续时间和潜伏期。
与治疗的OSA组相比，治疗的特发性嗜睡症/发作性睡病患者在一天中MWT试验中观察到微睡眠的频率显著更高（0.34±0.06次微睡眠/分钟 vs 0.07±0.02次微睡眠/分钟；P<.001），未治疗的OSA患者在一天结束时微睡眠频率也显著更高（0.31±0.06次微睡眠/分钟 vs 0.05±0.02次微睡眠/分钟；P<.001）。与治疗的OSA组（24.9±3.0分钟；P<.05）相比，治疗的特发性嗜睡症/发作性睡病患者（10.9±1.6分钟）和未治疗的OSA患者（16.2±2.7分钟）中微睡眠常呈连续性且出现得更早，如果将微睡眠考虑在内，将分别使表现出无法维持清醒的患者比例增加33%和22%。
不同患者群体的MWT表现差异显著。入睡之前的微睡眠分析可能是比单独的睡眠潜伏期更敏感的患者日间清醒度指标，在MWT评估中应予以考虑。
Anniss AM, Young A, O'Driscoll DM. Microsleep assessment enhances interpretation of the Maintenance of Wakefulness Test. . 2021;17(8):1571-1578.
