Frenkel Simon, Amaranayake Ashen, Molesworth Charlotte, Orellana Liliana, Southcott Anne Marie
Department of Respiratory and Sleep Disorders Medicine, Western Hospital, Melbourne, Victoria, Australia.
Biostatistics Unit, Deakin University, Geelong, Victoria, Australia.
J Clin Sleep Med. 2024 Dec 1;20(12):1937-1943. doi: 10.5664/jcsm.11302.
The Multiple Sleep Latency Test (MSLT) is a key diagnostic component in the diagnosis of central disorders of hypersomnolence. Due to time constraints, it is common practice to wake patients at a standard time from overnight polysomnography (PSG) prior to the MSLT. This has the potential to influence MSLT results due to sleep deprivation. We describe the impact of allowing ad libitum sleep on the night prior to the MSLT in patients being assessed for hypersomnolence.
A total of 580 consecutive patients undergoing PSG/MSLT for assessment of hypersomnolence were analyzed: 290 either side of a change in laboratory protocol that allowed patients ad libitum sleep during the PSG, rather than being woken at a prespecified time. Baseline characteristics, PSG and MSLT results were compared between the groups.
Groups were similar at baseline, other than there being more females in the ad libitum group. After adjusting for confounding variables, patients allowed ad libitum sleep had later sleep offset time (+58.7 minutes; < .001), longer PSG total sleep time (+47.8 minutes; < .001), longer MSLT mean sleep latency (+1.3 minutes; = .002), and 23% fewer MSLT with mean sleep latency less than 8 minutes ( = .004) when compared with patients who were woken at a standard time.
The common practice of waking patients from their PSG at a standard time has the potential to curtail sleep and affect MSLT results by reducing mean sleep latency. Patients being assessed for hypersomnolence should be allowed ad libitum sleep during the PSG on the night prior to their MSLT.
Frenkel S, Amaranayake A, Molesworth C, Orellana L, Southcott AM. Allowing ad libitum sleep during overnight polysomnography affects Multiple Sleep Latency Test results in patients being assessed for hypersomnolence. 2024;20(12):1937-1943.
多次睡眠潜伏期试验（MSLT）是诊断中枢性过度嗜睡症的关键诊断组成部分。由于时间限制，在进行MSLT之前，按照标准时间将患者从夜间多导睡眠图（PSG）中唤醒是常见的做法。由于睡眠剥夺，这有可能影响MSLT结果。我们描述了在对过度嗜睡症患者进行评估时，允许其在MSLT前一晚自由睡眠的影响。
对总共580例连续接受PSG/MSLT以评估过度嗜睡症的患者进行分析：在实验室方案改变前后各有290例患者，改变后的方案允许患者在PSG期间自由睡眠，而不是在预定时间唤醒。比较两组患者的基线特征、PSG和MSLT结果。
除了自由睡眠组女性更多外，两组在基线时相似。在调整混杂变量后，与按标准时间唤醒的患者相比，允许自由睡眠的患者睡眠结束时间更晚（+58.7分钟；P<0.001），PSG总睡眠时间更长（+47.8分钟；P<0.001），MSLT平均睡眠潜伏期更长（+1.3分钟；P=0.002），且MSLT平均睡眠潜伏期小于8分钟的情况减少了23%（P=0.004）。
按照标准时间将患者从PSG中唤醒的常见做法有可能缩短睡眠时间，并通过降低平均睡眠潜伏期来影响MSLT结果。对过度嗜睡症进行评估的患者应在MSLT前一晚的PSG期间允许自由睡眠。
Frenkel S, Amaranayake A, Molesworth C, Orellana L, Southcott AM. 夜间多导睡眠图期间允许自由睡眠会影响对过度嗜睡症患者进行评估时的多次睡眠潜伏期试验结果。2024；20(12):1937 - 1943。
