Multiple Sleep Latency Test
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OBJECTIVE: To evaluate sleep macrostructure, sleep disorders incidence and daytime sleepiness in attention-deficit/hyperactivity disorder (ADHD) affected children compared with controls. METHODS: Thirty-one patients (26 boys, 5 girls, mean age 9.3+1.7, age range 6-12 years) with ADHD diagnosed according to DSM-IV criteria, without comorbid psychiatric or other disorders, as never before pharmacologically treated for ADHD. The controls were 26 age- and sex-matched children (22 boys, 4 girls, age range 6-12 years, mean age 9.2+1.5). Nocturnal polysomnography (PSG) was performed for two nights followed by the multiple sleep latency test (MSLT). RESULTS: No differences between the two groups comparing both nights were found in the basic sleep macrostructure parameters or in the time (duration) of sleep onset. A first-night effect on sleep variables was apparent in the ADHD group. Occurrence of sleep disorders (sleep-disordered breathing [SDB], periodic limb movements in sleep [PLMS], parasomnias) did not show any significant differences between the investigated groups. A statistically significant difference (p=0.015) was found in the trend of the periodic limb movement index (PLMI) between two nights (a decrease of PLMI in the ADHD group and an increase of PLMI in the control group during the second night). While the mean sleep latency in the MSLT was comparable in both groups, children with ADHD showed significant (sleep latency) inter-test differences (between tests 1 and 2, 1 and 4, 1 and 5, p<0.01). CONCLUSION: After the inclusion of adaptation night and exclusion of psychiatric comorbidities, PSG showed no changes in basic sleep parameters or sleep timing, or in the frequency of sleep disorders (SDB, PLMS) in children with ADHD compared with controls, thus not supporting the hypothesis that specific changes in the sleep macrostructure and sleep disturbances are connected with ADHD. A first-night effect on sleep variables was apparent only in the ADHD group. Though we found no proof of increased daytime sleepiness in children with ADHD against the controls, we did find significant vigilance variability during MSLT in the ADHD group, possibly a sign of dysregulated arousal.
- MeSH
- dítě MeSH
- elektroencefalografie MeSH
- hyperkinetická porucha * komplikace patofyziologie MeSH
- lidé MeSH
- polysomnografie MeSH
- poruchy iniciace a udržování spánku komplikace patofyziologie MeSH
- poruchy nadměrné spavosti * komplikace patofyziologie MeSH
- poruchy spánku a bdění * komplikace patofyziologie MeSH
- spánek REM fyziologie MeSH
- spánek fyziologie MeSH
- studie případů a kontrol MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
Cíl: Narkolepsii objektivizuje test mnohočetné latence usnutí (Multiple Sleep Latency Test, MSLT) nálezem průměrné latence usnutí ≤ 8 min a ≥ 2 spánky s časným nástupem REM spánku. Cílem studie bylo zhodnotit přínos opakování MSLT při podezření na narkolepsii, když první MSLT narkolepsii nepotvrdilo. Soubor a metodika: Jedná se o retrospektivní studii výsledků MSLT u nemocných vyšetřených pro narkolepsii v Centru pro poruchy spánku a bdění Neurologické kliniky 1. LF UK a VFN za sledované období 13 let. Studie analyzuje 39 dospělých nemocných s podezřením na narkolepsii, kterým bylo v průběhu roku provedeno dvakrát MSLT a u nichž první výsledek nesplňoval kritéria narkolepsie, a 42 nemocných, jejichž první MSLT odpovídalo narkolepsii. Výsledky: Devatenáct nemocných mělo první MSLT negativní a druhé pozitivní a u 20 nemocných první i opakované MSLT nesplnilo diagnostická kritéria narkolepsie. Tyto skupiny se navzájem a také vzhledem k nemocným se stanovenou diagnózou při prvním MSLT lišily v latenci REM spánku během noční polysomnografie. Latence usnutí prvního MSLT předpovídá výsledek opakovaného MSLT (p < 0,001). Senzitivita jednoho vyšetření MSLT proti dvěma MSLT je 82,4 % a negativní prediktivní hodnota prvního nepotvrzujícího MSLT je 48,7 %. Závěry: Při podezření na narkolepsii a neprůkazném nálezu při vyšetření MSLT je přínosné toto vyšetření opakovat.
Aim:Narcolepsy is confirmed if the MSLT (Multiple Sleep Latency Test) shows the mean sleep latency of ≤8 min and ≥2 episodes of sleep with early onset of REM sleep. The aim was to assess the value of repeated MSLT in subjects with suspected narcolepsy after the first MSLT failed to confirm narcolepsy. Patients and methods: This is a retrospective study of the MSLT results in adult patients examined for narcolepsy at the Sleep and Wake Disorders Center of the Department of Neurology, First Faculty of Medicine and General University Hospital in Prague during a 13-year period. The study analysed 39 adults with suspected narcolepsy who underwent second MSLT in a course of one year after their first MSLT results failed to meet the criteria for narcolepsy, and 42 patients whose initial MSLT was consistent with narcolepsy. Results: In 19 patients, the first MSLT was negative, while the second was positive. In 20 patients, both the first and repeated MSLT failed to meet the diagnostic criteria for narcolepsy. These groups differed from one another and from patients diagnosed with the first MSLT in REM sleep latency during nocturnal polysomnography. Sleep latency in the first test is predictive of the outcome of the repeated MSLT (p < 0.001). Sensitivity of one MSLT compared to two is 82.4%, and negative predictive value of the first non-confirmatory test is 48%. Conclusions: It is useful to repeat testing in patients with suspected narcolepsy and inconclusive MSLT.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- narkolepsie * diagnóza MeSH
- obstrukční spánková apnoe * diagnóza patofyziologie MeSH
- polysomnografie MeSH
- poruchy nadměrné spavosti diagnóza MeSH
- retrospektivní studie MeSH
- senzitivita a specificita MeSH
- spánek REM MeSH
- stadia spánku fyziologie MeSH
- statistika jako téma MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
BACKGROUND: Wilson's disease (WD) is an autosomal recessive inherited disease with copper accumulation; neurodegeneration is associated with dopaminergic deficit. The aim of the study is to verify sleep co-morbidity by questionnaire and objective sleep examinations (polysomnography, multiple sleep latency test). METHODS: fifty-five patients with WD (22 hepatic, 28 neurological, five asymptomatic form) and 55 age- and sex-matched control subjects completed a questionnaire concerning their sleep habits, sleep co-morbidity, Epworth sleepiness scale (ESS), and answered screening questions for rapid eye movement (REM) behaviour disorder (RBD-SQ). Twenty-four patients with WD and control subjects underwent polysomnographic examination. RESULTS: unlike the controls, patients with WD were more prone to daytime napping accompanied by tiredness and excessive daytime sleepiness, cataplexy-like episodes and poor nocturnal sleep. Their mean ESS as well as RBD-SQ was higher than that of the controls. Total sleep time was lower, accompanied by decreased sleep efficiency and increased wakefulness. Patients with WD had lower latency of stage 1 and stage 2 of non-rapid eye movement (NREM) sleep and less amount of NREM sleep stage 2. One-third of the patients with WD were found to have short or borderline multiple sleep latency test (MSLT) values independent of nocturnal pathology (sleep apnoea, periodic leg movements and/or restless leg syndrome). CONCLUSIONS: patients with WD often suffer from sleep disturbances (regardless of the clinical form). The spectrum of sleep/wake symptoms raises the suspicion that altered REM sleep function may also be involved.
- MeSH
- dospělí MeSH
- hepatolentikulární degenerace komplikace MeSH
- lidé středního věku MeSH
- lidé MeSH
- polysomnografie MeSH
- poruchy spánku a bdění komplikace diagnóza MeSH
- průzkumy a dotazníky MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Sleep symptoms, including excessive sleepiness, are frequently reported by patients with functional motor disorders (FMD). We aimed to classify the comorbid sleep disorders in FMD, and to investigate the relationship between subjective sleepiness and objective measures of hypersomnia, comparing them with data from people with central hypersomnia. A total of 37 patients (mean [SD] age 46.4 [11.2] years) with clinically definite FMD, and 17 patients (mean [SD] age 41.1 [11.6] years) with central hypersomnia underwent structured medical and sleep history, neurological examination, polysomnography, multiple sleep latency test (MSLT), and questionnaires assessing sleepiness, fatigue, and depression. In all, 23 patients with FMD (62%) reported excessive daytime sleepiness. Evidence of specific sleep disorders was identified in our cohort, with 35% having restless legs syndrome; 49% obstructive sleep apnea; and 8% periodic limb movements in sleep; however, the presence of these disorders was not correlated with subjective sleepiness. Patients with FMD with self-reported sleepiness reported higher fatigue (p = 0.002), depression (p = 0.002), and had longer sleep latencies in the MSLT (p < 0.001) compared to the patients with central hypersomnia. No correlation was found between subjective and objective sleepiness in either group. Fatigue positively correlated with self-reported sleepiness in patients with FMD (p < 0.001). This study did not find objective correlates of increased sleepiness in patients with FMD. While sleep abnormalities were found to be common in FMD, they were not correlated with self-reports of excessive sleepiness. Positive correlations between self-reported sleepiness and fatigue support the current unified model of non-motor symptoms in FMD.
- MeSH
- deprese epidemiologie patofyziologie MeSH
- dospělí MeSH
- komorbidita * MeSH
- lidé středního věku MeSH
- lidé MeSH
- periodické pohyby končetinami ve spánku epidemiologie patofyziologie MeSH
- polysomnografie * MeSH
- poruchy nadměrné spavosti * epidemiologie patofyziologie MeSH
- poruchy spánku a bdění epidemiologie patofyziologie MeSH
- průzkumy a dotazníky MeSH
- somnolence MeSH
- spánková latence fyziologie MeSH
- syndrom neklidných nohou patofyziologie epidemiologie MeSH
- únava patofyziologie epidemiologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
Sleep abnormalities are frequently found in Parkinson's disease (PD). However, it is unclear if they are present from the initial stages of PD. We thus aimed to assess sleep disturbances in newly diagnosed PD patients. We investigated 20 untreated PD patients using the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI) and the PD Sleep Scale (PDSS). Video-polysomnography and multiple sleep latency test (MSLT) were performed in 15 patients and 15 healthy controls. The ESS score was abnormally high in one patient, while short MSLT times were found in three other patients. The PSQI was higher (p < 0.05) and the PDSS lower (p < 0.001) in patients compared with controls. Video-polysomnography demonstrated a higher percentage of rapid eye movement sleep without atonia (RWA) in patients compared with controls (mean 28 vs. 2.9%, p < 0.001), whereas only one patient had clinically manifested rapid eye movement sleep behavior disorder (RBD). Interestingly, the occurrence of RWA correlated with the motor score (ρ = 0.65, p < 0.05). This study demonstrates that sleep disturbances emerge, in a proportion of patients, from the early stages of PD. RWA is a common finding while RBD is rarely present in early untreated PD.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- Parkinsonova nemoc komplikace MeSH
- polysomnografie MeSH
- poruchy spánku z vnitřních příčin epidemiologie etiologie MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
STUDY OBJECTIVES: This study describes high-throughput phenotyping strategies for sleep and circadian behavior in mice, including examinations of robustness, reliability, and heritability among Diversity Outbred (DO) mice and their eight founder strains. METHODS: We performed high-throughput sleep and circadian phenotyping in male mice from the DO population (n = 338) and their eight founder strains: A/J (n = 6), C57BL/6J (n = 14), 129S1/SvlmJ (n = 6), NOD/LtJ (n = 6), NZO/H1LtJ (n = 6), CAST/EiJ (n = 8), PWK/PhJ (n = 8), and WSB/EiJ (n = 6). Using infrared beam break systems, we defined sleep as at least 40 s of continuous inactivity and quantified sleep-wake amounts and bout characteristics. We developed assays to measure sleep latency in a new environment and during a modified Murine Multiple Sleep Latency Test, and estimated circadian period from wheel-running experiments. For each trait, broad-sense heritability (proportion of variability explained by all genetic factors) was derived in founder strains, while narrow-sense heritability (proportion of variability explained by additive genetic effects) was calculated in DO mice. RESULTS: Phenotypes were robust to different inactivity durations to define sleep. Differences across founder strains and moderate/high broad-sense heritability were observed for most traits. There was large phenotypic variability among DO mice, and phenotypes were reliable, although estimates of heritability were lower than in founder mice. This likely reflects important nonadditive genetic effects. CONCLUSIONS: A high-throughput phenotyping strategy in mice, based primarily on monitoring of activity patterns, provides reliable and heritable estimates of sleep and circadian traits. This approach is suitable for discovery analyses in DO mice, where genetic factors explain some proportion of phenotypic variation.
- MeSH
- collaborative cross u myší * MeSH
- fenotyp MeSH
- inbrední kmeny myší MeSH
- myši inbrední C57BL MeSH
- myši inbrední NOD MeSH
- myši MeSH
- reprodukovatelnost výsledků MeSH
- spánek * genetika MeSH
- zvířata MeSH
- Check Tag
- mužské pohlaví MeSH
- myši MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Research Support, N.I.H., Extramural MeSH
Úvod: Syndróm spánkového apnoe zhoršuje kvalitu spánku, mení jeho architektúru a spôsobuje nadmernú dennú spavost. V práci sme verifikovali prítomnosť nadmernej dennej spavosti u pacientov so syndrómom obštrukčného spánkového apnoe pomocou nenáročného dotazníka a najpoužívanejšej objektívnej, ale časovo aj finančne nákladnej metódy. Porovnávali sme obidva spôsoby hodnotenia s cieľom navrhnút efektívny postup pri hodnotení dennej spavosti v klinickej praxi. V snahe overit hypotézu, do akej miery sa opakované prebudenia počas spánku a intermitentná nočná hypoxémia podieľajú na nadmernej dennej spavosti, sme realizovali korelácie výsledkov hodnotenia dennej spavosti s vybrannými polysomnografickými parametrami. Metodika: Pomocou Epworthskej škály spavosti a Testu viacpočetnej spánkovej latencie sme hodnotili dennú spavost U 42 pacientov s priemerným vekom 50,31 ± 9,85 rokov. Stupeň syndrómu spánkového apnoe bol stanovený celonočným polysomnografickým vyšetrením s priemerným apnoicko hypopnoickým indexom 31,38 ±24,03. Výsledky: Patologické Epworthské skóre spavosti nad 10 bodov malo 42,86 % pacientov. Pri objektívnom hodnotení spavosti priemerná latencia zaspania v štyroch testoch bola 6,45 minút. Pod 10 minút malo skrátenú latenciu zaspania 92,86 % pacientov. Zistili sme štatisticky význeminú nepriamu koreláciu medzi obidvoma spôsobmi hodnotenia spavosti (r = -0,443, p < 0,01). Avšak napriek významnej korelácii medzi subjektívnym a objektívnym hodnotením spavosti, 19,4 % pacientov s priemernou spánkovou latenciou pod 5 minút malo Epworthské skóre pod 10 bodov. Našli sme významnú nepriamu koreláciu medzi priemernou spánkovou latenciou a arousal indexom, menej výrazná bola závislost Epworthského skóre na arousal indexe. Záver: V skupine našich pacientov Epwothské skóre odráža úroveň spavosti meranej Testom viacpočetnej spánkovej latencie. Avšak subjektívne udávaná spavost nebola vždy v súlade s nálezom pri objektívnom hodnotení, preto výsledky našej štúdie naznačujú opatrnosť pri hodnotení dermej spavosti len subjektívnym postupom. Korelácie výsledkov subjektívneho a objektívneho hodnotenia dermej spavosti s polysomnografickými parametremi vykazujú výraznejšie závislosti v parametroch, ktoré fragmentujú spánok na rozdiel od parametrov poukazujúcich na stupeň desaturácie.
Introduction: The syndrome of sleep apnoea worsens the quality of sleep, changes its architecture and is responsible for excessive daytime somnolence. In our trial we verified the presence of excessive daytime somnolence in patients presenting vrith obstructive sleep apnoea. For this verfification we used a simple questionnaire and the most frequently used objective method, which is time-demanding and expensive. We compared the two assessment methods in order to propose an efficatious procedure for the assessment of daytime somnolence in clinical practice. In order to verify the hypothesis about the share of repeated awakening during sleep and intermittent night hypoxaemia in excessive daytime somnolence we correlated the results of the assessment of daytime somnolence and selected polysomnographic parameters. Method: Using the Epworth scale of somnolence and the test of multiple sleep latencies we assessed daytime somnolence in 42 patients - mean age 50.31 ± 9.85 years. The degree of the syndrome of sleep apnoea was determined on the basis of an all-night polysomnographic investigation with a mean apnoeic-hypopnoeic index 31.38124.03. Results: 42.86 % of the patients had a pathological Epworth somnolence score over 10 points. In an objective evaluation of somnolence the mean latency of falling asleep was 6.45 minutes in four tests. A shorter latency under 10 minutes was found in 92.86 % of the patients. We established a statistically significant indirect correlation between the two methods of somnolence evaluation (r = -0.443, p < 0.01). Despite the significant correlation of the subjective and objective assessment of somnolence, 19.4 % of the patients with a mesin sleep latency under 5 minutes had an Epworth score under 10 points. We found a significant indirect correlation between the mean sleep latency and the arousal index, the dependence of the Epworth score on the arouscd index was less significant. Conclusions: In our group of patients the Epworth score reflected the level of somnolence measured by the test of multiple sleep latency. Although the subjectively given somnolence did not always tally with the results of objective evaluation, the results of our trial suggest that we should be careful when assessing daytime somnolence solely by a subjective approach. The correlation of results of subjective assessment and objective evaluation of daytime somnolence with polysomnographic parameters indicate a higher dependence on parameters fragmenting sleep than on parameters giving the degree of desaturation.
BACKGROUND: Obstructive sleep apnoea (OSA) is a condition leading to excessive daytime sleepiness. The aim of the study was a) to study course of daytime sleepiness in patients with OSA and b) to find the most important nocturnal polysomnography parameters influencing daytime sleepiness in OSA. METHODS: The cohort consisted of forty-five patients (6 women, 39 men) diagnosed with OSA. All patients underwent polysomnography, Multiple Sleep Latency Test (MSLT) and rated subjectively their daytime tendency to sleep with the Epworth Sleepiness Scale. RESULTS: Sleep latency was significantly longer at 15:00 and at 17:00 hours compared to previous tests. A significant negative correlation was found between the mean of the MSLT sleep latency and a number of awakenings, the apnoea/hypopnoea index and oxygen desaturation index values. CONCLUSIONS: The study showed the sleep latency prolongation at 15:00 and 17:00 hours respectively and confirmed connection of excessive daytime sleepiness to fragmentation of nocturnal sleep and OSA severity.
- MeSH
- cirkadiánní rytmus fyziologie MeSH
- dospělí MeSH
- kardiovaskulární nemoci epidemiologie MeSH
- kohortové studie MeSH
- komorbidita MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- obstrukční spánková apnoe diagnóza epidemiologie patofyziologie MeSH
- polysomnografie MeSH
- porucha chování v REM spánku epidemiologie patofyziologie MeSH
- poruchy nadměrné spavosti epidemiologie patofyziologie MeSH
- senioři MeSH
- spánek fyziologie MeSH
- stadia spánku fyziologie MeSH
- syndrom neklidných nohou epidemiologie patofyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Narcolepsy is a rare life-long disease that exists in two forms, narcolepsy type-1 (NT1) or type-2 (NT2), but only NT1 is accepted as clearly defined entity. Both types of narcolepsies belong to the group of central hypersomnias (CH), a spectrum of poorly defined diseases with excessive daytime sleepiness as a core feature. Due to the considerable overlap of symptoms and the rarity of the diseases, it is difficult to identify distinct phenotypes of CH. Machine learning (ML) can help to identify phenotypes as it learns to recognize clinical features invisible for humans. Here we apply ML to data from the huge European Narcolepsy Network (EU-NN) that contains hundreds of mixed features of narcolepsy making it difficult to analyze with classical statistics. Stochastic gradient boosting, a supervised learning model with built-in feature selection, results in high performances in testing set. While cataplexy features are recognized as the most influential predictors, machine find additional features, e.g. mean rapid-eye-movement sleep latency of multiple sleep latency test contributes to classify NT1 and NT2 as confirmed by classical statistical analysis. Our results suggest ML can identify features of CH on machine scale from complex databases, thus providing 'ideas' and promising candidates for future diagnostic classifications.
- MeSH
- biologické modely * MeSH
- databáze faktografické statistika a číselné údaje MeSH
- datové soubory jako téma MeSH
- dospělí MeSH
- interpretace statistických dat MeSH
- lidé MeSH
- mladý dospělý MeSH
- narkolepsie klasifikace diagnóza patofyziologie MeSH
- polysomnografie statistika a číselné údaje MeSH
- řízené strojové učení * MeSH
- ROC křivka MeSH
- spánek REM fyziologie MeSH
- spánková latence fyziologie MeSH
- stochastické procesy MeSH
- vzácné nemoci klasifikace diagnóza patofyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
