Enhancements to the multiple sleep latency test

Sonia Meza-Vargas, Eleni Giannouli, Magdy Younes Sleep Disorders Centre, University of Manitoba, Winnipeg, MB, Canada Introduction: The utility of multiple sleep latency tests (MSLTs) is limited to determining sleep onset latency (SOL) and rapid eye movement sleep latency. The odds ratio product (O...

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Autores principales:	Meza-Vargas S, Giannouli E, Younes M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Odds ratio product ORP Sleep perception Excessive sleepiness Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
Acceso en línea:	https://doaj.org/article/5a353eb2647a4765835291ce8352f1e9
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spelling	oai:doaj.org-article:5a353eb2647a4765835291ce8352f1e92021-12-02T00:19:32ZEnhancements to the multiple sleep latency test1179-1608https://doaj.org/article/5a353eb2647a4765835291ce8352f1e92016-05-01T00:00:00Zhttps://www.dovepress.com/enhancements-to-the-multiple-sleep-latency-test-peer-reviewed-article-NSShttps://doaj.org/toc/1179-1608Sonia Meza-Vargas, Eleni Giannouli, Magdy Younes Sleep Disorders Centre, University of Manitoba, Winnipeg, MB, Canada Introduction: The utility of multiple sleep latency tests (MSLTs) is limited to determining sleep onset latency (SOL) and rapid eye movement sleep latency. The odds ratio product (ORP) is a continuous index of sleep depth with values of 0, 1.0, and 2.5 reflecting very deep sleep, light sleep, and full wakefulness, respectively. We determined the time course of sleep depth during MSLT naps expecting that this would enhance the test's clinical utility. Methods: Thirty MSLTs (150 naps) were performed for excessive somnolence. Patients indicated whether they slept (yes/no) after each nap. SOL was scored by two experienced technologists. Time course of ORP was determined with a commercial system. We determined ORP at SOL (ORPSOL), times ORP decreased <2.0, <1.5, <1.0 and <0.5 during the entire nap duration, and the integral of decrease in ORP over nap duration (ΔORPINT). Results: SOL occurred almost invariably when ORP was between 1.0 and 2.0. Of 47 naps (21 patients) with SOL ,5 minutes, ORP decreased <1.0 (light sleep) in <5 minutes in only 13 naps (nine patients) and <0.5 (deep sleep) in only two naps in one patient. The relation between ORPINT and frequency of sleep perception was well defined, allowing determination of a threshold for sleep perception. This threshold ranged widely (5–50 ΔORP*epoch). Conclusion: As currently identified, SOL reflects transition into a highly unstable state between wakefulness and sleep. Reporting the times of attaining different sleep depths may help better identify patients at high risk of vigilance loss. Furthermore, an ORPSOL outside the range 1.0–2.0 can help identify scoring errors. Keywords: odds ratio product, sleep perception, idiopathic hypersomniaMeza-Vargas SGiannouli EYounes MDove Medical PressarticleOdds ratio productORPSleep perceptionExcessive sleepinessPsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol 2016, Iss Issue 1, Pp 145-158 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Odds ratio product ORP Sleep perception Excessive sleepiness Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
spellingShingle	Odds ratio product ORP Sleep perception Excessive sleepiness Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495 Meza-Vargas S Giannouli E Younes M Enhancements to the multiple sleep latency test
description	Sonia Meza-Vargas, Eleni Giannouli, Magdy Younes Sleep Disorders Centre, University of Manitoba, Winnipeg, MB, Canada Introduction: The utility of multiple sleep latency tests (MSLTs) is limited to determining sleep onset latency (SOL) and rapid eye movement sleep latency. The odds ratio product (ORP) is a continuous index of sleep depth with values of 0, 1.0, and 2.5 reflecting very deep sleep, light sleep, and full wakefulness, respectively. We determined the time course of sleep depth during MSLT naps expecting that this would enhance the test's clinical utility. Methods: Thirty MSLTs (150 naps) were performed for excessive somnolence. Patients indicated whether they slept (yes/no) after each nap. SOL was scored by two experienced technologists. Time course of ORP was determined with a commercial system. We determined ORP at SOL (ORPSOL), times ORP decreased <2.0, <1.5, <1.0 and <0.5 during the entire nap duration, and the integral of decrease in ORP over nap duration (ΔORPINT). Results: SOL occurred almost invariably when ORP was between 1.0 and 2.0. Of 47 naps (21 patients) with SOL ,5 minutes, ORP decreased <1.0 (light sleep) in <5 minutes in only 13 naps (nine patients) and <0.5 (deep sleep) in only two naps in one patient. The relation between ORPINT and frequency of sleep perception was well defined, allowing determination of a threshold for sleep perception. This threshold ranged widely (5–50 ΔORP*epoch). Conclusion: As currently identified, SOL reflects transition into a highly unstable state between wakefulness and sleep. Reporting the times of attaining different sleep depths may help better identify patients at high risk of vigilance loss. Furthermore, an ORPSOL outside the range 1.0–2.0 can help identify scoring errors. Keywords: odds ratio product, sleep perception, idiopathic hypersomnia
format	article
author	Meza-Vargas S Giannouli E Younes M
author_facet	Meza-Vargas S Giannouli E Younes M
author_sort	Meza-Vargas S
title	Enhancements to the multiple sleep latency test
title_short	Enhancements to the multiple sleep latency test
title_full	Enhancements to the multiple sleep latency test
title_fullStr	Enhancements to the multiple sleep latency test
title_full_unstemmed	Enhancements to the multiple sleep latency test
title_sort	enhancements to the multiple sleep latency test
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/5a353eb2647a4765835291ce8352f1e9
work_keys_str_mv	AT mezavargass enhancementstothemultiplesleeplatencytest AT giannoulie enhancementstothemultiplesleeplatencytest AT younesm enhancementstothemultiplesleeplatencytest
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Enhancements to the multiple sleep latency test

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