Polysomnography (PSG) and Multiple Sleep Latency Test (MSLT)

Polysomnography (PSG)[1]

The PSG continuously records normal and abnormal physiologic activity during an entire night. A typical PSG montage includes an electroencephalogram (EEG), electrooculogram, electromyogram, electrocardiogram, and continuous pulse oximetry and includes measurement of airflow, respiratory effort, and leg movements. It documents the adequacy of sleep, including the frequency, duration, and total amounts of stages 1, 2, 3 and 4 (slow-wave sleep), and REM sleep. It also indicates whether other etiologies of EDS, such as sleep apnea, are present.

Multiple Sleep Latency Test (MSLT)[1][2]

The MSLT is the primary test for the diagnosis of narcolepsy. This test assesses 2 major components of narcolepsy: hypersomnolence and SOREMPs (Sleep Onset Rapid Eye Movement Periods), which occur in narcolepsy but are otherwise uncommon. The mean sleep latency, or time to sleep onset, provides evidence for hypersomnolence. The test uses an EEG to record sleep onset during normal waking hours. It consists of 4 or 5 20-minute nap opportunities at 2-hour intervals. Normally, sleep latency is greater than 10 minutes and REM sleep does not occur at sleep onset. Patients with narcolepsy typically fall asleep in 5 minutes or less and will display SOREMPs during at least 2 of the 5 daytime nap periods.

PSG/MSLT Chart
Source: [1][3][4]

References:

  1. ^ Guilleminault C, Angela A. Narcolepsy. In: Kryger MH, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine. 3rd ed. Philadelphia, Pa: Elsevier; 2000:676–686.
  2. ^ Mitler MM, Carskadon MA, Hirshkowitz M. Evaluating Sleepiness. In: Kryger MH, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine. 4th ed. Philadelphia, Pa: Elsevier; 2007:1417–1423.
  3. ^ Carskadon MA, Dement WC. Normal human sleep: an overview. In: Kryger MH, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine. 3rd ed. Philadelphia, Pa: Elsevier; 2000:15–25.
  4. ^ American Academy of Sleep Medicine. The International Classification of Sleep Disorders, Revised: Diagnostic and Coding Manual. Westchester, Ill: American Academy of Sleep Medicine; 2001.

Important Safety Information

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2. It is very important to keep XYREM out of reach of children and pets.

3. XYREM can cause serious side effects including trouble breathing while asleep, confusion, abnormal thinking, depression and loss of consciousness. Tell your doctor if you have any of these problems while taking XYREM.

BOXED WARNING:

!Warning

Central Nervous System Depressant with Abuse Potential. Should not be used with alcohol or other CNS depressants. Sodium oxybate is a form of GHB, a known drug of abuse. Abuse has been associated with some important central nervous system (CNS) adverse events (including death). Even at recommended doses, use has been associated with confusion, depression, and other neuropsychiatric events. Reports of respiratory depression occurred in clinical trials. Almost all of the patients who received sodium oxybate during clinical trials were receiving CNS stimulants.

Important CNS adverse events associated with abuse of GHB include seizure, respiratory depression and profound decreases in level of consciousness, with instances of coma and death. For events that occurred outside of clinical trials, in people taking GHB for recreational purposes, the circumstances surrounding the events are often unclear (e.g., dose of GHB taken, the nature and amount of alcohol or any concomitant drugs).

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