Polysomnography

2017 ◽  
Author(s):  
Sudhansu Chokroverty ◽  
Roberto Vertugno
Keyword(s):  
Neurological Disorders ◽  
Clinical Presentation ◽  
Sleep Latency ◽  
Clinical Aspects ◽  
Physiological Changes ◽  
Functional Neuroanatomy ◽  
Maintenance Of Wakefulness Test ◽  
Laboratory Procedures ◽  
Clinical Considerations ◽  
Multiple Sleep Latency

This chapter covers the technical and clinical aspects of polysomnography (PSG). Section 1 includes a brief review of the historical milestones, functional neuroanatomy of sleep, physiological changes (emphasizing those pertinent to overnight PSG interpretation) and clinical relevance as well as homeostatic and circadian factors, and functions of sleep. Section 2 deals with laboratory procedures, including PSG recording and scoring techniques, indications for PSG, video-PSG, ambulatory and computerized PSG, artifacts during PSG recording, and pitfalls of PSG. Section 3 includes clinical considerations, briefly describing the clinical presentation, diagnosis, and treatment but mainly focusing on PSG findings in common sleep disorders as well as sleep-related movement disorders, neurological disorders, and sleep-related epilepsies. Section 4 addresses related laboratory procedures for the assessment of sleep, including the multiple sleep latency test, the maintenance-of-wakefulness test, and actigraphy.

The Assessment of ‘Sleepiness’ in Human Drug Trials: A New Perspective

2019 ◽  
Vol 8 (1) ◽  
pp. 5-26
Author(s):  
Murray Johns
Keyword(s):  
Sleep Latency ◽  
Sleep Onset ◽  
Face Validity ◽  
Drug Trials ◽  
Efficacy And Safety ◽  
Short Term ◽  
Maintenance Of Wakefulness Test ◽  
New Perspective ◽  
The Relationship ◽  
Multiple Sleep Latency

The investigation of the efficacy and safety of drugs requires assessments of their effects on alertness/sleepiness. Unfortunately, there is confusion about the nature of ‘sleepiness’, the factors which influence it, and how it can be measured under different circumstances. This review aims to clarify these matters and to offer some suggestions about how current difficulties might be overcome. Different meanings of the word ‘sleepiness’ are examined initially. Methods that purport to measure ‘sleepiness’ are then examined, including their testretest reliability and the relationship between the results of different measurements within the same subjects. Some objective methods are found not to be as reliable as was initially reported. Information about the reliability of several other methods is either inadequate or nonexistent. One assumption which underlies two frequently used objective methods for measuring ‘sleepiness’ (the Multiple Sleep Latency Test and the Maintenance of Wakefulness Test) is that the ‘sleepier’ a person is, the quicker they will fall asleep. While this assumption has face validity, other assumptions about these tests are re-examined and are found wanting, at least sometimes. The difficulty arises in part because it is not always clear when the sleep onset process begins and ends. ‘Sleepiness’ is found to be influenced much more by short-term factors, such as the subject’s posture at the time and during the preceding few minutes, than has been acknowledged previously. Some possible solutions to these difficulties are suggested, including a new conceptual model of sleep-wake control, with implications for the design of drug trials.

scholarly journals Practice Parameters for Clinical Use of the Multiple Sleep Latency Test and the Maintenance of Wakefulness Test

SLEEP ◽  
2005 ◽  
Vol 28 (1) ◽  
pp. 113-121 ◽  
Author(s):  
Michael R. Littner ◽  
Clete Kushida ◽  
Merrill Wise ◽  
David G. Davila ◽  
Timothy Morgenthaler ◽  
...  
Keyword(s):  
Sleep Latency ◽  
Multiple Sleep Latency Test ◽  
Clinical Use ◽  
Maintenance Of Wakefulness Test ◽  
Practice Parameters ◽  
Multiple Sleep Latency

scholarly journals P106 Evaluating the correlation between objective daytime sleepiness, daytime functioning and subjective sleepiness

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A55-A55
Author(s):  
A Chee ◽  
P Lim ◽  
A Lee ◽  
L Narayan ◽  
T Zhang ◽  
...  
Keyword(s):  
Daytime Sleepiness ◽  
Sleep Latency ◽  
Clinical Settings ◽  
Clinical Judgments ◽  
Daytime Functioning ◽  
Psychomotor Vigilance Test ◽  
Maintenance Of Wakefulness Test ◽  
Stanford Sleepiness Scale ◽  
Psychomotor Vigilance ◽  
Multiple Sleep Latency

Abstract Introduction Daytime sleepiness is typically assessed in clinical settings with the Multiple Sleep Latency Test (MSLT) and Maintenance of Wakefulness Test (MWT). However, these tests do not necessarily assess daytime functioning. This study aimed to assess the correlation between a 10-min Psychomotor Vigilance Test (PVT), as a measure of daytime functioning, and excessive daytime sleepiness as measured with the MSLT or MWT. Methods Patients attending the sleep clinic for assessments of daytime sleepiness underwent overnight polysomnography (PSG) and completed the Epworth Sleepiness Scale (ESS). The following day, patients completed four test sessions every 2h starting 1.5h after waking. Testing sessions included the Stanford Sleepiness Scale (SSS), PVT, MWT or MSLT. PVT lapses (reaction time >500ms), SSS score and sleep latencies (MSLT and MWT) were averaged within participants across sessions and regression analyses performed to assess the relationship between PVT lapses and sleepiness measures. Results A total of 41 patients (BMI: 33.7±8.7kg/m²; aged 44.8±17.8 years) completed the study. Of these, 22 (19 F) underwent the MSLT and 19 (2 F) underwent the MWT. PVT lapses correlated with MWT mean sleep latency (r²=0.62; p<0.001), ESS (r²= 0.19; p<0.01) and SSS (r²= 0.12; p<0.05) but not MSLT mean sleep latency (r²= 0.02; p = 0.50). Discussion In clinical practice, MWT and ESS are often used in conjunction to assess daytime functioning. Results suggest that the PVT could be used alongside MWT to aid clinical judgments around an individuals’ daytime functioning.

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