Anybody had a MSLT test before?

[BigOrangeAsh]

I have one scheduled for Monday and have no idea what to expect. Anybody have experience?

[Slinky]

I had one 10-12 years ago. I was brought in for a sleep evaluation about 7:30 PM. In the morning, after the sleep evaluation they start the MSLT. Because I was having the MSLT they let me sleep in until 8 AM at which time I was "kicked" outta bed. (I hadn't slept for beans most of the night).

You continue to wear all the wires, etc. all day long. Every two hours they sent me to bed for 20 minutes. Made no difference if I fell asleep or not, I was in bed for 20 minutes and then they made me get up. I was allowed to read, watch TV, watch the RPSGT scoring the sleep evals and titrations from the previous night, go out to the "butt hut" for a smoke, breakfast and lunch were brought to the unit. After the last sleep session they unwire you, let you shower and send you on your merry way to wait for the results.

If you have a laptop, call and ask if they have the capability of your using it. I had to laugh as they tell you to go about your normal daily activities as much as possible between sleep sessions. Yeah, right. Like that is easy to do on the 4th floor of a hospital! You aren't allowed off the grounds, you need to be readily and easily available every two hours all day long.

[Bookbear]

It's a Multiple Sleep Latency Test... a series of (usually) five naps taken at specific intervals. They are looking at how you fall asleep...speed, what stages you enter into and when/how quickly. Here is a document you might find helpful:

medicalcenter.osu.edu/pdfs/PatientEd/Materials/PDFDocs/diagnost/other/mslt.pdf

It's not invasive or painful. It is boring, though. TV's are usually mentioned as being provided, but lordy, it's daytime TV!! Bring something with you to occupy your time... books, puzzles, laptop computer, etc. You will be there all day long, so check into meal arrangements. Will they feed you lunch, will you bring your own, will you need to eat at the cafeteria?

Good luck!

[echo]

I had one last year, on the day of my night-time titration (oh yeah I slept greeeat that night , not!).

Pretty much the same drill as slinky said. In between naps I wondered around the hospital, did some work, etc. Even cell phones were OK. They would tell me when the next nap was so I could get back in time (prob about 2 hours apart?).

The stuff they put on you is the same as a standard PSG, at least in my clinic: EEG (record brain waves), snore monitor (microphone), oximeter, chest/abdomen inspiration monitor... probably other things but i forgot.. oh yeah plus the big white box that all the leads hook up into, and that goes around your neck. I have pics from the PSG but I aint gonna post them. Well on second thought.... I was also recorded by a video camera, same as with the PSG and the titration. Curtains were closed (but they weren't very good at keeping light out).

Note if you're a women, they ask you to take your bra off, so if you're like me you gotta watch out if you start walking around the hospital....

They let me sleep for 30 min each time I think? Either 20 or 30. Hated it when they woke me up!

[bap40]

My 21 yr old daughter is having one done on the 4th of Aug. She sleeps all the time and is always extremely tired. She was sent to the pulmonologist for left side pain that was not able to be diagnosed and also has asthma. Once he heard about all the sleeping she does and asked her a few questions, he ordered the MSLT sleep test thinking she might have narcolepsy. Time will tell!

[kteague]

My two MSLTs were at sleep clinics not a part of hospitals so I was real bored. The hardest part for me was staying awake between naps. Someone ran out to Wendy's nearby and brought me lunch once, can't remember the other time (been 10 years).

Keep in mind they need to see exactly how much daytime sleepiness is present, so it is best try to not be a thinker when going into each nap. There are other tests I've read about that test how long one can stay awake, but this one wants to determine how quickly and deeply one falls asleep upon being given the opportunity. It's best to give in to it as when at home as much as possible.

Not a fun way to spend the day, but can garner a better understanding of what you are dealing with. On my first MSLT my average time to go to sleep was 3 minutes, the second was I think 6. Never reached REM though but the test commented there were limb movments during the naps. Wonder if I'd have reached REM with successfully treated limb movements.

I have a doctor who is a real stickler for not making a diagnosis of narcolepsy until other sleep disorders are therapeutically treated. I'm sure she evaluates each case and would consider if someone was having full fledged cataplectic episodes. I was having episodes that read nearly like textbook partial cataplexy except it happened only during the last few months of my steep decline and is barely evident since my cpap therapy has stabilized. My guess is I could have mild narcolepsy that was exacerbated by the long term erratic sleep. Being "sleepyheaded" seems a trait in our family.

[Snoredog]

[quote="kteague"]My two MSLTs were at sleep clinics not a part of hospitals so I was real bored. The hardest part for me was staying awake between naps. Someone ran out to Wendy's nearby and brought me lunch once, can't remember the other time (been 10 years).

Keep in mind they need to see exactly how much daytime sleepiness is present, so it is best try to not be a thinker when going into each nap. There are other tests I've read about that test how long one can stay awake, but this one wants to determine how quickly and deeply one falls asleep upon being given the opportunity. It's best to give in to it as when at home as much as possible.

Not a fun way to spend the day, but can garner a better understanding of what you are dealing with. On my first MSLT my average time to go to sleep was 3 minutes, the second was I think 6. Never reached REM though but the test commented there were limb movments during the naps. Wonder if I'd have reached REM with successfully treated limb movements.

I have a doctor who is a real stickler for not making a diagnosis of narcolepsy until other sleep disorders are therapeutically treated. I'm sure she evaluates each case and would consider if someone was having full fledged cataplectic episodes. I was having episodes that read nearly like textbook partial cataplexy except it happened only during the last few months of my steep decline and is barely evident since my cpap therapy has stabilized. My guess is I could have mild narcolepsy that was exacerbated by the long term erratic sleep. Being "sleepyheaded" seems a trait in our family.

[BigOrangeAsh]

Scary...

[bap40]

I am not so sure I agree with that but..... my daughter is not functioning during the day as she should. She has never just fallen asleep at the blink of an eye. She takes frequent naps during the daytime and wakes many, many times at night. She is always exhausted. For her, she wants to be able to get thru the day, when not working, feeling like a human and not a zombie. Kind of like us with apnea. She works in the medical field and is starting nursing school in Aug and wants to be able to get through life like a more normal person. We did find out from the pulmonologist that many kids who are dx'd with ADHD, as she WAS, actually have narcolepsy and not ADD or ADHD. We found this very interesting as she was taking meds for a few years and did much better. She stopped taking them in HS and grades did go down but at that time my influence on her med taking was non exsistant. Now she wishes she had kept up with it as her life was on an even keel and now it is not.

I know there are many, many opinions on this subject and everyone is free to make their own decisions.

[kteague]

Those who have excessive daytime sleepiness but don't quite fit the criteria for a diagnosis of narcolepsy sometimes are told they have idiopathic hypersomnolence, which I think is treated about the same as narcolepsy.

I very much agree with my doctor on not applying a diagnosis of narcolepsy while there are other sleep disorders not yet therapeutically treated. Now, I know that in the group of those with narcolepsy, some will develop other sleep disorders (like OSA and PLMD), as do people without narcolepsy. I just know the waters can get muddy, and considering the possible ramifications of a diagnosis of narcolepsy, I wouldn't want there to be a rush to judgement. We all know that there are doctors out there who will tell you what you want to hear.

A few years ago when I was at my lowest point, I had a "need to know" exactly what was destroying my life. I would have welcomed any diagnosis that helped me understand and know how to move forward. I didn't care what it meant to my future, as I felt I would be dead before I had to worry about it. I still wonder, but now I am just concerned that I am managing my residual sleepiness so as to not endanger myself or anyone else.

My tendency is to call things like they are and let the chips fall. But I'm 56 years old, no longer in the work force, and need to drive very little, so my sacrifice in minimal. If someone with more at stake can manage mild symptoms without a technical diagnosis, I can see the value in that. If they have severe life-altering symptoms, then I'm back at call it like it is and let the chips fall. I think my bottom line on this is safety. If I'm not safe on the roads or on particular jobs, I don't belong there. Shoot, I violated that principle with my PLMD and untreated OSA.

It's such an individualized issue. I do hear Snoredog's warning that seeking this diagnosis can be life changing even more than the sleepiness itself. I never even knew to consider all this 10 years ago when I had my first MSLT. Maybe there should be a sign on the door "Enter with Caution".

Wish all could be like Jimmy Kimmel. He's open about having mild narcolepsy, and he's chosen a career that it's apparently not hindering. Wonder if he has any restrictions on his driving?

Kathy

[Slinky]

Crohn's disease can be difficult to Dx and I know Crohn's patients whose gastro has told them they DEFINITELY had Crohn's, BUT, they were so young and the Crohn's Dx could affect their ability to get health insurance, life insurance, etc. for the time being he would treat it as Crohn's but would NOT give a Crohn's Dx.

Maybe a good air clearing talk w/the sleep doctor prior to the MSLT might be a good idea to discuss all the ramifications and the best way to handle the situation.

IF there was NOT a referral to this sleep doc or sleep clinic but rather a self-referral AND IF you were paying the total cost yourself and not using insurance AND you were careful to NOT let ANY of your doctors know the results if narcolepsy is the Dx so it does NOT appear ANYWHERE in ANY of your medical records .... that's a lot of IFs in this day of the government's so-called Patriot's Act and the freedom of access to our medical records that HIPAA does allow .... proceed at your own risk after CAREFULLY considering all your options.

[echo]

I am not so sure I agree with that but..... my daughter is not functioning during the day as she should. She has never just fallen asleep at the blink of an eye. She takes frequent naps during the daytime and wakes many, many times at night. She is always exhausted. For her, she wants to be able to get thru the day, when not working, feeling like a human and not a zombie. Kind of like us with apnea.

From my layman's understanding, Narcolepsy is different from OSA in that the basis of the disorder is neurological, and also affects muscle control. I assume a sleep doctor should be able to distinguish the two - so ask your questions! I would be hesistant to accept a Dx of Narcolepsy just because she fell asleep quickly at the MSLT test... that could just be the daytime sleepiness (again my layman's understanding).
If what you say is correct - trouble falling asleep - that's something that I have - insomnia AND daytime tiredness/sleepiness and OSA.

What you're describing are classic symptom's of Sleep Apnea - is there any reason that they will not do an overnight PSG first? I would say treat/figure out the night-time sleep problem FIRST and then see if there is still daytime sleepiness.. but that's just me.