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MSLT result intepretation

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Posted by nyems on March 31, 2003 at 17:52:27:

A patient with a 2-year history of EDS had an MSLT that had a SL of 13. The patient claims the MSLT situation was very uncharacteristic of daily life, and was in fact excited about finally having the test to get a diagnosis and tx and also had "test anxiety", concerned that by not having a SL of < 5, no tx would be prescribed. So a 2nd MSLT was performed, this time with an SL of 9.3, with each nap having decreasing SL's. Two questions - in a narcoleptic or someone with IH, is it possible for them to not be able to sleep due to anxiety during the MSLT? And, would it be worth doing a 3rd MSLT to rule-out narcolepsy (as opposed to IH) because on MSLT #2, the patient had a cough that was keeping her from falling asleep and waking her once a asleep and the tech actually recommended tossing out Nap #1 because of external sources of noise keeping the patient awake (housekeeping). Naps #3-5 had SL of < or equal to 3, but awakening before the entire nap was completely so REM was not witnessed. Any ideas, suggestions?

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