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Posted by RPSGT on February 06, 2003 at 22:35:14:In Reply to: MSLTS posted by clueless on February 06, 2003 at 17:45:41:
1. No but it may be helpful with certain patients.
2. No but it should. The preceding NPSG objectively qualifies the pt's sleep and validates the MSLT. MSLTs should only be performed after the pt. has had a prior NPSG (even if not the previous night) with relatively normal results.
3. A. You do not perform MSLTs on newly diagnosed OSA patients who have not used CPAP at home for at least 2 weeks to eradicate sleep debt and to become used to the device. The MSLT cannot be valid if it is performed on someone suffering from sleep debt caused by untreated OSA. B. Non-positional OSA patients compliant with CPAP therapy and still suffering from excessive daytime sleepiness should undergo the MSLT with CPAP in place. If the OSA is positional, then you let them sleep on their side during the MSLT, without CPAP. But you must make sure they are not having snore arousals. That can skew the MSLT.Use all standard leads C3, C4, O1, O2, A1, A2, LOC, ROC, plus Superior EOG, Inferior EOG, 3 chin EMG leads and EKG. It helps to run T3-CZ and CZ-T4 to see the V-waves.
Look it up in Principles and Practice of Sleep Medicine or in the Journal SLEEP online. Mary Carskadon's MSLT protocol is the most widely used. You need to have and understand her protocol before attempting to perform an MSLT.
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