Modification of Multiple Sleep Latency Test (MSLT)

摘要

The Multiple Sleep Latency Test (MSLT) is used in Sleep Medicine for thediagnosis of pathological sleepiness. The MSLT defines latency to sleep onset, adjusting for circadian/circasemidian rhythms by calculating a mean sleep latency from repeated tests throughout the waking portion of the day. A mean sleep latency on MSLT of less than 5 minutes represents pathological sleepiness. The MSLT evaluation of sleepiness has a high test-retest reliability. However, the MSLT has two important methodological flaws. First, it fails to control the mental state of patients being tested. Second, it assumes that a patient's ability to fall asleep is necessarily equal to sleepiness. This paper reviews the basic assumptions of the MSLT and proposes a variation on the standard MSLT protocol, which will provide a better control of the mental state of patients under test by 'channeling mental activity into the execution of a task.' A variant of event-related potentials, Contingent Negative Variation (CNV) will be suggested as a candidate task. The CNV has yet to be tested as an integral part of the MSLT, but some preliminary evidence will be presented to support this proposal.