Value of the multiple sleep latency test (MSLT) for the diagnosis of narcolepsy
Since its introduction, the multiple sleep latency test (MSLT) has played a major role in the diagnosis of narcolepsy. We assessed its diagnostic value in a series of 2,083 subjects of whom 170 (8.2%) were diagnosed with narcolepsy. The sensitivity of the combination of two or more sleep onset rapid...
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Veröffentlicht in: | Sleep (New York, N.Y.) N.Y.), 1997-08, Vol.20 (8), p.620-629 |
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description | Since its introduction, the multiple sleep latency test (MSLT) has played a major role in the diagnosis of narcolepsy. We assessed its diagnostic value in a series of 2,083 subjects of whom 170 (8.2%) were diagnosed with narcolepsy. The sensitivity of the combination of two or more sleep onset rapid eye movement (REM) periods (SOREMPs) with a mean sleep latency of < 5 minutes on an initial MSLT was 70% with a specificity of 97%, but 30% of all subjects with this combination of findings did not have narcolepsy. In some narcoleptics who had more than one MSLT, the proportion of naps with SOREMPs varied substantially from the initial MSLT to the follow-up test. The highest specificity (99.2%) and positive predictive value (PPV) (87%) for MSLT findings was obtained with the criteria of three or more SOREMPs combined with a mean sleep latency of < 5 minutes, but the sensitivity of this combination was only 46%. The combination of a SOREMP with a sleep latency < 10 minutes on polysomnography yielded a specificity (98.9%) and PPV (73%) almost equal to those obtained from combinations of MSLT findings, but the sensitivity was much lower. Our results suggest that the MSLT cannot be used in isolation to confirm or exclude narcolepsy, is indicated only in selected patients with excessive daytime sleepiness, and is most valuable when interpreted in conjunction with clinical findings. |
doi_str_mv | 10.1093/sleep/20.8.620 |
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S ; CHERVIN, R. D ; MALOW, B. A</creator><creatorcontrib>ALDRICH, M. S ; CHERVIN, R. D ; MALOW, B. A</creatorcontrib><description>Since its introduction, the multiple sleep latency test (MSLT) has played a major role in the diagnosis of narcolepsy. We assessed its diagnostic value in a series of 2,083 subjects of whom 170 (8.2%) were diagnosed with narcolepsy. The sensitivity of the combination of two or more sleep onset rapid eye movement (REM) periods (SOREMPs) with a mean sleep latency of < 5 minutes on an initial MSLT was 70% with a specificity of 97%, but 30% of all subjects with this combination of findings did not have narcolepsy. In some narcoleptics who had more than one MSLT, the proportion of naps with SOREMPs varied substantially from the initial MSLT to the follow-up test. The highest specificity (99.2%) and positive predictive value (PPV) (87%) for MSLT findings was obtained with the criteria of three or more SOREMPs combined with a mean sleep latency of < 5 minutes, but the sensitivity of this combination was only 46%. The combination of a SOREMP with a sleep latency < 10 minutes on polysomnography yielded a specificity (98.9%) and PPV (73%) almost equal to those obtained from combinations of MSLT findings, but the sensitivity was much lower. Our results suggest that the MSLT cannot be used in isolation to confirm or exclude narcolepsy, is indicated only in selected patients with excessive daytime sleepiness, and is most valuable when interpreted in conjunction with clinical findings.</description><identifier>ISSN: 0161-8105</identifier><identifier>ISSN: 1550-9109</identifier><identifier>EISSN: 1550-9109</identifier><identifier>DOI: 10.1093/sleep/20.8.620</identifier><identifier>PMID: 9351129</identifier><identifier>CODEN: SLEED6</identifier><language>eng</language><publisher>Rochester, MN: American Academy of Sleep Medicine</publisher><subject>Adolescent ; Adult ; Aged ; Biological and medical sciences ; Cataplexy - diagnosis ; Child ; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes ; Female ; Follow-Up Studies ; Humans ; Male ; Medical sciences ; Middle Aged ; Narcolepsy - diagnosis ; Nervous system (semeiology, syndromes) ; Neurology ; Polysomnography ; Predictive Value of Tests ; Sleep Apnea Syndromes - diagnosis ; Sleep, REM</subject><ispartof>Sleep (New York, N.Y.), 1997-08, Vol.20 (8), p.620-629</ispartof><rights>1997 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-291a54372569e1e18df8df7ed3f6c6f9a4a51396cf08124fdc3a126f7f4998c3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2849850$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9351129$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>ALDRICH, M. S</creatorcontrib><creatorcontrib>CHERVIN, R. D</creatorcontrib><creatorcontrib>MALOW, B. A</creatorcontrib><title>Value of the multiple sleep latency test (MSLT) for the diagnosis of narcolepsy</title><title>Sleep (New York, N.Y.)</title><addtitle>Sleep</addtitle><description>Since its introduction, the multiple sleep latency test (MSLT) has played a major role in the diagnosis of narcolepsy. We assessed its diagnostic value in a series of 2,083 subjects of whom 170 (8.2%) were diagnosed with narcolepsy. The sensitivity of the combination of two or more sleep onset rapid eye movement (REM) periods (SOREMPs) with a mean sleep latency of < 5 minutes on an initial MSLT was 70% with a specificity of 97%, but 30% of all subjects with this combination of findings did not have narcolepsy. In some narcoleptics who had more than one MSLT, the proportion of naps with SOREMPs varied substantially from the initial MSLT to the follow-up test. The highest specificity (99.2%) and positive predictive value (PPV) (87%) for MSLT findings was obtained with the criteria of three or more SOREMPs combined with a mean sleep latency of < 5 minutes, but the sensitivity of this combination was only 46%. The combination of a SOREMP with a sleep latency < 10 minutes on polysomnography yielded a specificity (98.9%) and PPV (73%) almost equal to those obtained from combinations of MSLT findings, but the sensitivity was much lower. Our results suggest that the MSLT cannot be used in isolation to confirm or exclude narcolepsy, is indicated only in selected patients with excessive daytime sleepiness, and is most valuable when interpreted in conjunction with clinical findings.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cataplexy - diagnosis</subject><subject>Child</subject><subject>Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Narcolepsy - diagnosis</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Polysomnography</subject><subject>Predictive Value of Tests</subject><subject>Sleep Apnea Syndromes - diagnosis</subject><subject>Sleep, REM</subject><issn>0161-8105</issn><issn>1550-9109</issn><issn>1550-9109</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kMtLAzEQxoMotVav3oQcRPSw2zw22-QoxRdUerB4DTE70ZXsw83uof-9absUBobh-83HzIfQNSUpJYrPgwdo54ykMs0ZOUFTKgRJVNRO0ZTQnCaSEnGOLkL4JXHOFJ-gieKCUqamaP1p_AC4cbj_AVwNvi9bD3jvir3pobZb3EPo8f37x2rzgF3T7dGiNN91E8qw261NZxsPbdheojNnfICrsc_Q5vlps3xNVuuXt-XjKrFcqD5hihqR8QUTuQIKVBYu1gIK7nKbO2UyIyhXuXVEUpa5wnJDWe4WLlNKWj5Ddwfbtmv-hnierspgwXtTQzMEvVDRm0sRwfQA2q4JoQOn266sTLfVlOhdgHr_qmZESx0DjAs3o_PwVUFxxMfEon476iZY411naluGI8ZkpqQg_B94K3jm</recordid><startdate>199708</startdate><enddate>199708</enddate><creator>ALDRICH, M. S</creator><creator>CHERVIN, R. D</creator><creator>MALOW, B. A</creator><general>American Academy of Sleep Medicine</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199708</creationdate><title>Value of the multiple sleep latency test (MSLT) for the diagnosis of narcolepsy</title><author>ALDRICH, M. S ; CHERVIN, R. D ; MALOW, B. A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-291a54372569e1e18df8df7ed3f6c6f9a4a51396cf08124fdc3a126f7f4998c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cataplexy - diagnosis</topic><topic>Child</topic><topic>Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Narcolepsy - diagnosis</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Polysomnography</topic><topic>Predictive Value of Tests</topic><topic>Sleep Apnea Syndromes - diagnosis</topic><topic>Sleep, REM</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>ALDRICH, M. S</creatorcontrib><creatorcontrib>CHERVIN, R. D</creatorcontrib><creatorcontrib>MALOW, B. A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Sleep (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>ALDRICH, M. S</au><au>CHERVIN, R. D</au><au>MALOW, B. A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Value of the multiple sleep latency test (MSLT) for the diagnosis of narcolepsy</atitle><jtitle>Sleep (New York, N.Y.)</jtitle><addtitle>Sleep</addtitle><date>1997-08</date><risdate>1997</risdate><volume>20</volume><issue>8</issue><spage>620</spage><epage>629</epage><pages>620-629</pages><issn>0161-8105</issn><issn>1550-9109</issn><eissn>1550-9109</eissn><coden>SLEED6</coden><abstract>Since its introduction, the multiple sleep latency test (MSLT) has played a major role in the diagnosis of narcolepsy. We assessed its diagnostic value in a series of 2,083 subjects of whom 170 (8.2%) were diagnosed with narcolepsy. The sensitivity of the combination of two or more sleep onset rapid eye movement (REM) periods (SOREMPs) with a mean sleep latency of < 5 minutes on an initial MSLT was 70% with a specificity of 97%, but 30% of all subjects with this combination of findings did not have narcolepsy. In some narcoleptics who had more than one MSLT, the proportion of naps with SOREMPs varied substantially from the initial MSLT to the follow-up test. The highest specificity (99.2%) and positive predictive value (PPV) (87%) for MSLT findings was obtained with the criteria of three or more SOREMPs combined with a mean sleep latency of < 5 minutes, but the sensitivity of this combination was only 46%. The combination of a SOREMP with a sleep latency < 10 minutes on polysomnography yielded a specificity (98.9%) and PPV (73%) almost equal to those obtained from combinations of MSLT findings, but the sensitivity was much lower. Our results suggest that the MSLT cannot be used in isolation to confirm or exclude narcolepsy, is indicated only in selected patients with excessive daytime sleepiness, and is most valuable when interpreted in conjunction with clinical findings.</abstract><cop>Rochester, MN</cop><pub>American Academy of Sleep Medicine</pub><pmid>9351129</pmid><doi>10.1093/sleep/20.8.620</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adolescent Adult Aged Biological and medical sciences Cataplexy - diagnosis Child Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes Female Follow-Up Studies Humans Male Medical sciences Middle Aged Narcolepsy - diagnosis Nervous system (semeiology, syndromes) Neurology Polysomnography Predictive Value of Tests Sleep Apnea Syndromes - diagnosis Sleep, REM |
title | Value of the multiple sleep latency test (MSLT) for the diagnosis of narcolepsy |
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