valnagy

What Were Your Mslt Results & Diagnosis?

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Just trying to see what everyone's MSLT records were & their diagnosis for informational purposes. :)

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My PSG, I slept for 7 or 8 hours (don't remember), with a 92% sleep efficiency.

 

The MSLT, I slept in all 5 naps with a sleep latency of 8 minutes and 2 SOREMs.

 

Borderline for the Narcolepsy diagnosis, I know, but as the neurologist put it, "No one who's slept that long, with that sleep efficiency rating the night before should have been able to fall asleep at all for any of the naps if they didn't have Narcolepsy."

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I slept something like seven hours with a 90ish% effieciency. Then during the MSLT I had a mean latency of 4.7 minutes, but only one SOREM. On the nap after lunch I slept in two minutes. Also, even though I only had one SOREM, four out of the five naps were 20 minute sleep paralysis episodes.

 

My current sleep doctor considers my condition to be narcolepsy due to my tests combined with my history of SP, HH and the big C.

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I'm 26 and have Narcolepsy without Cataplexy.

 

My PSG on 10/13/2012:

I slept for 432 Minutes (7 Hours 12 Minutes), with a sleep efficiency of 88%. I had decreased Stage 1 sleep, normal stage 2 and REM sleep, and increased slow-wave sleep. Latency to REM sleep was at the upper end of normal, measured at 114 minutes from sleep onset. It took me 5.5 Minutes to fall asleep. Overall normal AHI (Apnea + Hypopnea Index) consisted of 1 obstructive apnea and 38 obstructive hypopneas. Overall AHI was 5 per hour of sleep, during REM was 13 per Hour. O2 Saturation dropped to a low of 88%, with a mean O2 saturation of 93%.

 

My MSLT on 11/12/2012 (SL= Sleep Latency, LR= Latency to REM):

Nap#1  SL 5.5 Min  LR 9 Min

Nap#2  SL 1.5 Min  LR 7 Min

Nap#3  SL 7.5 Min  No REM

Nap#4  SL 5.0 Min  No REM

Nap#5  SL 1.0 Min  LR 16 Min

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I wish I could remember it all (I really should request a copy of my results).

 

From what I remember- My PSG I slept for just over 7 hours alternating between stage 1, 2, and a ton of REM.  I also woke 10+ times. I think my sleep efficiency was 87%.

 

My MSLT they only made me take 4 of the 5 naps and my mean latency was 1.2 Min and no REM in any naps.  But, I remember dreaming in each nap.  I also kept having sleep attacks throughout the day.  I normally do not have such a hard time, but not having coffee and being bored made things harder then normal.   Due to having minor Cateplexy, SP/HH the doc had no problem giving me the Dx.

 

If I get a copy of my test I will revise. 

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I am brand new to the board. This thread seemed to be as good a place as any to make my first post. I am on a crash course in this stuff so I hope I get everything right.

 

My PSG on 01/02/2013:

 

I slept for 411 Minutes, with a sleep efficiency of 90.6%. “sleep architecture was fragmented and included only 26 minutes of stage REM with a prolonged latency of 116 minutes.” I had mild intermittent snoring. AHI was 3.2 events per hour and RDI of 14 events/hr. Nothing else of note. Diagnosed with very mild obstructive sleep apnea (upper airway resistant syndrome variant).

 

My MSLT on 01/03/2013:

 

I slept in all 5 naps and had REM in 3. Mean Values:

Time in Bed: 15:53
Total Sleep Time: 14:47
Sleep onset: 36 seconds
REM latency: 7:49

 

During the nap test, I was mad at the tech because I thought the naps were 20 minutes and she kept waking me up after 15 – robbing me of sleep! I held my tongue and am glad I did as I have since learned that she was supposed to do that. Also, I was very reluctant to tell her that I was having dreams as I thought dreams meant “good sleep” and if I was getting into good sleep that quickly they would say there was nothing wrong with me and I would get no help. I told her anyway but I left that building convinced my sleeping was fine and that I was going to have to find another solution to my sleepiness. That was an awful feeling.

 

The next week I was diagnosed with Hypersomnia. I was put on a CPAP to see if the relatively high RDI of 14 has anything to do with my sleepiness. At my request they also put me on a stimulant (nuvigil) and I just went to 250mg today. No help so far and job in real jeopardy and going on FMLA next week (that’s for another thread) No narcolepsy diagnosis yet, but I appear to be headed that way.

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Hi Arrow2 - I felt the same way after my sleep study.  I went in for the PSG on 12/27/12 and stayed for the MSLT on the 28th.  When I woke up after the PSG without a CPAP on I was devastated.  All I knew about sleep disorders was sleep apnea and they said if I had it that they would come in a strap me up during the night.  They asked me to stay for the MLST saying that they would look for other issues, but it was 6am, I had just woken up, my mind was foggy as usual and I don't remember anything they said.  I fell asleep for each nap and hated the whole process, i just wanted to sleep more!  I agree, leaving the study with no answers was awful.

Last week I got a letter that said the results indicated I have EDS and that I would need to meet with a specialist to review the details of my study.  Is that how you got the specifics of your study or were they sent to you in a report?  When they diagnosed you with Hypersomnia did they plan to leave that untreated?  I ask because you said you had to request the stimulants.  I meet with my specialist this week and I don't know if I should request stimulants although I know I want to.

I hope you find relief soon.

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Mina - I can't remember if I got the sleep report before the specialist or from him. I think from him. I had to ask for stimulant because the Dr. wanted to do the CPAP first and totally separate from meds so that we could get a nice "clean" diagnosis. I requested stimulants because work informed me that 30 more days (the length of the proposed CPAP test) of my erratic attendance was not acceptable. Once I asked, he gave it no big deal. I see you are in MN. Me too. I had the sleep study at north memorial and got referred to the minneapolis neurological clinic. I also saw a sleep behavioral specialist at Abbott in MPLS yesterday. Thanks for your reply and please keep me posted on what you learn.

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this was my initial diagnosis in 2003 (wow 10 years now?)

 

t89onr.jpg

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Mina - Regarding my post above, if you want to respond maybe its better to do so under your "what to ask the Dr Thread." We should keep this thread focused on test results and talk in the other one.

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my results are as follows:  (my dr. appt is next week).  If anyone has any insight, please feel free to comment, as I am compiling questions to prepare for my appt.

 

Please feel free to comment on individual sections, because I am scratching my head about several things that were said (my questions are in bold).

***This sleep test was done while using a CPAP machine & taking Ambien.***

 

Sleep Architecture

This full night sleep study demonstrates an increased sleep latency of 35.0 minutes.  Sleep architecture showed decreased stage N1 sleep (1.9%), normal Stage N2 sleep (75.1%), normal Stage N3 (Slow Wave Sleep) (8.1%), and decreased Stage REM sleep (13.8%).  There was a normal REM latency of 92.5 minutes.  There was a total sleep time of 376.0 minutes with a normal sleep eficiency of 88.1%

Respiratory Analysis

The study showed no obstructive sleep apnea with mild sleep fragmentation characterized by an overall Apnea Hypopnea Index (AHI) of 1.0/hour.  The AHI's were NREM 0.9/hour, and REM 1.32/hour.  The patient had 0 obstructive apneas, 0 mixed apneas, 3 central apneas, 3 hypopneas, and 0 flow limitation events (RERA).  Positional influence was not a contributing factor.

Sleep Fragmentation Analysis

There were 61 spontaneous arousals, 1 respiratory arousal, and 15 limb movement arousals leading to a total arousal index of 10/hour.

Limb Movement Analysis

There were 104 limb movements.  Limb movements resulted in 15 brief arousals during the night.  The PLM Index of 16.6/hour.

Cardiac Analysis

The patient's EKG displayed Normal Sinus Rhythm.

Oxygenation Analysis

Moderate oxygen desaturations were noted with a nadir attained being 86%.  The baseline SpO2 was 93.  Total sleep time spent below 90% is 0.40%

MSLT Results

MSLT was performed with 5 nap opportunities on CPAP 12.  Average sleep latency was 11 minutes with 1 SOREM at 9 minutes.

Physician's Interpretation

No evidence of significant residual OSA on CPAP 12.  There are moderate PLM's present.  MSLT demonstrates borderline hypersomnia with sleep latency of 11 minutes.  Recommend clinical follow-up.

 

Ok, here are my questions:

What are the normal percentages of time spent in each sleep stage?

I woke up spontaneously for no reason 61 times (I only remember waking once).  This is my issue nightly-waking up for no reason.  What can cause this?  This goes hand in hand with my next question, I never knew neither did my boyfriend about my PLM's.  I would wake up once a week or so with cramps in my lower legs where it felt like I would stretch and hold it and would wake up from the pain.

MSLT-I remember dreaming more than once.  During one nap it seemed like I was having a seizure from jerking, but I will bring that up with the doctor b/c it was all recorded.

The moderate PLM's seem to not bother me too much as the "spontaneous arousals".  What causes this?

What is "borderline hypersomnia"?

 

Thank you in advance for your comments/input/knowledge!

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I don't have my sheets in front of me, but I was just diagnosed a month ago so here is what I remember.

 

 My nighttime sleep was just over 7.5 hours. Sleep latency was 27 minutes with two Ambien. Sleep was mostly normal and not much cause for concern, although I was diagnosed with VERY mild sleep apnea. My AHI was 5.2 and consisted of hypopneas, not full obstructions. The sleep techs didn't put a CPAP on me during the PSG, however my Dr has advised I try using a CPAP for a couple months to see if it helps. I haven't noticed any difference thus far, however at some point each night I take the mask off and turn my machine off. I have no clue when this happens or any memory of doing this.

 

For my MSLT, they sent me home after only doing three naps, although I wasn't sure at the time why, (now I get it). Anyways, I fell asleep for 3/3 of my naps, my sleep latency average was 2 minutes, and I had SOREM on all three of my naps.

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Can I just say what a miserable experience the MSLT was? I kept falling asleep in between each nap! My nurse kept coming in saying 'your sleeping!' :)

 

I don't have them in front of me, but I will edit when I grab them. 

 

Study Showed:

 

Total sleep time was 513 minutes, but I don't have the data for each cycle. 

Fell asleep in 5/5 naps with a sleep latency of 2 minutes in the first 4 naps and 8 minutes final nap. I had two SOREM.

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my mslt=2.18 min avg. onset lat., 7 min rem lat., only 1 sorem.  di not remain wakeful in the intervals at all; was right back to sleep as soon as the tech left the room at the end of each nap-he wasn't present but for a few seconds, just turned off the equipment i was connected to w/23 wires, tured on the lights and the tv and reminds me i am to stay awake until he returns.  the fact that i had had no wakefulness promoting medication for 2 full weeks as the washout perceding mine and any mslt meant that i was not able to comply. i tried my best.  unmedicated, wakefulness for me is futile.

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my mslt of 3 naps resulted in an average of 28 sec. two of the three were less than 1 sec. actually .9 sec. and the 3rd was 28 sec. that sounds unbelievable to me.  the rem onset average was about 5 min. I think for 3 naps.

so I am king... :)

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I was just diagnosed on July 1st 2013. Still trying to figure what this disease is . Just glad I am not crazy as almost all of family thought I was.Now to try to get them to understand.

 

Polysomnogram fairly normal 6 hours of sleep...

 

Mslt results. sleep time was 6  with  all four sleep periods with REM

 

nap 1: latency 4 minutes. REM present

nap 2: latency 6 minutes REM present

nap 3: latency 5 minutes REM present

nap 4: latency 7 minutes REM present.

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I was diagnosed in 2009 and I still question it. My results were

Sleep 425 mins - w/sleep efficiency of 94%, elevated breathing disturbance and arousals suggested of increased upper airway resistance syndrome.

MSLT

nap#1- 0 mins to latency, no REM

#2 - 1 min to latency, 4 mins REM

#3 - 0 mins latency, 2.5 mins REM

#4 - 4 mins Latency, 5 mins REM

#5 - 3 mins latency, 0.5 min REM

Summary

latency to first epoch of sleep 1.6 mins / latency to sleep onset 1.6 mins

4 out of 5 naps containing REM w/mean of 3 mins

I question it because I don't fall asleep like that normally. But just hanging out waiting to fall asleep is boring.

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The mean sleep latency for me was 1 minute (0.9, 0.7, 0.0, 1.4, and 1.2 minutes). I only had sleep onset REM on 2/5 of the naps though. I'm not really sure what that means?

 

My overnight total was 437 minutes @ a sleep efficiency rate of 96% & The diagnosis was narcolepsy.

 

I totally agree with previous commenters - it was incredibly tough to stay awake in between the morning naps! I had to be woken up by the nurse a couple of times. 

 

I don't know if it's just me, but during the naps it almost felt like after I started dreaming that something was messing with my head and pulling me back to consciousness. It didn't feel the same way as it usually does when a loud noise wakes me up - it felt more like a jolt from inside, and kind of unsettling. Maybe it was because of the strange environment...

 

p.s.

As a patient not knowing the extensiveness of the data being collected from all those wires reading my brain activity - So happy to make it through the testing without having an embarrassing sex dream! ;0  

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This thread is a tad old but...

Sleep architecture:

Time in bed 7 hours 29 minutes, total sleep time 6 hours 15 minutes, sleep latency 9 minutes, REM latency 1 hour 48 minutes, sleep efficiency 86%.

69 arousals with arousal index of 11/h

MLST:

Nap 1: I didn't sleep

Nap 2: sleep onset: 3.5 min, REM onset: 14.5 min

Nap 3: sleep onset: 1.5 min, REM onset: 13.5 min

Nap 4: sleep onset: 2.5 min, REM onset: none

Nap 5: sleep onset: 2.5 min, REM onset: none

Average sleep latency: 6 min (actually 2.5 if you only average the naps I fell asleep)

Average REM latency: 14 minutes

I was diagnosed with narcolepsy the day after my MSLT

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MSLT:

 

Nap 1: sleep latency: 1.0 min, REM latency: 8 min

Nap 2: sleep latency: 0.5 min, REM latency: none

Nap 3: sleep latency: 0.5 min, REM latency: 3.5 min

Nap 4: sleep latency: 0.0 min, REM latency: 8 min

Nap 5: sleep latency: 2.5 min, REM latency: none

 

Average sleep latency =  0.9 min

 

Average REM latency =   6.5 min

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Reply to TiredAgain, you said you question your results???  There is no reason to question them!  It is very clear narcolepsy!   You might think that you don't fall asleep like that normally, but that's what I thought as well.  The problem is that Stage 1 sleep is very much like being awake.  You might think that you are awake when you are really doing automatic behavior.  For all my naps (above), I thought that I was awake.

 

Sunshine000, I also had those jolts that you described, and I'm not sure what they were from.  

I don't think they can tell if you have a sex dream  ;)   It's not a Functional MRI so they can't tell which part of your brain is in use.  Wait....  <bleep>.

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Livi I think it's hard to get a good reading of sleep habits when your hanging out in a room trying to stay away. I really don't sleep that much when I can. When I try to nap it takes forever for me to fall asleep. On average I probably get about 5hrs a night and like 10 / 15mins during the day. Most people with N can fall asleep anytime. I keep going through sleep episodes 95% of the time because I know if I do lay down I probably wont sleep anyway

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Trying to stay away? Did you mean awake? Why would you be trying to stay awake during your MSLT? Sorry, I'm just confused.... I'm trying to understand....

When you try to nap it takes you forever to fall asleep. That's what I would say too. Except I don't even realize that I'm in Stage 1 sleep and you might not realize it either.

What are the sleep episodes that you have 95% of the time?

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They need you to stay awake between naps, or it'll skew the results, unless it was an actual MWT.  Is that the right acronym, maintain wakefullness test?

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Oh, he meant stay awake between naps? Well I did plenty of things between naps - watched movies, read books, talked to other patients & joked with the techs, did Sudoku, went down to the cafe, surfed the web. It wasn't hard to stay awake..... I'd say it's harder to stay awake at work every day than to do things i can quietly enjoy, knowing i am taking an excused "sick leave" from work which is exciting for me!

The purpose of the MSLT is not to get a good reading of your sleep habits. It's to see how quickly you fall asleep in that particular circumstance. The protocol exists so that there can be a standardization, regardless of how you normally live your life. And you said you have "sleep episodes" 95% of the time in your everyday life.

I dont want to argue about your beliefs though. Just had been wondering about your thought process.

Iron, yeah, it's the Maintenance of Wakefulness test. Is that even used for diagnosing N? I thought it was just used for the elderly, to determine whether they are fit to drive.

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