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Abstract
Introduction Multiple sleep latency tests (MLSTs) is used widely for the diagnosis of narcolepsy and idiopathic hypersomnia. This test objectively measures the time taken to fall asleep under controlled conditions. Traditionally, MLSTs have been performed in specialised sleep laboratories or in-hospital sleep centres following the performance of nocturnal polysomnography. The methodology consists of four to five naps separated by a 2-hour interval during the day.1–3
After Covid-19, most sleep providers have experienced a shortfall in hospital bed availabilities and prolonged waiting times.
Methods IPDiagnostics linked with home video technology considered implementing a service to investigate the applicability of Home-video polysomnography followed by remote attended daytime Home-video MSLT. The AASM guidelines 2.6 and AASM protocol for MSLT were followed for the recording and scoring of studies. A second camera was added to independently monitor and provide remote connectivity with patients.
Results Table 1 presents our five consecutive illustrative cases undergoing home MSLT.
Descriptive statistics for patients who underwent Home Video MSLT
Discussion Two studies resulted in a positive diagnosis of narcolepsy. Home-video PSG and MSLT testing has the potential for patient cost savings and massively reduced in-hospital waiting lists. The presence of SOREMs in a familiar setting is perhaps the objective measure sleep laboratories need for those investigated for idiopathic hypersomnia and narcolepsy.
References
Arand DL, Bonnet MH. ‘The multiple sleep latency test’. Handb Clin Neurol 2019;160:393–403
Beiske KK, Sand T, Rugland E, Stavem K. ‘Comparison of Sleep Latency and Number of SOREMPs in the home and hospital with a modified multiple sleep latency test: a randomized crossover study’. Journal of Clinical Neurophysiology 2017;34:3
Krahn LE, Arand DL, Avidan AY, Davila DG, DeBassio WA, Ruoff CM, Harrod CG. ‘Recommended protocols for the Multiple Sleep Latency Test and Maintenance of Wakefulness Test in adults: guidance from the American Academy of Sleep Medicine’, Clinical Sleep Medicine 2021;17:12
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