Do you also often feel sleepy during the day? To be precise, even if you sleep well at night, do you have difficulty staying awake during the day, and you just feel like your eyes are closing? Then this is about a special test that may be very important for you. This is what we call the Multiple Sleep Latency Test, or MSLT test as it is called among doctors for short. Let's see what it is and why it is done.
What is the Multiple Sleep Latency Test (MSLT)?
Simply put, this MSLT test measures how quickly you fall asleep during the day (this is called sleep latency ) and what stages of sleep you go into when you take a nap. A healthcare provider, usually your doctor, uses this test to help determine the cause of your excessive daytime sleepiness and to help diagnose underlying sleep disorders.
What exactly does this MSLT test detect?
An MSLT test mainly helps to identify conditions such as:
- Narcolepsy: This is characterized by uncontrollable daytime sleepiness and sudden onset of sleep.
- Hypersomnia: This is also characterized by excessive sleepiness. Even though you get enough sleep at night, you still feel sleepy during the day.
When is an MSLT performed?
This MSLT test is done during the day . Also, it is always done after an overnight sleep study. That is, doctors first perform an overnight sleep study (also called ``Polysomnography'') to get a complete picture of your sleep, and then they do this MSLT.
Who is this MSLT test best suited for?
If you also have difficulty staying awake during the day, that is, if you often feel sleepy, a doctor may suggest that you take this MSLT test. Imagine, if this sleepiness is preventing you from doing your daily tasks properly, disrupting your work at the office, schoolwork, or even daily social interactions, it is something to take into account. Especially if this daytime sleepiness continues for several months, it is definitely a good idea to see a doctor and get advice.
Before deciding whether you should have an MSLT, your doctor may first ask you to take a test called the Epworth Sleepiness Scale . It consists of eight questions that you answer yourself. This will give your doctor an idea of how daytime sleepiness is affecting your daily life.
How does this MSLT test work? What exactly happens?
The MSLT test assesses your daytime sleepiness by giving you five scheduled naps during the day. After each nap, you are given a two-hour rest period before the next one. During each nap, small sensors are attached to your body. These sensors allow your doctor to monitor your brain activity and eye movements.
Doctors mainly look at how quickly you fall asleep, and whether you enter a special sleep stage called REM (Rapid Eye Movement) sleep during your naps. REM sleep usually occurs when we go into a deep sleep. So, if you're still going into REM even during your naps, it could be a sign of an underlying sleep disorder like narcolepsy.
How do we prepare before an MSLT?
Your doctor will give you some specific instructions to follow before an MSLT. These instructions may include:
- Maintain a sleep schedule, going to bed and waking up at the same time, for a few weeks before the test. This is very important.
- Keep a sleep diary to record your bedtime and wake-up times for at least two weeks.
- You may be asked to wear a device called an actigraph , which can track your sleep and wake patterns.
- If you are currently taking any medications or supplements, you should ask your doctor if you need to make any changes. Do not start or stop taking any medications without your doctor's advice.
The MSLT test usually begins with an overnight sleep study (polysomnography) the next morning. After you wake up from the test that night, you have a few hours to rest before the MSLT begins. During this time, your doctor may do additional tests, such as a blood or urine test (especially a drug screening ), because some drugs can affect your sleep as well as your waking state. You may also be asked to complete a short survey at the sleep center about how you slept.
What to expect during the MSLT test?
Here is a step-by-step guide to how the MSLT test is performed:
1. They make you lie down on a bed.
2. A healthcare worker will attach some sensors to the surface of your skin.
3. Then check if the sensors are working properly.
4. Turn off the lights in the room and they leave the room.
5. You are told to take a nap.
6. They wake you up after a predetermined time (usually one nap is at least 20 minutes).
7. They will remove the sensors from your body.
8. You will be asked to answer a questionnaire asking how you feel after waking up.
9. Then you will have two hours of rest . This time is yours. However, you must remain awake during these two hours. If you want, you can leave the sleep center and have a snack or drink. But do not drink anything that contains caffeine, such as coffee, tea, or chocolate.
You have to take up to five naps during the day like this, with that two-hour rest after each nap.
If you have any problems while you're sleeping, the doctor or health worker is right outside the room. There's a two-way microphone by the bed, so you can talk to them at any time.
The sleeping rooms are dark and quiet . You may want to bring comfortable clothing to wear during the test.
What happens if I don't fall asleep during the MSLT?
Now you might be thinking, "Oh, I'm in a strange place, with all this stuff on my body, and I can't fall asleep." That's perfectly normal. It's not easy for any of us to fall asleep in a new environment, especially when we have sensors attached to our bodies. In an MSLT test, if you're awake 20 minutes after your scheduled bedtime, they record it as 20 minutes , even though you didn't actually fall asleep. Then you get that two-hour rest period before your next nap.
Some of the things in the MSLT test may prevent you from falling asleep at the right time. That's okay. Your doctor will suggest other tests if this test isn't right for you to find the cause of your daytime sleepiness.
To help you fall asleep, you can bring the following items from your home to the sleep center:
- Your favorite pillow .
- Your blanket .
- Read a book (read during your free time).
It's important to maintain a consistent sleep schedule for a few weeks before the test. You may need to change the medications you take. You may also need to make changes to what you eat and drink, especially if you regularly consume caffeine- containing foods like coffee, soda, and chocolate. It's also a good idea to cut back on nicotine , but if it's absolutely necessary, you should stop at least 30 minutes before bedtime.
What happens after the MSLT?
After the final sleep phase of the MSLT test, you can go home. Your doctor will schedule a follow-up appointment to discuss the test results.
How is the MSLT test scored?
The following data is collected from the results of the MSLT test to assess your daytime sleepiness:
- The time it takes you to fall asleep (`(sleep latency)`).
- Brain waves.
- Eye movements.
The way the test is scored can vary slightly depending on how your doctor measures the data. Your doctor may use the average values of your MSLT data to diagnose a sleep disorder if you meet these criteria:
- Narcolepsy: If it takes you less than 8 minutes to fall asleep, and you go into REM sleep on at least two occasions .
- Hypersomnia: If it takes you less than 8 minutes to fall asleep, but you enter the REM stage in less than two sleeps .
It takes about 11 minutes for a person to fall asleep on average. Most people enter REM sleep after about 90 minutes.
A doctor will compare the data from the MSLT with data from other tests such as:
- The sleep diary you've been keeping for the past few weeks.
- The data obtained from the Actigraph device if worn.
- Data from an overnight sleep study (`(Polysomnography)`).
How long does it usually take to get the results?
Your doctor will give you a few days to discuss the results with you after the MSLT. This time frame may vary, especially if the doctor needs additional tests to make a complete diagnosis.
What's next after the MSLT?
If you are diagnosed with a sleep disorder after the MSLT test, your doctor will meet with you to discuss a treatment plan that can help reduce daytime sleepiness. You may need to take medication or change your sleep habits to help manage your symptoms.
Even if the MSLT test results do not diagnose a sleep disorder, you may still have persistent daytime sleepiness. If so, additional tests may be needed to find the cause of this symptom.
How effective is MSLT in diagnosing narcolepsy?
The MSLT is a reliable test for diagnosing some types of narcolepsy. But keep in mind that a doctor usually doesn't use the MSLT alone to make a diagnosis. It's just one part of several other tests.
When should I see a doctor?
If your daytime sleepiness is interfering with your daily activities, be sure to see a doctor . They will perform an MSLT and/or other tests to provide an official diagnosis.
The most important things for you to keep in mind (Take-Home Message)
Daytime sleepiness is a condition that makes it difficult to perform daily tasks, even if you sleep well at night. To find out how this symptom affects you and what is causing it, your doctor may suggest a Multiple Sleep Latency Test (MSLT) if they suspect you have narcolepsy or hypersomnia.
It's normal to feel a little nervous before an MSLT. Because you're not sleeping in your own bed, you may feel like you're not going to sleep. Don't worry. You can bring your favorite pillow, blanket, etc. to the sleep center. Also, maintaining a consistent sleep schedule for a few weeks before the test will help your body get used to going to bed on time.
If you have any questions before or after the test, ask your medical team. They will review the results and, if necessary, advise you on what to do next. It's never too late to talk about your sleep problems!
` Sleep test, MSLT, daytime sleepiness, narcolepsy, hypersomnia, REM sleep, sleep disorders
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