The influence of antidepressants and actigraphy-derived sleep characteristics on pediatric multiple sleep latency testing

2021 ◽  
Author(s):  
Meghna P. Mansukhani ◽  
Swati Dhankikar ◽  
Suresh Kotagal ◽  
Bhanu Prakash Kolla
Keyword(s):  
Sleep Latency ◽  
Multiple Sleep Latency ◽  
Multiple Sleep Latency Testing

scholarly journals Practice Parameters for the Non-Respiratory Indications for Polysomnography and Multiple Sleep Latency Testing for Children

SLEEP ◽  
2012 ◽  
Vol 35 (11) ◽  
pp. 1467-1473 ◽  
Author(s):  
R. Nisha Aurora ◽  
Carin I. Lamm ◽  
Rochelle S. Zak ◽  
David A. Kristo ◽  
Sabin R. Bista ◽  
...  
Keyword(s):  
Sleep Latency ◽  
Practice Parameters ◽  
Multiple Sleep Latency ◽  
Multiple Sleep Latency Testing

scholarly journals 0738 Advance Taper of Antidepressants Prior to Multiple Sleep Latency Testing Increases the Number of Sleep-Onset Rapid Eye Movement Periods and Reduces Mean Sleep Latency

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A281-A281
Author(s):  
B Kolla ◽  
M Jahani Kondori ◽  
M Silber ◽  
H Samman ◽  
S Dhankikar ◽  
...  
Keyword(s):  
Eye Movement ◽  
Sleep Latency ◽  
Sleep Onset ◽  
Initial Assessment ◽  
Rapid Eye Movement ◽  
Regression Analyses ◽  
Practice Parameters ◽  
The Impact ◽  
Multiple Sleep Latency ◽  
Multiple Sleep Latency Testing

Abstract Introduction Patients presenting with excessive sleepiness are frequently on antidepressant medication(s). While practice parameters recommend discontinuation of antidepressants prior to multiple sleep latency testing (MSLT), data examining the impact of tapering these medications on MSLT results are limited. Methods Adult patients who underwent MSLT at Mayo Clinic Rochester, Minnesota, between 2014-2018 were included. Clinical and demographic characteristics, medications, including use of rapid eye movement suppressing antidepressants (REMS-AD) at assessment and during testing, actigraphy and polysomnography data were manually abstracted. The difference in number of sleep-onset rapid eye movement periods (SOREMS), proportion with ≥2 SOREMS and mean sleep latency (MSL) in patients who were on REMS-AD and discontinued prior to testing versus those who remained on REMS-AD were examined. At our center, all antidepressants are discontinued 2 weeks prior to MSLT wherever feasible; fluoxetine is stopped 4 weeks prior. Regression analyses accounting for demographic, clinical and other medication-related confounders were performed. Results A total of 502 patients (age=38.18±15.90 years; 67% female) underwent MSLT; 178 (35%) were on REMS-AD at the time of assessment. REMS-AD were discontinued prior to testing in 121/178 (70%) patients. Patients tapered off REMS-AD were more likely to have ≥2 SOREMS (OR-12.20; 95%CI=1.60-92.94) compared to patients who remained on REMS-AD at the time of the MSLT. They also had shorter MSL (8.77±0.46 vs 10.21±0.28; p>0.009) and higher odds of having ≥2 SOREMS (OR=2.22; 95%CI=1.23-3.98) compared to patients not on REMS-AD at initial assessment. These differences persisted after regression analyses accounting for confounders. Conclusion Patients who taper off REMS-AD prior to MSLT are more likely to demonstrate ≥2SOREMs and have a shorter MSL. Pending further prospective investigations, clinicians should preferably withdraw REMs-AD before an MSLT. If this is not done, the test interpretation should include a statement regarding the potential effect of the drugs on the results. Support None

scholarly journals 1258 No Laughing Matter - Laughter Induced Syncope (Gelastic Syncope) Mimicking Cataplexy

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A479-A479
Author(s):  
Dinesh Belani ◽  
Edwin Simon
Keyword(s):  
Sleep Latency ◽  
Loss Of Consciousness ◽  
The Past ◽  
Obstructive Sleep ◽  
Neurological Illnesses ◽  
Emotional Trigger ◽  
Waking Up ◽  
Sleep Talking ◽  
Multiple Sleep Latency ◽  
Multiple Sleep Latency Testing

Abstract Introduction Laughter is a common emotion and may rarely be a manifestation of neurological illnesses. It has been associated with cataplexy as well. Cataplexy is usually triggered by strong emotions. Gelastic syncope is an uncommon phenomenon which may be mistaken for cataplexy. We summarize 3 cases referred to the Sleep Medicine clinic for evaluation for Narcolepsy. Report of Case 55 yo male comes with 2 episodes of blacking out and falling down relating to episodes of laughter in 3 months. Patient describes loss of consciousness and no episodes of freezing. Reported 15 years of snoring and witnessed apneas along with grinding his teeth while sleeping. Polysomnogram revealed Obstructive Sleep Apnea (OSA) with an AHI of 20. 60 yo male comes with episodes of loss of consciousness over the past 6 months, including sitting in a chair, laughing, urinating, washing dishes while standing, expressing strong emotions (father’s funeral), etc. Also reports bugs crawling over his legs when trying to sleep, loud snoring and waking up choking while sleeping. Polysomnogram revealed OSA with an AHI of 20. 43 yo male comes 3 episodes of loss of consciousness, 2 of them related to laughing and the last one related to stretching his arms out. He passes out for 5-10 seconds at a time and a period of 20-30 seconds before passing out where he feels dizzy when he is unable to respond at this time, no post episode confusion. Positive on the Cataplexy Emotional Trigger Questionairre. Reported witnessed apneas, snoring and sleep talking. Polysomnogram revealed OSA, hence the Multiple Sleep Latency Testing ordered was not completed. Conclusion While the first two episodes point towards Gelastic Syncope based on symptoms, the third did warrant MSLT if there was no OSA on PSG. It is important to recognize gelastic syncope as an entity and differentiate it from cataplexy.

scholarly journals Cancer-related fatigue presenting with excessive daytime sleepiness

2017 ◽  
Vol 5 ◽  
pp. 2050313X1774886
Author(s):  
Diwakar D Balachandran ◽  
Saadia A Faiz ◽  
Lara Bashoura ◽  
Ellen Manzullo
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Excessive Daytime Sleepiness ◽  
Breast Cancer Survivor ◽  
Daytime Sleepiness ◽  
Sleep Latency ◽  
Common Symptom ◽  
Cancer Related Fatigue ◽  
Multiple Sleep Latency ◽  
Multiple Sleep Latency Testing

Cancer-related fatigue is a common symptom in cancer patients which commonly occurs in relation to sleep disturbance. We report a case of a 35-year-old breast cancer survivor, in whom polysomnography and multiple sleep latency testing were utilized to objectively quantify the contribution of excessive daytime sleepiness to the patient’s cancer-related fatigue.

scholarly journals Systematic Review of Sleep Characteristics in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 568
Author(s):  
Rebekah Maksoud ◽  
Natalie Eaton-Fitch ◽  
Michael Matula ◽  
Hélène Cabanas ◽  
Donald Staines ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Fatigue Syndrome ◽  
Sleep Quality ◽  
Sleep Latency ◽  
Chronic Fatigue ◽  
Myalgic Encephalomyelitis ◽  
Objective Measures ◽  
Fatigue Syndrome ◽  
Multiple Sleep Latency ◽  
Multiple Sleep Latency Testing

(1) Background—Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a multifaceted illness characterized by profound and persistent fatigue unrelieved by rest along with a range of other debilitating symptoms. Experiences of unrefreshing and disturbed sleep are frequently described by ME/CFS patients. This is the first systematic review assessing sleep characteristics in ME/CFS. The aim of this review is to determine whether there are clinical characteristics of sleep in ME/CFS patients compared to healthy controls using objective measures such as polysomnography and multiple sleep latency testing. (2) Methods—the following databases—Pubmed, Embase, Medline (EBSCO host) and Web of Science, were systematically searched for journal articles published between January 1994 to 19 February 2021. Articles that referred to polysomnography or multiple sleep latency testing and ME/CFS patients were selected, and further refined through use of specific inclusion and exclusion criteria. Quality and bias were measured using the Joanna Briggs Institute checklist. (3) Results—twenty observational studies were included in this review. The studies investigated objective measures of sleep quality in ME/CFS. Subjective measures including perceived sleep quality and other quality of life factors were also described. (4) Conclusions— Many of the parameters measured including slow- wave sleep, apnea- hypopnea index, spectral activity and multiple sleep latency testing were inconsistent across the studies. The available research on sleep quality in ME/CFS was also limited by recruitment decisions, confounding factors, small sample sizes and non-replicated findings. Future well-designed studies are required to understand sleep quality in ME/CFS patients.

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