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Microsleep versus Sleep Onset Latency during Maintenance Wakefulness Tests: Which One Is the Best Marker of

Ludivine Des Champs de Boishebert1, Pierre Pradat2, Hélène Bastuji1,3

  • 1Center for Sleep Medicine and Respiratory Diseases, Hospices Civils de Lyon, 69004 Lyon, France.

Clocks & Sleep
|May 5, 2021
PubMed

Insights

Microsleeps (MSs) are common during the Maintenance Wakefulness Test (MWT) in patients with sleep disorders. Their presence does not significantly alter the test

Area of Science:

  • Sleep Medicine
  • Neurophysiology
  • Diagnostic Testing

Background:

  • The Maintenance Wakefulness Test (MWT) is crucial for diagnosing residual sleepiness.
  • Microsleeps (MSs) are brief sleep intrusions that can occur before sleep onset.
  • Understanding MS prevalence during MWT is important for accurate sleepiness assessment.

Purpose of the Study:

  • To determine the frequency of microsleeps during the MWT.
  • To evaluate the diagnostic contribution of microsleep latency (MSL) versus sleep onset latency (SOL) in detecting residual sleepiness.
  • To assess the impact of MSs on MWT interpretation in patients with obstructive sleep apnea (OSA) or hypersomnia.

Main Methods:

  • Analysis of MWT recordings from 98 patients undergoing treatment for sleep disorders.
  • Scoring of microsleeps and calculation of microsleep latency (MSL).
  • Comparison of MSL and SOL diagnostic performance using ROC curve analysis for sleepiness detection (Epworth Sleepiness Scale > 10).

Main Results:

  • At least one microsleep was observed in 62.2% of patients.
  • Microsleep latency (MSL) correlated positively with sleep onset latency (SOL) (r = 0.72, p < 0.0001).
  • Neither SOL nor MSL significantly improved the diagnostic performance of the MWT for subjective sleepiness (AUC = 0.66 vs. 0.63).

Conclusions:

  • Microsleeps are frequent during MWTs in patients with treated sleep disorders, irrespective of subjective sleepiness.
  • MSs may serve as physiological indicators of the wake-to-sleep transition.
  • Current MWT interpretation protocols may need refinement to account for MS prevalence.
Keywords:
Maintenance Wakefulness Testpolysomnographysleep latencysleepinesswakefulness

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