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Author Notes:

Correspondence: Alyssa Cairns, PhD, SleepMed, Inc. Columbia, SC, 700 Gervais Street, Suite 200, Columbia, SC 29201, Telephone- (803) 779-5454, acairns@sleepmedinc.com

Author Contributions: AC- (1) conception and design of the study, (2) data analysis, and (3) data interpretation, (4) full manuscript drafting. LMT- (1) conception and design of the study, (2) data analysis, and (3) data interpretation and discussion drafting. RKB- (1) conception and design of the study and (2) data interpretation

The authors thank the NIH for partially funding this work as well as SleepMed’s data team and research staff for assisting with data coding, transcription, and quality assessments.

A special thank you to Jill Vaughn, RPSGT, Cindy Price, RPSGT, Julie Sutton, RPSGT, Brenda Brown, RPGST, Tenikie Johnson, and Barbara Grice for their hard work on this project.

Disclosures: Drs. Bogan and Cairns have received research support from Jazz Pharmaceuticals, a company that owns therapeutic compounds for Narcolepsy. Dr. Bogan also serves on the speakers bureau for and is a consultant to Jazz Pharmaceuticals. Drs. Bogan and Cairns and are employed by SleepMed, Inc., a commercial diagnostic, research, and therapy company.

Research Funding:

This study was internally funded through SleepMed, Inc. and NIH K23 NS083748 (LMT)


  • Science & Technology
  • Life Sciences & Biomedicine
  • Clinical Neurology
  • Neurosciences & Neurology
  • MSLT
  • Hypersomnia
  • Narcolepsy
  • Gender
  • Age

Demographic and nap-related variance of the MSLT: results from 2,498 suspected hypersomnia patients Clinical MSLT variance


Journal Title:

Sleep Medicine


Volume 55


, Pages 115-123

Type of Work:

Article | Post-print: After Peer Review


Objective: The purpose of this study was to enhance our understanding of clinical trends in sleep and rapid eye movement (REM) propensity on the multiple sleep latency test (MSLT). Demographic variables of interest included early childhood/advanced age, gender, race, and REM-suppressant use. Methods: Nocturnal sleep studies and 5-nap MSLTs were retrieved from a large repository of deidentified studies from various US sleep clinics between 2007 and 2015. Studies were signal processed, human-edited, and underwent rigorous quality assurance for inclusion. Results: The final sample consisted of N = 2498 MSLTs (24.2% Black; 34.2% Men; Age 4–89). In adults (age ≥ 21), sleep propensity modestly decreased across nap (90% at nap 1 to 80% at nap 5; p < 0.001). Children ≤12 years were least likely to fall asleep on any nap (∼55% at nap 5). REM propensity troughed at nap 4 (13%) and varied with age. Advanced age (≥60 years; OR: 0.28, p < 0.001), REM-suppressant use (OR:0.52, p < 0.001), and female sex (men OR: 1.48, p = 0.012) was associated with a decreased proportion of ≥2 REMs in adjusted logistic models. Children often demonstrated only 1 REM and generally had long sleep latencies, yielding a low proportion of MSLTs consistent with narcolepsy (11.0% vs. 19.2% and 16.8% in those between 13–20 and 21–59, respectively; p = 0.003). Conclusions: MSLT outcomes vary greatly across age, gender, and use of psychotropic medication. Demographic variance should be considered when interpreting MSLT results. Robust age effect question the appropriateness of the MSLT as currently designed and implemented for children and older adults.

Copyright information:

© 2018 Elsevier B.V.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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