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Other sleep laboratory procedures (MSLT, MWT, and actigraphy) 

Other sleep laboratory procedures (MSLT, MWT, and actigraphy)
Other sleep laboratory procedures (MSLT, MWT, and actigraphy)

Fabio Pizza

, and Carlo Cipolli

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date: 27 November 2020

Sleep medicine practice requires different objective procedures apart from nocturnal polysomnography (PSG) to quantify sleep patterns and daytime sleepiness. Two approaches are available to measure daytime sleep propensity and vigilance: the multiple sleep latency test (MSLT) and the maintenance of wakefulness test (MWT). Both tests require multiple nap opportunities under online dynamic PSG monitoring; however, in the MSLT, the subject is asked to try to fall asleep (and sleep 15 minutes to document sleep onset REM periods), but in the MWT to remain awake. The MSLT is the gold standard test for the differential diagnosis of central disorders of hypersomnolence after careful clinical assessment, while the MWT is useful to document vigilance levels for safety reasons. Rest–activity patterns can be documented for prolonged periods by actigraphy to measure circadian sleep distribution. Actigraphy is therefore a useful objective tool for insomnia, circadian rhythm, and sleepiness assessment and to track treatment response.

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