Kan standard test for objektiv måling av søvnighet utføres hjemme?

I denne studien ble det sammenlignet resultater fra objektiv måling av søvnighet ved hjelp av Multiple Sleep Latency Test (MSLT) når denne utføres på sykehus eller hjemme uten tilsyn av helsepersonell.

 

Studien hadde en randomisert kross-over design og inkluderte 34 personer som var henvist til klinisk undersøkelse med mistanke om hypersomni eller narkolepsi. Det ble ikke funnet signifikante forskjeller mellom de to MSLT testene når det gjelder innsovningstid. Antall innsovningsperioder med REM søvn var derimot høyere ved MSLT utført hjemme, noe som kan tyde på at overgang til REM søvn oppstår lettere under høneblund i kjente omgivelser. Flere studier er nødvendig for å kunne validere bruk av hjemmebasert MSLT i klinisk sammenheng.

Studien er publisert i Journal of Clinical Neurophysiology

Comparison of sleep latency and number of SOREMPs in the home and hospital with a modified Multiple Sleep Latency Test: A randomized crossover study


Kornelia K. Beiske, Trond Sand, Eyvind Rugland, Knut Stavem


PURPOSE:  Comparison of mean sleep latencies and number of sleep-onset rapid eye movement periods (SOREMPs) between modified multiple sleep latency test (MSLT) performed in the unattended home and in-hospital laboratory setting.

METHODS:  A randomized crossover single-blinded design. Thirty-four subjects referred to MSLT for suspected hypersomnia or narcolepsy were included. Participants were randomized to perform modified MSLT in the unattended home or in the hospital first. Scores in the two settings were compared using Wilcoxon signed-rank test or exact McNemar test. Agreement between home and hospital categorized mean sleep latency and number of SOREMPs was assessed using simple kappa (κ) and proportion agreement. Agreement between home and hospital mean sleep latency was assessed using a Bland-Altman plot and an intraclass correlation coefficient.

RESULTS:  There was no difference between home and hospital assessment of mean sleep latency (P = 0.86). Two or more SOREMPs were found more frequently on modified MSLTs performed at home compared with those at the hospital (7 and 2, respectively; P = 0.025). Agreement was moderate for categorized sleep latency (κ = 0.53) and fair for categorized SOREMPs (κ = 0.39) in the 2 settings. Analysis of mean sleep latency using intraclass correlation coefficient showed a very good agreement between the two settings.

CONCLUSIONS:  Group mean sleep latency for home modified MSLTs seems to be reliable compared with that for the attended sleep-laboratory setting. Higher rate of SOREMP in the unattended home suggests that napping in a familiar environment facilitates the transition into REM sleep. Further studies are needed to assess the normal limit, sensitivity, and specificity for SOREMP at home before the clinical utility of home-based napping can be determined.