Page 100 - The autoimmune hypothesis of narcolepsy and its unexplored clinical features M.S. Schinkelshoek
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Chapter 6
20-minute nap opportunities of a multiple sleep latency test (MSLT). We also assessed the association between SOREMPs and dream perception.
Methods
Patients
In this prospective observational study, all consecutive patients undergoing a routine multiple sleep latency test between March 2014 and October 2017 in a tertiary sleep-wake centre were assessed for inclusion. All diagnosis were based on ICSD-3 criteria (ICSD, 2005). People with a diagnosis of narcolepsy type 1 (NT1) or 2 (NT2), idiopathic hypersomnia (IH), OSA or insufficient sleep syndrome were included.
Questionnaires
EDS was assessed using the Epworth Sleepiness Scale (ESS), which is validated in NT1 and NT2, IH and OSA (Johns, 1992). Sleep state and dream perception were assessed in the context of clinical care by asking patients after each nap whether they slept and dreamed during that specific nap. No feedback was given to the patient. Two types of sleep state misperception were defined: classical sleep state misperception was present when a patient did not report sleep when sleep was recorded, whereas reverse sleep state misperception was present when a patient did report sleep although sleep was not recorded. Dream perception was not defined as correct or incorrect.
Multiple sleep latency test (MSLT)
The MSLT was performed according to guidelines published before (Littner et al., 2005). It consisted of five sessions of 20 min in which patients had the opportunity to fall asleep. We did not extend these 20 minutes to allow for 15 min sleep after sleep onset. Nap opportunities were given with two hour intervals. The first session started at 09:00 hours. The night before the MSLT took place, a polysomnography was performed.
Statistical analysis
For assessing differences in ESS scores between sleep disorders with EDS, we used one-way ANOVA. Patients were stratified by diagnosis for these analyses.























































































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