Sleep: Getting too much or too little?

Prior to and during the MSLT no unauthorised naps are to be had nor is caffeine (or any other stimulant) allowed. Vital medications are of course permissible.

If you fall asleep during the daytime test too quickly then you’ve got a problem.

There is little or no discomfort during the MSLT.  Small electrodes or patches remain from the night time study glued to the scalp and various areas of the body and some equipment, like the leg monitors (keeping a look out for restless leg syndrome) will be removed.

You remain in the same hospital or clinic’s room. You will continue to be monitored by closed circuit TV and an intercom. From the moment the electrodes were attached to your scalp the night before, until after the MSLT you cannot shower. In fact the closest you get to look or smell reasonable is by brushing your teeth.

Bring a book or hope daytime TV has something worthwhile to watch. Some clinics have DVD players. And bring a water bottle with a small spout. Trust me on that (remember what I said about electrodes all over your head, face, nose and near your mouth?)

You’ll be allowed to leave at around 5:30 pm after the electrodes have been taken off your skin.  Note glue residue left in your hair can be shampooed out.

The MLST test proves or disproves the presence of excessive daytime sleepiness (EDS). Why EDS takes place is another question.

You’ll find the night and day tests are very illuminating inasmuch as they reveal:

• How long you actually sleep for, which may be at variance with how long you think you sleep. It was in my case.
• If your sleep is more restless than you thought (i.e. do you suffer from Restless Legs Syndrome?). That’s a “no” in my case.
• If you may suffer a particular sleep disorder (such as sleep apnoea or narcolepsy) and will be told what treatment options are available.
• If unexplained excessive sleeping is confirmed as it was in my case, you will not know why you suffer it, as there is no definitive test to answers that. Possibly it is a consequence of a brain hemorrhage, but nobody knows. Possibly it’s just “me”.

Relief from excessive daytime sleepiness, no matter its cause, is available by prescription. The stimulant drug modafinil (marketed as Provigil) is the specialist’s first choice of treatment. It is believed to be less likely to be abused than other meds. Other meds include the far cheaper, dextroamphetamine and to a lesser extent methylphenidate (marketed as Ritalin).

Possibly one in four people suffer from a sleeping disorder of some type. Some of which can be life threatening. Assuming you’re free of psychological or psychiatric problems - which could keep you up for other reasons - ask yourself or your partner the following: Do you snore? Fall asleep when you don’t intend to? Wake up at night and don’t need to go to the bathroom? Or don’t enjoy sound and uninterrupted sleep?

If yes to one or more, then you may have a disorder. The sooner you get it checked out, the better. Whatever you do, don’t sleep on it.