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

ABSTRACT: 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.

SUBMITTER: Cairns A

PROVIDER: S-EPMC6411434 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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

Cairns Alyssa A Trotti Lynn Marie LM Bogan Richard R

Sleep medicine 20181230

<h4>Objective</h4>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.<h4>Methods</h4>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 ...[more]

PMID: 30785052

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Project description:BackgroundThrough the comparison of the demographic, epidemiological, and clinical characteristics of hospital human influenza (influenza A (H1N1) pdm09, H3N2, and B)-related and hospitalized avian-origin influenza A (H7N9)-related viral pneumonia patients, find the different between them.MethodsA retrospective study was conducted in hospitalized influenza-related viral pneumonia patients.ResultsHuman influenza A-related patients in the 35-49-year-old group were more than those with B pneumonia patients (p = 0.027), and relatively less in the ≥ 65-year-old group than B pneumonia patients (p = 0.079). The proportion of comorbid condition to human influenza A pneumonia was 58%, lower than B pneumonia and H7N9 pneumonia patients (78% vs. 77.8%; p = 0.013). The proportion of invasive mechanical ventilation (IMV), lymphocytopenia, elevated lactate dehydrogenase to hospitalized human influenza A-related viral pneumonia patients was higher than B pneumonia patients (p < 0.05), but lower than H7N9 pneumonia patients (p < 0.05). In the multivariate analysis, pulmonary consolidation (odds ratio (OR): 13.67; 95% confidence interval (CI) 1.54-121.12; p = 0.019) and positive bacterial culture (sputum) (OR: 7.71; 95% CI 2.48-24.03; p < 0.001) were independently associated with IMV, while shock (OR: 13.16; 95% CI 2.06-84.07; p = 0.006), white blood cell count > 10,000/mm3 (OR: 7.22; 95% CI 1.47-35.58; p = 0.015) and positive bacterial culture(blood or sputum) (OR: 6.27; 95% CI 1.36-28.85; p = 0.018) were independently associated with death in the three types hospitalized influenza-related viral pneumonia patients.ConclusionsHospital influenza B-related viral pneumonia mainly affects the elderly and people with underlying diseases, while human influenza A pneumonia mainly affects the young adults; however, the mortality was similar. The hospitalized human influenza A-related viral pneumonia patients was severer than B pneumonia patients, but milder than H7N9 pneumonia patients. Pulmonary consolidation and positive bacterial culture (sputum) were independently associated with IMV, while shock, white blood cell count > 10,000/mm3, and positive bacterial culture (blood or sputum) were independently associated with death to three types hospitalized influenza-related viral pneumonia patients.

Dataset Information

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

Publications

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

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