A doctor asked on the AASM message board about prn (as needed) MSLT's. In his sleep medicine group, doctors sometimes order a nocturnal polysomnogram to evaluate for OSA, with instructions to the technicians to perform an MSLT if OSA is not found.
Should the practice of "prn" MSLT be abandoned? Is it a bad idea?
Here is my answer to the the doctor's question?
yes and yes.
If you think someone has narcolepsy/idiopathic hypersomnia it is reasonable to order a psg/MSLT with instructions that the MSLT be canceled if OSA is present (with the sleep physician being avaliable in the am to review the psg in borderline cases).
I think it is unreasonable and puts too much responsibility on the techs to have them decide whether an MSLT is neeed on large numbers of patients being evaluated for OSA.
Showing posts with label narcolepsy. Show all posts
Showing posts with label narcolepsy. Show all posts
Sunday, June 27, 2010
Wednesday, September 17, 2008
Near Death Experiences Linked to REM Intrusion
According to a new study, many persons with a Near Death Experience (NDE) have symptoms of REM sleep intruding into wakefulness:
For 60 percent of those who had been through an NDE, the rapid-eye movement (REM) state of sleep intrudes into their regular consciousness while awake, the study found. Both before and after their traumatic event, these people had experiences that include waking up and not being able to move, sudden muscle weakness in their legs, and hearing sounds that no one else hears upon waking or falling asleep.
Persons with narcolepsy commonly have symptoms of REM sleep intruding into wakefulness, including sleep paralysis (waking up and not being able to move), cataplexy (sudden bilateral muscle weakness/limpness in response to strong emotion) and hypnagogic/hypnopompic hallucinations (hallucinations, usually visual, as one is falling asleep or waking up).
These symptoms occur when features of REM sleep (muscle paralysis, dreams) occur during wakefulness.
I wonder Near Death Experiences are more common in narcoleptics??
For 60 percent of those who had been through an NDE, the rapid-eye movement (REM) state of sleep intrudes into their regular consciousness while awake, the study found. Both before and after their traumatic event, these people had experiences that include waking up and not being able to move, sudden muscle weakness in their legs, and hearing sounds that no one else hears upon waking or falling asleep.
Persons with narcolepsy commonly have symptoms of REM sleep intruding into wakefulness, including sleep paralysis (waking up and not being able to move), cataplexy (sudden bilateral muscle weakness/limpness in response to strong emotion) and hypnagogic/hypnopompic hallucinations (hallucinations, usually visual, as one is falling asleep or waking up).
These symptoms occur when features of REM sleep (muscle paralysis, dreams) occur during wakefulness.
I wonder Near Death Experiences are more common in narcoleptics??
Thursday, October 18, 2007
Fish can get Insomnia too
Yahoo News reports that Zebrafish lacking a hypocretin receptor sleep 30% less than fish without this mutation:
LOS ANGELES (Reuters) - Fish might not have eyelids, but they do sleep, and some suffer from insomnia, scientists reported on Monday.
California scientists studying sleep disorders in humans found that some zebrafish, a common aquarium pet, have a mutant gene that disrupts their sleep patterns in a way similar to insomnia in humans.
Zebrafish with the mutant gene slept 30 percent less than fish without the mutation. When they finally drifted off they remained asleep half as long as the normal fish, the researchers at the Stanford University School of Medicine said.
The mutant fish lacked a working receptor for hypocretin, a neuropeptide that is secreted in normal fish by neurons in the region of the brain that controls hunger, sex and other basic behaviors.
The researchers, led by Emmanuel Mignot, said they would look for fish that have a mutation that causes them to oversleep or never sleep in the hope of discovering if sleep-regulating molecules and brain networks developed through evolution.
The study was published in Tuesday's edition of the Public Library of Science-Biology.
Hypocretin is the neurochemical linked to the narcolepsy-cataplexy syndrome; human narcoleptics (with cataplexy) have a hypocretin deficiency. Disturbed, fragmented nocturnal sleep is a common, underrecognized symptom of narcolepsy.
Narcolepsy without cataplexy is a poorly understood condition and we sleep doctors have no idea what causes most cases of this condition.
LOS ANGELES (Reuters) - Fish might not have eyelids, but they do sleep, and some suffer from insomnia, scientists reported on Monday.
California scientists studying sleep disorders in humans found that some zebrafish, a common aquarium pet, have a mutant gene that disrupts their sleep patterns in a way similar to insomnia in humans.
Zebrafish with the mutant gene slept 30 percent less than fish without the mutation. When they finally drifted off they remained asleep half as long as the normal fish, the researchers at the Stanford University School of Medicine said.
The mutant fish lacked a working receptor for hypocretin, a neuropeptide that is secreted in normal fish by neurons in the region of the brain that controls hunger, sex and other basic behaviors.
The researchers, led by Emmanuel Mignot, said they would look for fish that have a mutation that causes them to oversleep or never sleep in the hope of discovering if sleep-regulating molecules and brain networks developed through evolution.
The study was published in Tuesday's edition of the Public Library of Science-Biology.
Hypocretin is the neurochemical linked to the narcolepsy-cataplexy syndrome; human narcoleptics (with cataplexy) have a hypocretin deficiency. Disturbed, fragmented nocturnal sleep is a common, underrecognized symptom of narcolepsy.
Narcolepsy without cataplexy is a poorly understood condition and we sleep doctors have no idea what causes most cases of this condition.
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