I saw a third sleep specialist today. Something he said to me that I thought would be useful to share here, was that the MSLT is a good "rule in" test, but not a good "rule out" test. That is, if you are positive for narcolepsy on the MSLT, then you are very likely to have narcolepsy; but if the MSLT is negative, that doesn't mean you don't have narcolepsy, just that you may or may not have it.
I know that there have been lots of people, like me, who were not able to sleep like they normally do in their MSLT. He also told me that 30% of PWN will have a negative result on their first MSLT. Subsequent MSLTs are more likely to to show positive results for PWN according to him.
With the symptoms I have, he has given me a "possible narcolepsy" diagnosis. He wants me to do another overnight sleep study and MSLT. But in the meantime he has started me on a trial of dexamphetamine.
I also wanted to ask for some advice. I was referred to this sleep specialist by my local doctor (after this new sleep specialist was recommended to me, by my boss, who is friend's with this doctor's mother). So my other sleep specialist didn't know about the appointment I had today (I wanted to keep my options open). My question is, should I go back and see my previous sleep specialist in a couple of weeks, when my next appointment is currently? Or cancel it for now, and decide if I want to see him at a later date? Last time I saw him, he sent me to have an MRI (I have the results of that, and it was normal), and from our discussion from my last appointment I think he was also headed down the track of a repeat MSLT.