Hi
After reading some of the posts on the forum, it seems like a number of people have had different results on the PSG and MSLT tests.
Does anyone know:
A) do narcoleptics ALWAYS have messed up REM patterns in the PSG, or can they vary from night to night, or month to month?
how reliable are the PSG and MSLT tests? how often do you get false positives or false negatives? (how would you even know?) and how do doctors use them? like are there people who are normal on the PSG and MSLT who have sleepiness problems that are still labeled narcoleptic? I think if you were sleep deprived you could still end up positive on the MSLT for narcolepsy because you would go into REM sleep really quickly... right?
thanks
For me, my PSG showed very fragmented sleep with many "arousals". For my first MSLT, I was reducing off a medication which my doctor knew would invalidate the results. I did fall asleep on all 5 naps but did not have any REM.
When I repeated the MSLT 6 months later, I slept 5 of 5 naps. In 2 naps I reached REM in 3 minutes. Strangely, the naps I reached REM were the naps I did not think I slept at all. I remember telling the tech that I did not sleep. My dreams were an extension of what I was thinking about while falling asleep. I seemlessly went from remembering an event to dreaming about the event in great detail. It made me curious how many other times I did not know I was dreaming.
Even then, my doctor was not willing to say Narcolepsy, until we discussed Cataplexy in detail. Once she was certain about Cataplexy, she made the diagnosis.
For me, Narcolepsy was a rigorous diagnosis. My doctor strongly suspected it, but was very reluctant to make it- even when I had 2 sleep onset REM episodes and slept all 5 naps.
An MSLT is always done immediately following a PSG, so they can make sure you got enough sleep to make the MSLT valid. The MSLT is where the N diagnosis is made. The PSG is where a sleep apnea diagnosis is made. If you had sleep apnea, they would have put you on a CPAP.
