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Giuseppe Plazzi - One of the best experts on this subject based on the ideXlab platform.
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Excessive daytime sleepiness in narcolepsy and central nervous system Hypersomnias
Sleep and Breathing, 2019Co-Authors: Fabio Pizza, Marco Filardi, Monica Moresco, Alice Mazzoni, Stefano Vandi, Giulia Neccia, Elena Antelmi, Giuseppe PlazziAbstract:PurposeExcessive daytime sleepiness (EDS) is the core complaint of central nervous system (CNS) Hypersomnias. In this mini-review, we summarized EDS features in CNS Hypersomnias to provide a guide for differential diagnosis purposes.MethodsA review of recent literature was performed to provide an update in CNS Hypersomnias.ResultsAt clinical evaluation, narcolepsy patients report a good restorative potential of sleep together with the frequent occurrence of dreaming even during short-lasting naps. These features are mirrored by the neurophysiological evidence of REM sleep at sleep onset (SOREMP) during the Multiple Sleep Latency Test (MSLT), a specific marker. Conversely, patients with idiopathic Hypersomnia (IH) complain sleep inertia and prolonged nocturnal sleep. Polysomnographic studies show high sleep propensity on the MSLT or high 24-h total sleep time during continuous monitoring. Patients with insufficient sleep syndrome (ISS) can present with variable clinical EDS features in between narcolepsy and IH. ISS diagnosis is based on the clinical evidence of nocturnal sleep curtailment (weekdays versus vacations) associated with the disappearance of EDS complaint after sleep extension. Polysomnographic data are not required, but when the MSLT is performed, ISS patients can present with SOREMP arising from non-REM stage 2 sleep (vs narcolepsy patients entering into SOREM most frequently from wakefulness). Kleine-Levin Syndrome is characterized by recurrent episodes of enormously prolonged sleep time lasting days associated with abnormal cognition and behavior intermixed by asymptomatic periods, a sleep pattern that can be well documented by actigraphy.ConclusionsDifferent CNS Hypersomnias present with specific features of EDS are useful to guide the clinician to apply and interpret appropriate neurophysiological investigations.
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a standardized test to document cataplexy
Sleep Medicine, 2017Co-Authors: Stefano Vandi, Alice Mazzoni, Giulia Neccia, Elena Antelmi, Fabio Pizza, Martina Iloti, Patrizia Avoni, Giuseppe PlazziAbstract:Abstract Objective/Background Cataplexy is the pathognomonic symptom of narcolepsy type 1 (NT1). Since it is considered difficult to be directly observed or documented by clinicians, its diagnosis relies mainly on history taking. Our study aimed at testing the feasibility of a standardized video recording procedure under emotional stimulation to document cataplexy in the diagnostic work-up of suspected Hypersomnia of central origin. Patients/Methods Two-hundred-eight consecutive patients underwent the diagnostic work-up and reached the final diagnosis of NT1 (n = 133), idiopathic Hypersomnia or narcolepsy type 2 (IH/NT2 group, n = 33), or subjective excessive daytime sleepiness (sEDS group, n = 42). All subjects underwent a standardized video recording procedure while watching funny movies selected according to individual preferences, and a technician blind to clinical features reviewed the recordings to identify hypotonic phenomena that were finally confirmed by patients. Results The video recording under emotional stimulation captured hypotonic phenomena in 72.2%, 9.1% and 4.8% of NT1, IH/NT2, and sEDS subjects (p Conclusions A standardized video recording procedure under emotional stimulation can help in the characterization of suspected Hypersomnia of central origin. Further multi-center studies are warranted to extend the present findings and integrate a shared procedure for the laboratory work-up of narcolepsy.
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daytime continuous polysomnography predicts mslt results in Hypersomnias of central origin
Journal of Sleep Research, 2013Co-Authors: Fabio Pizza, Stefano Vandi, Keivan Kaveh Moghadam, Stefania Detto, Francesca Poli, Emmanuel Mignot, Raffaele Ferri, Giuseppe PlazziAbstract:SUMMARY In the diagnostic work-up of Hypersomnias of central origin, the complaint of excessive daytime sleepiness should be objectively confirmed by MSLT findings. Indeed, the features and diagnostic utility of spontaneous daytime sleep at 24 h continuous polysomnography (PSG) have never been investigated. We compared daytime PSG features to MSLT data in 98 consecutive patients presenting with excessive daytime sleepiness and with a final diagnosis of narcolepsy with cataplexy ⁄hypocretin deficiency (n = 39), narcolepsy without cataplexy (n = 7), idiopathic Hypersomnia without long sleep time (n = 19), and Hypersomnia with normal sleep latency at MSLT (n = 33). Daytime sleep time was significantly higher in narcolepsy-cataplexy but similar in the other groups. Receiver operating characteristics (ROC) curves showed that the number of naps during daytime PSG predicted a mean sleep latency £8 min at MSLT with an area under the curve of 0.67 ± 0.05 (P = 0.005). The number of daytime sleep-onset REM periods (SOREMPs) in spontaneous naps strikingly predicted the scheduled occurrence of two or more SOREMPs at MSLT, with an area under the ROC curve of 0.93 ± 0.03 (P <1 0 )12 ). One spontaneous SOREMP during daytime had a sensitivity of 96% with specificity of 74%, whereas two SOREMPs had a sensitivity of 75%, with a specificity of 95% for a pathological REM sleep propensity at MSLT. The features of spontaneous daytime sleep well correlated with MSLT findings. Notably, the occurrence of multiple spontaneous SOREMPs during daytime clearly identified patients with narcolepsy, as well as during the MSLT.
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different sleep onset criteria at the multiple sleep latency test mslt an additional marker to differentiate central nervous system cns Hypersomnias
Journal of Sleep Research, 2011Co-Authors: Fabio Pizza, Stefano Vandi, Stefania Detto, Francesca Poli, Christian Franceschini, Pasquale Montagna, Giuseppe PlazziAbstract:Excessive daytime sleepiness (EDS) has different correlates in non-rapid eye movement (NREM) [idiopathic Hypersomnia (IH) without long sleep time] and REM sleep [narcolepsy without cataplexy (NwoC) and narcolepsy with cataplexy (NC)]-related Hypersomnias of central origin. We analysed sleep onset characteristics at the multiple sleep latency test (MSLT) applying simultaneously two sleep onset criteria in 44 NC, seven NwoC and 16 IH consecutive patients referred for subjective EDS complaint. Sleep latency (SL) at MSLT was assessed both as the time elapsed to the occurrence of a single epoch of sleep Stage 1 NREM (SL) and of unequivocal sleep [three sleep Stage 1 NREM epochs or any other sleep stage epoch, sustained SL (SusSL)]. Idiopathic Hypersomnia patients showed significantly (P<0.0001) longer SusSL than SL (7.7±2.5 versus 5.6±1.3 min, respectively) compared to NwoC (5.8±2.5 versus 5.3±2.2 min) and NC patients (4.1±3 versus 3.9±3 min). A mean difference threshold between SusSL and SL ≥27 s reached a diagnostic value to discriminate IH versus NC and NwoC sufferers (sensitivity 88%; specificity 82%). Moreover, NC patients showed better subjective sleepiness perception than NwoC and IH cases in the comparison between naps with or without sleep occurrence. Simultaneous application of the two widely used sleep onset criteria differentiates IH further from NC and NwoC patients: IH fluctuate through a wake-Stage 1 NREM sleep state before the onset of sustained sleep, while NC and NwoC shift abruptly into a sustained sleep. The combination of SusSL and SL determination at MSLT should be tested as an additional objective differential criterion for EDS disorders.
Fabio Pizza - One of the best experts on this subject based on the ideXlab platform.
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To split or to lump? Classifying the central disorders of hypersomnolence
SLEEP, 2020Co-Authors: Rolf Fronczek, Fabio Pizza, Isabelle Arnulf, Christian Baumann, Kiran Maski, Lynn Marie TrottiAbstract:The classification of the central disorders of hypersomnolence has undergone multiple iterations in an attempt to capture biologically meaningful disease entities in the absence of known pathophysiology. Accumulating data suggests that further refinements may be necessary. At the 7th International Symposium on Narcolepsy, a group of clinician-scientists evaluated data in support of keeping or changing classifications, and as a result suggest several changes. First, idiopathic Hypersomnia with long sleep durations appears to be an identifiable and meaningful disease subtype. Second, idiopathic Hypersomnia without long sleep time and narcolepsy without cataplexy share substantial phenotypic overlap and cannot reliably be distinguished with current testing, and so combining them into a single disease entity seems warranted at present. Moving forward, it is critical to phenotype patients across a wide variety of clinical and biological features, to aid in future refinements of disease classification.
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Excessive daytime sleepiness in narcolepsy and central nervous system Hypersomnias
Sleep and Breathing, 2019Co-Authors: Fabio Pizza, Marco Filardi, Monica Moresco, Alice Mazzoni, Stefano Vandi, Giulia Neccia, Elena Antelmi, Giuseppe PlazziAbstract:PurposeExcessive daytime sleepiness (EDS) is the core complaint of central nervous system (CNS) Hypersomnias. In this mini-review, we summarized EDS features in CNS Hypersomnias to provide a guide for differential diagnosis purposes.MethodsA review of recent literature was performed to provide an update in CNS Hypersomnias.ResultsAt clinical evaluation, narcolepsy patients report a good restorative potential of sleep together with the frequent occurrence of dreaming even during short-lasting naps. These features are mirrored by the neurophysiological evidence of REM sleep at sleep onset (SOREMP) during the Multiple Sleep Latency Test (MSLT), a specific marker. Conversely, patients with idiopathic Hypersomnia (IH) complain sleep inertia and prolonged nocturnal sleep. Polysomnographic studies show high sleep propensity on the MSLT or high 24-h total sleep time during continuous monitoring. Patients with insufficient sleep syndrome (ISS) can present with variable clinical EDS features in between narcolepsy and IH. ISS diagnosis is based on the clinical evidence of nocturnal sleep curtailment (weekdays versus vacations) associated with the disappearance of EDS complaint after sleep extension. Polysomnographic data are not required, but when the MSLT is performed, ISS patients can present with SOREMP arising from non-REM stage 2 sleep (vs narcolepsy patients entering into SOREM most frequently from wakefulness). Kleine-Levin Syndrome is characterized by recurrent episodes of enormously prolonged sleep time lasting days associated with abnormal cognition and behavior intermixed by asymptomatic periods, a sleep pattern that can be well documented by actigraphy.ConclusionsDifferent CNS Hypersomnias present with specific features of EDS are useful to guide the clinician to apply and interpret appropriate neurophysiological investigations.
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a standardized test to document cataplexy
Sleep Medicine, 2017Co-Authors: Stefano Vandi, Alice Mazzoni, Giulia Neccia, Elena Antelmi, Fabio Pizza, Martina Iloti, Patrizia Avoni, Giuseppe PlazziAbstract:Abstract Objective/Background Cataplexy is the pathognomonic symptom of narcolepsy type 1 (NT1). Since it is considered difficult to be directly observed or documented by clinicians, its diagnosis relies mainly on history taking. Our study aimed at testing the feasibility of a standardized video recording procedure under emotional stimulation to document cataplexy in the diagnostic work-up of suspected Hypersomnia of central origin. Patients/Methods Two-hundred-eight consecutive patients underwent the diagnostic work-up and reached the final diagnosis of NT1 (n = 133), idiopathic Hypersomnia or narcolepsy type 2 (IH/NT2 group, n = 33), or subjective excessive daytime sleepiness (sEDS group, n = 42). All subjects underwent a standardized video recording procedure while watching funny movies selected according to individual preferences, and a technician blind to clinical features reviewed the recordings to identify hypotonic phenomena that were finally confirmed by patients. Results The video recording under emotional stimulation captured hypotonic phenomena in 72.2%, 9.1% and 4.8% of NT1, IH/NT2, and sEDS subjects (p Conclusions A standardized video recording procedure under emotional stimulation can help in the characterization of suspected Hypersomnia of central origin. Further multi-center studies are warranted to extend the present findings and integrate a shared procedure for the laboratory work-up of narcolepsy.
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daytime continuous polysomnography predicts mslt results in Hypersomnias of central origin
Journal of Sleep Research, 2013Co-Authors: Fabio Pizza, Stefano Vandi, Keivan Kaveh Moghadam, Stefania Detto, Francesca Poli, Emmanuel Mignot, Raffaele Ferri, Giuseppe PlazziAbstract:SUMMARY In the diagnostic work-up of Hypersomnias of central origin, the complaint of excessive daytime sleepiness should be objectively confirmed by MSLT findings. Indeed, the features and diagnostic utility of spontaneous daytime sleep at 24 h continuous polysomnography (PSG) have never been investigated. We compared daytime PSG features to MSLT data in 98 consecutive patients presenting with excessive daytime sleepiness and with a final diagnosis of narcolepsy with cataplexy ⁄hypocretin deficiency (n = 39), narcolepsy without cataplexy (n = 7), idiopathic Hypersomnia without long sleep time (n = 19), and Hypersomnia with normal sleep latency at MSLT (n = 33). Daytime sleep time was significantly higher in narcolepsy-cataplexy but similar in the other groups. Receiver operating characteristics (ROC) curves showed that the number of naps during daytime PSG predicted a mean sleep latency £8 min at MSLT with an area under the curve of 0.67 ± 0.05 (P = 0.005). The number of daytime sleep-onset REM periods (SOREMPs) in spontaneous naps strikingly predicted the scheduled occurrence of two or more SOREMPs at MSLT, with an area under the ROC curve of 0.93 ± 0.03 (P <1 0 )12 ). One spontaneous SOREMP during daytime had a sensitivity of 96% with specificity of 74%, whereas two SOREMPs had a sensitivity of 75%, with a specificity of 95% for a pathological REM sleep propensity at MSLT. The features of spontaneous daytime sleep well correlated with MSLT findings. Notably, the occurrence of multiple spontaneous SOREMPs during daytime clearly identified patients with narcolepsy, as well as during the MSLT.
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different sleep onset criteria at the multiple sleep latency test mslt an additional marker to differentiate central nervous system cns Hypersomnias
Journal of Sleep Research, 2011Co-Authors: Fabio Pizza, Stefano Vandi, Stefania Detto, Francesca Poli, Christian Franceschini, Pasquale Montagna, Giuseppe PlazziAbstract:Excessive daytime sleepiness (EDS) has different correlates in non-rapid eye movement (NREM) [idiopathic Hypersomnia (IH) without long sleep time] and REM sleep [narcolepsy without cataplexy (NwoC) and narcolepsy with cataplexy (NC)]-related Hypersomnias of central origin. We analysed sleep onset characteristics at the multiple sleep latency test (MSLT) applying simultaneously two sleep onset criteria in 44 NC, seven NwoC and 16 IH consecutive patients referred for subjective EDS complaint. Sleep latency (SL) at MSLT was assessed both as the time elapsed to the occurrence of a single epoch of sleep Stage 1 NREM (SL) and of unequivocal sleep [three sleep Stage 1 NREM epochs or any other sleep stage epoch, sustained SL (SusSL)]. Idiopathic Hypersomnia patients showed significantly (P<0.0001) longer SusSL than SL (7.7±2.5 versus 5.6±1.3 min, respectively) compared to NwoC (5.8±2.5 versus 5.3±2.2 min) and NC patients (4.1±3 versus 3.9±3 min). A mean difference threshold between SusSL and SL ≥27 s reached a diagnostic value to discriminate IH versus NC and NwoC sufferers (sensitivity 88%; specificity 82%). Moreover, NC patients showed better subjective sleepiness perception than NwoC and IH cases in the comparison between naps with or without sleep occurrence. Simultaneous application of the two widely used sleep onset criteria differentiates IH further from NC and NwoC patients: IH fluctuate through a wake-Stage 1 NREM sleep state before the onset of sustained sleep, while NC and NwoC shift abruptly into a sustained sleep. The combination of SusSL and SL determination at MSLT should be tested as an additional objective differential criterion for EDS disorders.
Stefano Vandi - One of the best experts on this subject based on the ideXlab platform.
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Excessive daytime sleepiness in narcolepsy and central nervous system Hypersomnias
Sleep and Breathing, 2019Co-Authors: Fabio Pizza, Marco Filardi, Monica Moresco, Alice Mazzoni, Stefano Vandi, Giulia Neccia, Elena Antelmi, Giuseppe PlazziAbstract:PurposeExcessive daytime sleepiness (EDS) is the core complaint of central nervous system (CNS) Hypersomnias. In this mini-review, we summarized EDS features in CNS Hypersomnias to provide a guide for differential diagnosis purposes.MethodsA review of recent literature was performed to provide an update in CNS Hypersomnias.ResultsAt clinical evaluation, narcolepsy patients report a good restorative potential of sleep together with the frequent occurrence of dreaming even during short-lasting naps. These features are mirrored by the neurophysiological evidence of REM sleep at sleep onset (SOREMP) during the Multiple Sleep Latency Test (MSLT), a specific marker. Conversely, patients with idiopathic Hypersomnia (IH) complain sleep inertia and prolonged nocturnal sleep. Polysomnographic studies show high sleep propensity on the MSLT or high 24-h total sleep time during continuous monitoring. Patients with insufficient sleep syndrome (ISS) can present with variable clinical EDS features in between narcolepsy and IH. ISS diagnosis is based on the clinical evidence of nocturnal sleep curtailment (weekdays versus vacations) associated with the disappearance of EDS complaint after sleep extension. Polysomnographic data are not required, but when the MSLT is performed, ISS patients can present with SOREMP arising from non-REM stage 2 sleep (vs narcolepsy patients entering into SOREM most frequently from wakefulness). Kleine-Levin Syndrome is characterized by recurrent episodes of enormously prolonged sleep time lasting days associated with abnormal cognition and behavior intermixed by asymptomatic periods, a sleep pattern that can be well documented by actigraphy.ConclusionsDifferent CNS Hypersomnias present with specific features of EDS are useful to guide the clinician to apply and interpret appropriate neurophysiological investigations.
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a standardized test to document cataplexy
Sleep Medicine, 2017Co-Authors: Stefano Vandi, Alice Mazzoni, Giulia Neccia, Elena Antelmi, Fabio Pizza, Martina Iloti, Patrizia Avoni, Giuseppe PlazziAbstract:Abstract Objective/Background Cataplexy is the pathognomonic symptom of narcolepsy type 1 (NT1). Since it is considered difficult to be directly observed or documented by clinicians, its diagnosis relies mainly on history taking. Our study aimed at testing the feasibility of a standardized video recording procedure under emotional stimulation to document cataplexy in the diagnostic work-up of suspected Hypersomnia of central origin. Patients/Methods Two-hundred-eight consecutive patients underwent the diagnostic work-up and reached the final diagnosis of NT1 (n = 133), idiopathic Hypersomnia or narcolepsy type 2 (IH/NT2 group, n = 33), or subjective excessive daytime sleepiness (sEDS group, n = 42). All subjects underwent a standardized video recording procedure while watching funny movies selected according to individual preferences, and a technician blind to clinical features reviewed the recordings to identify hypotonic phenomena that were finally confirmed by patients. Results The video recording under emotional stimulation captured hypotonic phenomena in 72.2%, 9.1% and 4.8% of NT1, IH/NT2, and sEDS subjects (p Conclusions A standardized video recording procedure under emotional stimulation can help in the characterization of suspected Hypersomnia of central origin. Further multi-center studies are warranted to extend the present findings and integrate a shared procedure for the laboratory work-up of narcolepsy.
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daytime continuous polysomnography predicts mslt results in Hypersomnias of central origin
Journal of Sleep Research, 2013Co-Authors: Fabio Pizza, Stefano Vandi, Keivan Kaveh Moghadam, Stefania Detto, Francesca Poli, Emmanuel Mignot, Raffaele Ferri, Giuseppe PlazziAbstract:SUMMARY In the diagnostic work-up of Hypersomnias of central origin, the complaint of excessive daytime sleepiness should be objectively confirmed by MSLT findings. Indeed, the features and diagnostic utility of spontaneous daytime sleep at 24 h continuous polysomnography (PSG) have never been investigated. We compared daytime PSG features to MSLT data in 98 consecutive patients presenting with excessive daytime sleepiness and with a final diagnosis of narcolepsy with cataplexy ⁄hypocretin deficiency (n = 39), narcolepsy without cataplexy (n = 7), idiopathic Hypersomnia without long sleep time (n = 19), and Hypersomnia with normal sleep latency at MSLT (n = 33). Daytime sleep time was significantly higher in narcolepsy-cataplexy but similar in the other groups. Receiver operating characteristics (ROC) curves showed that the number of naps during daytime PSG predicted a mean sleep latency £8 min at MSLT with an area under the curve of 0.67 ± 0.05 (P = 0.005). The number of daytime sleep-onset REM periods (SOREMPs) in spontaneous naps strikingly predicted the scheduled occurrence of two or more SOREMPs at MSLT, with an area under the ROC curve of 0.93 ± 0.03 (P <1 0 )12 ). One spontaneous SOREMP during daytime had a sensitivity of 96% with specificity of 74%, whereas two SOREMPs had a sensitivity of 75%, with a specificity of 95% for a pathological REM sleep propensity at MSLT. The features of spontaneous daytime sleep well correlated with MSLT findings. Notably, the occurrence of multiple spontaneous SOREMPs during daytime clearly identified patients with narcolepsy, as well as during the MSLT.
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different sleep onset criteria at the multiple sleep latency test mslt an additional marker to differentiate central nervous system cns Hypersomnias
Journal of Sleep Research, 2011Co-Authors: Fabio Pizza, Stefano Vandi, Stefania Detto, Francesca Poli, Christian Franceschini, Pasquale Montagna, Giuseppe PlazziAbstract:Excessive daytime sleepiness (EDS) has different correlates in non-rapid eye movement (NREM) [idiopathic Hypersomnia (IH) without long sleep time] and REM sleep [narcolepsy without cataplexy (NwoC) and narcolepsy with cataplexy (NC)]-related Hypersomnias of central origin. We analysed sleep onset characteristics at the multiple sleep latency test (MSLT) applying simultaneously two sleep onset criteria in 44 NC, seven NwoC and 16 IH consecutive patients referred for subjective EDS complaint. Sleep latency (SL) at MSLT was assessed both as the time elapsed to the occurrence of a single epoch of sleep Stage 1 NREM (SL) and of unequivocal sleep [three sleep Stage 1 NREM epochs or any other sleep stage epoch, sustained SL (SusSL)]. Idiopathic Hypersomnia patients showed significantly (P<0.0001) longer SusSL than SL (7.7±2.5 versus 5.6±1.3 min, respectively) compared to NwoC (5.8±2.5 versus 5.3±2.2 min) and NC patients (4.1±3 versus 3.9±3 min). A mean difference threshold between SusSL and SL ≥27 s reached a diagnostic value to discriminate IH versus NC and NwoC sufferers (sensitivity 88%; specificity 82%). Moreover, NC patients showed better subjective sleepiness perception than NwoC and IH cases in the comparison between naps with or without sleep occurrence. Simultaneous application of the two widely used sleep onset criteria differentiates IH further from NC and NwoC patients: IH fluctuate through a wake-Stage 1 NREM sleep state before the onset of sustained sleep, while NC and NwoC shift abruptly into a sustained sleep. The combination of SusSL and SL determination at MSLT should be tested as an additional objective differential criterion for EDS disorders.
Lynn Marie Trotti - One of the best experts on this subject based on the ideXlab platform.
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To split or to lump? Classifying the central disorders of hypersomnolence
SLEEP, 2020Co-Authors: Rolf Fronczek, Fabio Pizza, Isabelle Arnulf, Christian Baumann, Kiran Maski, Lynn Marie TrottiAbstract:The classification of the central disorders of hypersomnolence has undergone multiple iterations in an attempt to capture biologically meaningful disease entities in the absence of known pathophysiology. Accumulating data suggests that further refinements may be necessary. At the 7th International Symposium on Narcolepsy, a group of clinician-scientists evaluated data in support of keeping or changing classifications, and as a result suggest several changes. First, idiopathic Hypersomnia with long sleep durations appears to be an identifiable and meaningful disease subtype. Second, idiopathic Hypersomnia without long sleep time and narcolepsy without cataplexy share substantial phenotypic overlap and cannot reliably be distinguished with current testing, and so combining them into a single disease entity seems warranted at present. Moving forward, it is critical to phenotype patients across a wide variety of clinical and biological features, to aid in future refinements of disease classification.
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test retest reliability of the multiple sleep latency test in narcolepsy without cataplexy and idiopathic Hypersomnia
Journal of Clinical Sleep Medicine, 2013Co-Authors: Lynn Marie Trotti, Beth A StaabAbstract:Study Objectives:Differentiation of narcolepsy without cataplexy from idiopathic Hypersomnia relies entirely upon the multiple sleep latency test (MSLT). However, the test-retest reliability for th...
Beth A Staab - One of the best experts on this subject based on the ideXlab platform.
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test retest reliability of the multiple sleep latency test in narcolepsy without cataplexy and idiopathic Hypersomnia
Journal of Clinical Sleep Medicine, 2013Co-Authors: Lynn Marie Trotti, Beth A StaabAbstract:Study Objectives:Differentiation of narcolepsy without cataplexy from idiopathic Hypersomnia relies entirely upon the multiple sleep latency test (MSLT). However, the test-retest reliability for th...