Title

Recommended Protocols for the Multiple Sleep Latency Test and Maintenance of Wakefulness Test in Children

Authoring Organization

Publication Month/Year

December 27, 2023

Last Updated Month/Year

February 15, 2024

Document Type

Consensus

Country of Publication

US

Document Objectives

The American Academy of Sleep Medicine commissioned a task force of clinical experts in pediatric sleep medicine to review published literature on performing the Multiple Sleep Latency Test (MSLT) and Maintenance of Wakefulness Test (MWT) for diagnosis and management of central disorders of hypersomnolence among children and adolescents. This paper follows a similar format to the paper “Recommended protocols for the Multiple Sleep Latency Test and Maintenance of Wakefulness Test in adults: guidance from the American Academy of Sleep Medicine” that was published in 2021. Since there is insufficient evidence to specify a recommended protocol for the MWT in children and adolescents, this paper focuses only on the MSLT protocol. This protocol paper provides guidance to health care providers who order, sleep specialists who interpret, and technical staff who administer the MSLT to pediatric patients. Similar to the adult protocol paper, this document provides guidance based on pediatric expert consensus and evidence-based data when available. Topics include patient preparation, evaluation of medication and substance use, sleep needs before testing, scheduling considerations, optimal test conditions for youth, and documentation. Specific changes recommended for pediatric MSLT protocols include (1) provision of a minimum of 7 hours of sleep (with a minimum 8-hour recording time) on polysomnography (PSG) the night before the MSLT, ideally meeting age-based needs; (2) use of clinical judgment to guide the need for sleep-disordered breathing treatments before PSG-MSLT testing; and (3) shared patient-health care provider decision-making regarding modifications in the protocol for children and adolescents with neurodevelopmental/neurological disorders, young age, and/or delayed sleep phase.
 

Inclusion Criteria

Male, Female, Adolescent, Child

Health Care Settings

Ambulatory, Outpatient

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Diagnosis, Assessment and screening

Diseases/Conditions (MeSH)

D014851 - Wakefulness, D000074361 - Sleep Latency

Keywords

wakefulness, sleep test, multiple sleep latency test, wakefulness test

Source Citation

Maski KP, Amos LB, Carter JC, Koch EE, Kazmi U, Rosen CL. Recommended protocols for the Multiple Sleep Latency Test and Maintenance of Wakefulness Test in children: guidance from the American Academy of Sleep Medicine. J Clin Sleep Med. 2023 Dec 27. doi: 10.5664/jcsm.10974. Epub ahead of print. PMID: 38149645.