不同午睡状况下夜间睡眠时长与2型糖尿病的关系

目的探讨不同午睡情况下夜间睡眠时长与2型糖尿病(T2DM)发病的关系。方法采用病例对照研究法。病例为2009年9月至2011年3月收集的新发T2DM患者,年龄40⁷8岁。对照为同期住院非糖尿病(DM)患者,年龄与患者相同。以1∶1匹配。病例与对照各348例,采用自行设计的调查表对研究对象进行访谈式问卷调查。采用分级分析χ2检验计算出不同睡眠时长组与7 h/晚组的关系,采用多元条件Logistic回归分析计算各组OR值和95%CI。结果与睡眠7 h/晚组相比,全部研究对象中,夜睡≤5 h/晚组和>8 h/组与T2DM相关性强于其他组(OR≤5 h/晚=5.615,95%CI 1.68978岁。对照为同期住院非糖尿病(DM)患者,年龄与患者相同。以1∶1匹配。病例与对照各348例,采用自行设计的调查表对研究对象进行访谈式问卷调查。采用分级分析χ2检验计算出不同睡眠时长组与7 h/晚组的关系,采用多元条件Logistic回归分析计算各组OR值和95%CI。结果与睡眠7 h/晚组相比,全部研究对象中,夜睡≤5 h/晚组和>8 h/组与T2DM相关性强于其他组(OR≤5 h/晚=5.615,95%CI 1.689¹8.665;OR>8 h/晚=2.387,95%CI:1.60918.665;OR>8 h/晚=2.387,95%CI:1.609³.542),睡眠不足强于睡眠过长组。不午睡群体中,趋势与上述相同〔(OR≤5 h/晚=6.500,95%CI:1.1273.542),睡眠不足强于睡眠过长组。不午睡群体中,趋势与上述相同〔(OR≤5 h/晚=6.500,95%CI:1.127³7.484);(OR>8 h/晚=6.356,95%CI:1.74937.484);(OR>8 h/晚=6.356,95%CI:1.749²3.098)〕。午睡群体中仅夜间睡眠>8 h/晚组差异有统计学意义(P=0.001,OR>8 h/晚=2.042,95%CI:1.33623.098)〕。午睡群体中仅夜间睡眠>8 h/晚组差异有统计学意义(P=0.001,OR>8 h/晚=2.042,95%CI:1.336³.119)。结论夜间睡眠时间过短(≤5/晚,6 h/晚)或过长(>8 h/晚)均可增加T2DM的发病风险,夜间睡眠时长与T2DM发病呈U型关系,睡眠不足相对睡眠过长危害更大,不午睡群体这种趋势更明显;午睡群体,夜睡时间过长(>8 h/晚)增加T2DM发病风险,睡眠不足及正常者差异不明显。     

午睡与青年职业人群高血压关联性的性别差异

目的探讨午睡与青年职业人群血压的关联性及其性别差异。方法以在合肥市某三级医院进行健康体检的20~45岁青年职业人群2853人为研究对象,采用自编问卷调查人口统计学、行为生活方式、夜间睡眠时间、午睡情况、总体睡眠质量和疾病史等信息,并测量身高、体质量、血压,检测空腹血糖、血脂、尿酸等。结果研究对象经常午睡者1777人,占62.3%。夜间睡眠≥7h男性经常午睡者的高血压检出率(22.4%)明显高于很少午睡者高血压的检出率(14.1%,P0.01);而女性中的差异无统计学意义(P0.05)。采用二元非条件Logistic回归分析控制了潜在的混杂因素后,夜间睡眠≥7h男性经常午睡相对很少午睡者发生高血压的OR值(95%CI)为1.861(1.269~2.729)。结论夜间睡眠≥7h男性,经常午睡者高血压检出率较高。     

福州市社区居民睡眠特征与正常高值血压的关系

目的 探讨睡眠时长、睡眠质量与正常高值血压之间的关联,并探索血脂指标在睡眠与正常高值血压关联中的中介效应。方法 选取2018年1月至2019年12月,福州仓山区、连江县和马尾区的社区居民共计1 917人作为研究对象进行横断面研究,其中包括正常高值血压1 028名,正常血压889名;运用一般资料问卷和睡眠相关问卷进行问卷调查,并测量身高、体质量、腰围、臀围、收缩压和舒张压;采用多因素logistic回归模型分析睡眠因素与正常高值血压的关联。中介效应模型分析睡眠时长与正常高值血压关联中血脂指标的中介效应。结果 多因素logistic回归分析显示,在调整混杂因素后,与正常睡眠时长(6～<8 h)相比,短睡眠时长(睡眠时长<6 h/d)是正常高值血压的危险因素(OR=1.259,95%CI 1.012～1.567)。中介效应分析显示,低密度脂蛋白胆固醇在短睡眠时长与正常高值血压间存在部分中介效应,中介效应占其总效应的比例为10.9%。结论 睡眠时长过短是正常高值血压的危险因素。低密度脂蛋白胆固醇在短睡眠时长与正常高值血压之间发挥部分中介效应。     

睡眠时长对心房颤动患者射频消融术后复发的影响

目的:探讨不同睡眠时长(SD)对心房颤动患者射频消融术后复发的影响。方法:入选2017年2月至2017年10月,在北京安贞医院首次接受导管射频消融治疗的432例心房颤动患者,定期随访并收集患者的睡眠时长、心电图、24 h动态心电图及超声心动图等资料。根据术后第6个月的睡眠时长,将患者分为三组:睡眠时长不足组(SD≤6 h)、睡眠时长正常组(6SD8 h)、睡眠时长过多组(SD≥8 h)。结果:随访至术后第6个月, 330例患者维持窦性心律,97例患者复发,4例患者失访,1例患者死亡。睡眠时长正常组患者的窦性心律维持率明显高于睡眠时长不足组和睡眠时长过多组(85.9%vs. 60.7%vs. 69.5%,P0.001)。多因素Cox回归分析显示左心房内径(HR=1.060, 95%CI:1.004～1.118)、睡眠时长不足(HR=2.643, 95%CI:1.540～4.535)及睡眠时长过多(HR=1.920, 95%CI:1.120～3.290)是消融术后心房颤动复发的独立危险因素。结论:睡眠时长不足或过多是心房颤动患者射频消融术后复发的危险因素。     

睡眠时长、入睡时间与臂踝脉搏波传导速度的关系

目的探索睡眠时长、入睡时间与社区人群臂踝脉搏波传导速度(brachial-ankle pulse wave velocity, baPWV)关系。方法本研究以社区人群为研究对象, 进行问卷调查、体格检查、血样检验、臂踝脉搏波速度检查。最后将资料完整者3 912例观察对象纳入研究分析。采用二分类logistic回归分析方法, 评估睡眠时长、入睡时间与baPWV的关系。结果在调整了年龄、性别、糖尿病患病率、睡眠情况、体质量指数、血糖、血压、血脂异常、踝臂指数等混杂因素后, 发现睡眠时长、入睡时间与脉搏波传导速度(pulse wave velocity, PWV)相关。与睡眠时长为6～8 h组相比, 睡眠时长≥8 h组PWV异常率的患病风险升高(OR=1.155, 95%CI 0.995～1.367,P=0.037)。与入睡时间～23:00组相比, 00:00以后组PWV异常率患病风险升高(OR=1.482, 95%CI 1.008～2.179,P=0.045)。结论睡眠时长过长(≥8 h)和入睡时间过晚(00:00以后)可能与动脉硬化患病风险升高相关。     

午睡与中老年人高血压的关系

背景午睡在国内外是一种普遍现象,其对心脑血管疾病的利弊影响尚无定论.目的 探索午睡频率与血压及中老年人高血压的关系.方法 以<广州生物库队列>招募的30 518名受检者为研究对象,通过标准化问卷收集其一般人口学特征、生活方式、午睡频率、打鼾、睡眠总时间以及个人健康状况等,并进行包括身高、体质量、腰围、血压、血脂和空腹血...     

多发性硬化睡眠障碍研究进展

多发性硬化(MS)患者睡眠障碍是常见的,但在临床上尚未被认识,大约50%的MS患者主诉睡眠有关的问题,生理和心理因素如疼痛、抑郁、睡眠呼吸障碍、疾病的严重程度都干扰睡眠,MS患者常见的睡眠障碍包括失眠、睡眠呼吸暂停、     

农村地区轻度认知障碍老年人睡眠时长与睡眠效率对认知功能的影响

目的 探讨农村地区轻度认知障碍老年人睡眠时长与睡眠效率对其认知功能的影响.方法 采用MoCA和匹兹堡睡眠质量指数量表(PSQI)调查114例农村轻度认知障碍老年人的认知功能及睡眠质量,根据睡眠效率(睡眠时间/床上时间×100％)将其分为>85％组、75％～85％组、<75％组,按睡眠时长将其分为≤6 h组、(6,8)h...     

基于智能穿戴设备探讨睡眠时长与高血压关系的真实世界研究

目的 基于智能穿戴设备测量睡眠时长与家庭血压,明确睡眠时长与高血压的关联性。方法 本研究数据资料来自由中国医疗保健国际交流促进会发起的“血压健康研究”,由中国人民解放军总医院执行。本研究采用在线招募方式,招募来自全国34个省、自治区、直辖市的受试者。根据纳入与排除标准,2021年12月至2023年1月共纳入1706例既往无高血压病史的成年受试者,采用华为智能血压手表测量睡眠数据及家庭血压数据,通过填写电子问卷收集受试者人口学资料和病史等信息。按照基线时血压测量数值将受试者分为高血压组[收缩压(SBP)≥135mmHg(1mmHg=0.133kPa),和(或)舒张压(DBP)≥85mmHg,n=851]和非高血压组(SBP＜135mmHg,且DBP＜85mmHg,n=855)。采用SPSS 26.0统计软件进行数据分析。根据数据类型,分别采用t检验或χ²检验进行组间比较。采用多因素logistic回归分析睡眠时长与高血压之间的横断面关系。结果 1706例受试者中男性1519例(89.04%),女性187例(10.96%);年龄(44.87±11.52)岁;体质量指数(BMI)为(24.99±3.33)kg/m²;睡眠时长(7.35±1.10)h;收缩压(125.97±11.75)mmHg,舒张压(84.66±8.45)mmHg;心率(77.43±9.63)次/min。在不同睡眠时长(≥9h、7~<9h、5~<7h、<5h)受试者中,高血压患病率比较(45.26%、48.16%、52.63%和67.65%),差异有统计学意义(P=0.046)。随着睡眠时长缩短,高血压患病率有增高趋势。未校正混杂因素的多因素logistic回归分析结果显示,与睡眠时长7~<9h组比较,睡眠时长≥9h组(OR=0.890,95%CI 0.583~1.358;P=0.589)及睡眠时长5~<7h组(OR=1.196,95%CI 0.974~1.469;P=0.088)高血压风险无统计学差异;睡眠时长<5h组(OR=2.250,95%CI 1.086~4.665;P=0.029)的受试者高血压风险增加。校正了所有可获取混杂因素(年龄、性别、BMI、高盐饮食习惯、吸烟/饮酒史、呼吸睡眠暂停综合征史、糖尿病史、慢性肾脏病史等)后,与睡眠时长7~<9h组的受试者比较,睡眠时长≥9h组(OR=0.952,95%CI 0.606~1.495;P=0.831)及睡眠时长5~<7h组(OR=1.056,95%CI 0.848~1.315;P=0.625)高血压风险无统计学差异;睡眠时长<5h组(OR=2.238,95%CI 1.026~4.884;P=0.043)受试者的高血压风险依然增加。结论 睡眠时长过长及睡眠时长轻度不足与高血压风险无显著关联,睡眠时长过短与高血压风险增加显著关联。     

各年龄阶段午睡情况对老年人联结记忆的影响

目的探讨青年、中年、老年阶段是否午睡对老年人联结记忆的影响。方法在北京社区招募507名60岁以上,临床医师评定无睡眠障碍,且北京版蒙特利尔认知评估量表得分≥21分的老年被试者,进行午睡情况的自述式调查;并根据不同午睡情况,对联想学习成绩进行比较。结果在控制了受试者的性别、年龄、受教育年数等因素后,青年期、中年期和老年期的午睡组和对照组的联想学习成绩之间均有统计学差异(P0.05或P0.01),其中三个阶段的午睡组成绩均高于对照组,而其他认知功能未发现差异(P0.05)。结论青年、中年、老年三个阶段是否午睡均会影响老年人的联结记忆,其中有午睡习惯的联结记忆功能要强于没有午睡习惯者。     

Sleep of children living in institutional care facilities

Purpose

To describe sleep patterns and problems among institutionalized children.

Methods

In this cross-sectional study, the caregivers of 118 children, aged 4?C12?years from six institutional care facilities completed the Children??s Sleep Habits Questionnaire (CSHQ).

Results

The mean (±SD) of night bedtime was 21:05?±?2:52, mean morning wake-up time was 06:58?±?0:31, mean total sleep duration was 10?±?1.1?h, and mean night-sleep duration was 9.5?±?0.9?h. The percentage of children who took a daytime nap was 34.7% (n?=?41) and the mean duration of nap was 0.5?±?0.7?h. The most frequently reported sleep problems were bedtime resistance, daytime sleepiness and night awakening. Children with bedtime at or after 9?PM, night-sleep duration less than 10?h and daytime napping had more disturbed sleep.

Conclusions

Sleep problems are common among this sample of institutionalized children.     

Sleep-disordered breathing and daytime napping are associated with maternal hyperglycemia

Objectives

Sleep disturbances in pregnancy may impair glucose mechanism. This study aimed to examine associations of sleep-disordered breathing, sleep, and nap duration with 1-h glucose challenge test (GCT) levels in pregnant women after controlling for known risk factors for gestational diabetes.

Methods

This is a case–control study of 104 pregnant women. All women underwent full polysomnography and a GCT and completed the multivariable apnea prediction and Pittsburgh Sleep Quality indexes. The primary outcome was maternal hyperglycemia measured by GCT. Bivariate and multivariable logistic regression analyses were performed.

Results

Over 13 % subjects reported habitual snoring in the first trimester. Only 9.3 % women with normoglycemia (GCT?<?135) were habitual snorers, whereas 45.5 % women with hyperglycemia (GCT?≥?135) had habitual snoring (p?<?0.001). Sleep-disordered breathing symptoms (loud snoring, snorting/gasping, and apneas) (odds ratio (OR) 2.85; 95 % confidence interval (CI) 1.50–5.41; p?=?0.001) and total nap duration (OR 1.48; 95 % CI 0.96–2.28; p?=?0.08) were associated with hyperglycemia. After adjusting for confounders, sleep-disordered breathing symptoms (OR 3.37; 95 % CI 1.44–8.32; p?=?0.005) and nap duration (OR 1.64; 95 % CI 1.00–2.681.02; p?=?0.05) continued to be associated with hyperglycemia. However, the primary exposure measure, the apnea/hypopnea index in the first trimester was not significantly associated with hyperglycemia (OR 1.03; 95 % CI 0.83–1.28; p?=?0.77).

Conclusions

Sleep-disordered breathing symptoms and nap duration are associated with hyperglycemia. Sleep duration was not associated with hyperglycemia. Research is needed concerning whether women with sleep-disordered breathing and/or daytime napping are at risk for gestational diabetes.     

Self-reported sleep and nap habits and risk of falls and fractures in older women: the study of osteoporotic fractures

OBJECTIVES: To test the association between self-reported sleep and nap habits and risk of falls and fractures in a large cohort of older women. DESIGN: Study of Osteoporotic Fractures prospective cohort study. SETTING: Clinical centers in Baltimore, Maryland; Minneapolis, Minnesota; Portland, Oregon; and the Monongahela Valley, near Pittsburgh, Pennsylvania. PARTICIPANTS: Eight thousand one hundred one community-dwelling Caucasian women aged 69 and older (mean 77.0). MEASUREMENTS: Sleep and nap habits were assessed using a questionnaire at the fourth clinic visit (1993/94). Fall frequency during the subsequent year was ascertained using tri-annual questionnaire. Incident hip and nonspinal fractures during 6 years of follow-up were confirmed using radiographic reports. RESULTS: Five hundred fifty-three women suffered hip fractures, and 1,938 suffered nonspinal fractures. In multivariate models, women who reported napping daily had significantly higher odds of suffering two or more falls during the subsequent year (odds ratio=1.32, 95% confidence interval (CI)=1.03-1.69) and were more likely to suffer a hip fracture (hazard ratio (HR)=1.33, 95% CI=0.99-1.78) than women who did not nap daily. Those sleeping at least 10 hours per 24 hours had a higher risk of nonspinal fracture than (HR=1.26, 95% CI=1.00-1.58) and a similar but nonsignificant increased risk of hip fracture to (HR=1.43, 95% CI=0.95-2.15) those who reported sleeping between 8 and 9 hours. CONCLUSION: Self-reported long sleep and daily napping are associated with greater risk of falls and fractures in older women. Interventions to improve sleep may reduce their risk of falls and fractures. Future research is needed to determine whether specific sleep disorders contribute to these relationships.     

Self-Reported Sleep and Nap Habits and Risk of Mortality in a Large Cohort of Older Women

OBJECTIVES: To determine the association between self-reported sleep and nap habits and mortality in a large cohort of older women.
DESIGN: Study of Osteoporotic Fractures prospective cohort study.
SETTING: Four communities within the United States.
PARTICIPANTS: Eight thousand one hundred one Caucasian women aged 69 and older (mean age 77.0).
MEASUREMENTS: Sleep and nap habits were assessed using a questionnaire at the fourth clinic visit (1993/94). Deaths during 7 years of follow-up were confirmed with death certificates. Underlying cause of death was assigned according to the International Classification of Diseases, Ninth Revision, Clinical Modification.
RESULTS: In multivariate models, women who reported napping daily were 44% more likely to die from any cause (95% confidence interval (CI)=1.23–1.67), 58% more likely to die from cardiovascular causes (95% CI=1.25–2.00), and 59% more likely to die from noncardiovascular noncancer causes (95% CI=1.24–2.03) than women who did not nap daily. This relationship remained significant in relatively healthy women (those who reported no comorbidities). Women who slept 9 to 10 hours per 24 hours were at greater risk of death from cardiovascular and other (noncardiovascular, noncancer) causes than those who reported sleeping 8 to 9 hours.
CONCLUSION: Older women who reported napping daily or sleeping at least 9 hours per 24 hours are at greater risk of death from all causes except cancer. Future research could determine whether specific sleep disorders contribute to these relationships.     

Experimental sleep restriction effect on adult body weight: a meta-analysis

Sleep and Breathing - Sleep is increasingly recognized as a potential risk for overweight and obesity. Observational studies have shown links between short sleep duration with weight gain. However,...     

Self-reported napping and duration and quality of sleep in the lifestyle interventions and independence for elders pilot study

OBJECTIVES: To determine the prevalence of self‐reported napping and its association with subjective nighttime sleep duration and quality, as measured according to sleep‐onset latency and sleep efficiency. DESIGN: Cross‐sectional study. SETTING: Lifestyle Interventions and Independence for Elders Pilot Study. PARTICIPANTS: Community‐dwelling older adults (N=414) aged 70 to 89. MEASUREMENTS: Self‐report questionnaire on napping and sleep derived from the Pittsburgh Sleep Quality Index (PSQI) scale. RESULTS: Fifty‐four percent of participants reported napping, with mean nap duration of 55.0±41.2 minutes. Nappers were more likely to be male (37.3% vs 23.8%, P=.003) and African American (20.4% vs 14.4%, P=.06) and to have diabetes mellitus (28% vs 14.3%, P=.007) than non‐nappers. Nappers and non‐nappers had similar nighttime sleep duration and quality, but nappers spent approximately 10% of their 24‐hour sleep occupied in napping. In a multivariate model, the odds of napping were higher for subjects with diabetes mellitus (odds ratio (OR)=1.9, 95% confidence interval (CI)=1.2–3.0) and men (OR=1.9, 95% CI=1.2–3.0). In nappers, diabetes mellitus (β=12.3 minutes, P=.005), male sex (β=9.0 minutes, P=.04), higher body mass index (β=0.8 minutes, P=.02), and lower Mini‐Mental State Examination score (β=2.2 minutes, P=.03) were independently associated with longer nap duration. CONCLUSION: Napping was a common practice in community‐dwelling older adults and did not detract from nighttime sleep duration or quality. Given its high prevalence and association with diabetes mellitus, napping behavior should be assessed as part of sleep behavior in future research and in clinical practice.     

Effects of a nap on nighttime sleep and waking function in older subjects

OBJECTIVES: To examine, in older subjects, the effect on waking function of increasing 24-hour sleep amounts by providing a nap opportunity; to assess what effects an afternoon nap may have on subsequent nighttime sleep quality and composition. DESIGN: Two-session, within-subject laboratory design. SETTING: The study was conducted in the Laboratory of Human Chronobiology at Weill Cornell Medical College. PARTICIPANTS: Thirty-two healthy men and women aged 55 to 85. MEASUREMENTS: Polysomnography (sleep electroencephalogram), cognitive and psychomotor performance, body core temperature. RESULTS: Napping had little effect on subsequent nighttime sleep quality or duration, resulting in a significant increase in 24-hour sleep amounts. Such increased sleep resulted in enhanced cognitive and psychomotor performance immediately after the nap and throughout the next day. CONCLUSION: A behavioral approach that adds daytime sleep to the 24-hour sleep quota seems worthy of consideration when presented with a situation in which physiological changes associated with aging may limit the duration of nighttime sleep.     

Longitudinal impact of sleep on overweight and obesity in children and adolescents: a systematic review and bias‐adjusted meta‐analysis

Short sleep duration is considered a potential risk for overweight/obesity in childhood and adolescence. However, most of the evidence on this topic is obtained from cross‐sectional studies; therefore, the nature and extent of the longitudinal associations are unclear. This study explores the prospective association between short sleep and overweight/obesity in young subjects. The MEDLINE, EMBASE, Pubmed, and CINAHL databases were searched for English‐language articles, published until May 2014, reporting longitudinal association between sleep and body mass index (BMI) in children and adolescents. Recommendations of the Sleep Health Foundation were used to standardize reference sleep duration. Sleep category, with sleep duration less than the reference sleep, was considered as the short sleep category. Meta‐analysis was conducted to explore the association between short sleep and overweight/obesity. A review of 22 longitudinal studies, with subjects from diverse backgrounds, suggested an inverse association between sleep duration and BMI. Meta‐analysis of 11 longitudinal studies, comprising 24,821 participants, revealed that subjects sleeping for short duration had twice the risk of being overweight/obese, compared with subjects sleeping for long duration (odds ratio 2.15; 95% confidence interval: 1.64–2.81). This study provides evidence that short sleep duration in young subjects is significantly associated with future overweight/obesity.     

中重度OSAHS患者白天小睡与夜间睡眠时Auto-CPAP治疗及压力滴定的对照研究

目的　通过白天小睡与夜间睡眠Auto CPAP治疗时的压力滴定在中重度OSAHS患者中应用的对比研究 ,找出其差异性或规律性 ,同时为中重度OSAHS患者白天Auto CPAP治疗及压力滴定的可行性提供一客观依据。方法　选择 2 0 0 2 - 0 2～ 2 0 0 2 - 0 8北京协和医院呼吸内科门诊中睡眠时打鼾及白天嗜睡、睡眠时憋醒等不适主诉的患者行睡眠监测检查及Epworth嗜睡程度评价并筛选出AHI>2 0的OSAHS患者为研究对象。每位入选患者均于压力治疗滴定检查当日分别行午间及夜晚 2次Auto CPAP治疗滴定检查 ,白天小睡治疗滴定时间为1h至 2h 30min。测定项目包括 :睡眠呼吸紊乱指数 (AHI)、呼吸暂停指数 (AI)、低通气指数 (HI)、最长呼吸暂停和低通气持续时间 (LAHT)、最低甲床血氧饱和度 (LSaO2 )、治疗所需最高压力 (HP)、平均压力 (MP)、90 %压力(90 %P)和 95 %压力 (95 %P)。结果　Auto CPAP诊断治疗系统对于中重度睡眠呼吸暂停低通气患者的午间小睡与夜间治疗的效果显著且效果一致。中重度睡眠呼吸暂停低通气患者白天小睡时所需的治疗压力与夜间治疗时所需要的治疗压力差异无显著性 (P >0 0 5 )。结论　白天小睡Auto CPAP治疗及压力滴定能代替夜晚治疗时的压力滴定检查。     

The utility of a 5th nap in multiple sleep latency test

Background

This is the first study that aimed to look specifically at the utility of the 5^th nap in the multiple sleep latency test (MSLT), a test used to assist in the diagnosis of narcolepsy.

Methods

Data was retrospectively collected from the Sleep Disorders Centre of a Tertiary Hospital on patients that had a 5^th nap during their MSLT from the 08^th November 2011 to 12^th November 2014.

Results

Fifty-three patients had a 5^th nap performed out of 378 MSLT studies. In 16% of cases a diagnosis of narcolepsy was given directly due to the inclusion of the 5^th nap on the MSLT. Here a 5^th nap allowed diagnostic criteria of mean sleep latency <8 minutes and >2 SOREMPS to be met. In 53% of cases the mean sleep latency increased due to 5^th nap inclusion; the mean sleep latency of the first four naps was 5.6 vs. 6.7 after inclusion of the 5^th nap.

Conclusions

The 5^th nap is not often performed within the MSLT studies. Our study shows that only a few patients may benefit from a 5^th nap opportunity which also led to increase of the mean sleep latency at the expense of extra time, cost, labour and increased patient anxiety.