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Maintenance of Wakefulness Test

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Book cover Sleep Disorders Medicine

Abstract

Excessive daytime sleepiness is a symptom of sleep disorders that can impair quality of life, performance, and safety. Multiple subjective and objective measures exist to quantify sleepiness. The maintenance of wakefulness test (MWT) is an objective tool that monitors electrophysiological parameters to assess an individual’s ability to remain awake in an environment lacking stimulation. The MWT is typically used to evaluate individuals in whom sleepiness may impact their own or the general public’s safety (i.e. drivers or aviators) or to measure residual sleepiness in the context of treatment. Although the MWT provides meaningful information, a normal test result does not guarantee the ability to maintain alertness in real-life situations.

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References

  1. American Academy of Sleep Medicine (2005) International classification of sleep disorders, 2nd edn. Diagnostic and Coding Manual, American Academy of Sleep Medicine, Westchester

    Google Scholar 

  2. Dinges DF (1995) An overview of sleepiness and accidents. Sleep Res 4:4–14

    Article  CAS  Google Scholar 

  3. Williamson A, Lombardi DA, Folkard S, Stutts J, Courtney TK, Connor JL (2011) The link between fatigue and safety. Accid Anal Prev 43(2):498–515

    Article  PubMed  Google Scholar 

  4. National Sleep Foundation (2008) Sleep in America Poll: sleep, performance and the workplace. The Foundation, Washington DC. Available from http://www.sleepfoundation.org

  5. Arand D, Bonnet M, Hurwitz T, Mitler M, Rosa R, Sangal RB (2005) The clinical use of the multiple sleep latency test and the maintenance of wakefulness test. Sleep 28(1):123–144

    Article  PubMed  Google Scholar 

  6. Hoddes E, Zarcone V, Smythe H, Phillips R, Dement W (1973) Quantification of sleepiness: a new approach. Psychophysiology 10(4):431–436

    Article  CAS  PubMed  Google Scholar 

  7. Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 1991:50–55

    Google Scholar 

  8. Priest B, Brichard C, Aubert G, Liistro G, Rodenstein DO (2001) Microsleep during a simplified maintenance of wakefulness test. A validation study of the OSLER test. Am J Respir Crit Care Med 163(7):1619–1625

    Article  CAS  PubMed  Google Scholar 

  9. Yoss RE, Moyer NJ, Ogle KN (1969) The pupillogram and narcolepsy: a method to measure decreased levels of wakefulness. Neurology 19:921–928

    Article  CAS  PubMed  Google Scholar 

  10. Littner M, Kushida C, Wise M et al (2005) Standards of Practice Committee of the American Academy of Sleep Medicine. Practice parameters for clinical use of the multiple sleep latency test and the maintenance of wakefulness test. Sleep 28(1):113–121

    Article  PubMed  Google Scholar 

  11. Dement W, Carskadon M, Richardson G (1978) Excessive daytime sleepiness in the sleep apnea syndrome. In: Guilleminault C, Dement WC (eds) Sleep apnea syndromes. Alan R. Liss, New York, pp 23–46

    Google Scholar 

  12. Richardson GS, Carskadon MA, Flagg W, Van den Hoed J, Dement WC, Mitler MM (1978) Excessive daytime sleepiness in man: multiple sleep latency measurement in narcoleptic and control subjects. Electroencephalogr Clin Neurophysiol 45(5):621–627

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Carskadon M, Dement C (1979) Effects of total sleep loss on sleep tendency. Percept Mot Skills 48:495–506

    Article  CAS  PubMed  Google Scholar 

  14. Roth T, Hartse K, Zorick F, Conway W (1980) Multiple naps and the evaluation of daytime sleepiness in patients with upper airway sleep apnea. Sleep 3:425–439

    CAS  PubMed  Google Scholar 

  15. Mitler M, Gujavarty K, Browman C (1982) Maintenance of wakefulness test: a polysomnographic technique for evaluation treatment efficacy in patients with excessive somnolence. Electroencephalogr Clin Neurophysio 53(6):658–661

    Article  CAS  Google Scholar 

  16. Hartse K, Roth T, Zorick F, Zammit G (1980) The effect of instruction upon sleep latency during multiple daytime naps of normal subjects. Sleep Res. 9:123

    Google Scholar 

  17. Poceta JS, Timms RM, Jeong DU, Ho SL, Erman MK, Mitler MM (1992) Maintenance of wakefulness test in obstructive sleep apnea syndrome. Chest 101:893–897

    Article  CAS  PubMed  Google Scholar 

  18. Mitler MM, Doghramji K, Shapiro C (2000) The maintenance of wakefulness test: normative data by age. J Psychosom Res 49(5):363–365

    Article  CAS  PubMed  Google Scholar 

  19. Berry RB, Brooks R, Gamaldo CE, Harding SM, Marcus CL and Vaughn BV, American Academy of Sleep Medicine (2013) The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications, version 2.0.1. American Academy of Sleep Medicine, Darien, Illinois. www.aasmnet.org

  20. Doghramji K, Mitler MM, Sangal RB, Shapiro C, Taylor S, Walsleben J, Belisle C, Erman MK, Hayduk R, Hosn R, O’Malley EB, Sangal JM, Schutte SL, Youakim JM (1997) A normative study of the maintenance of wakefulness test (MWT). Electroencephalogr Clin Neurophysiol 1997:554–562

    Google Scholar 

  21. Banks S, Barnes M, Tarquinio N, Pierce RJ, Lack LC, McEvoy RD (2004) The maintenance of wakefulness test in normal health yubjects. Sleep 27:799–802

    Article  PubMed  Google Scholar 

  22. Bliwise DL, Trotti LM, Wilson AG, Greer SA, Wood-Silverio C, Juncos JJ, Factor SA, Freeman A, Rye DB (2012) Daytime alertness in Parkinson’s disease: potentially dose-dependent, divergent effects by drug class. Mov Disord 27(9):1118–1124

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Bonnet MH, Arand DL (2005) Impact of motivation on multiple sleep latency test and maintenance of wakefulness test measurements. J Clin Sleep Med 1(4):386–390

    PubMed  Google Scholar 

  24. Härmä M, Suvanto S, Popkin S, Pulli K, Mulder M, Hirvonen K (1998) A dose-response study of total sleep time and the ability to maintain wakefulness. J Sleep Res 7(3):167–174

    Article  PubMed  Google Scholar 

  25. Hilliker NA, Muehlbach MJ, Schweitzer PK, Walsh JK (1992) Sleepiness/alertness on a simulated night shift schedule and morningness-eveningness tendency. Sleep 15(5):430–433

    Article  CAS  PubMed  Google Scholar 

  26. Kayumov L, Rotenberg V, Buttoo K, Auch C, Pandi-Perumal SR, Shapiro CM (2000) Interrelationships between nocturnal sleep, daytime alertness, and sleepiness: two types of alertness proposed. J Neuropsychiatry Clin Neurosci 12(1):86–90

    Article  CAS  PubMed  Google Scholar 

  27. Kelly TL, Mitler MM, Bonnet MH (1997) Sleep latency measures of caffeine effects during sleep deprivation. Electroencephalogr Clin Neurophysiol 102(5):397–400

    Article  CAS  PubMed  Google Scholar 

  28. Martin SE, Wraith PK, Deary IJ, Douglas NJ (1997) The effect of nonvisible sleep fragmentation on daytime function. Am J Respir Crit Care Med 155(5):1596–1601

    Article  CAS  PubMed  Google Scholar 

  29. Martin SE, Engleman HM, Deary IJ, Douglas NJ (1996) The effect of sleep fragmentation on daytime function. Am J Respir Crit Care Med 153:1328–1332

    Article  CAS  PubMed  Google Scholar 

  30. Razmy A, Lang AE, Shapiro CM (2004) Predictors of impaired daytime sleep and wakefulness in patients with Parkinson disease treated with older (ergot) vs newer (nonergot) dopamine agonists. Arch Neurol 61(1):97–102

    Article  PubMed  Google Scholar 

  31. Rupp TL, Wesensten NJ, Bliese PD, Balkin TJ (2009) Banking sleep: realization of benefits during subsequent sleep restriction and recovery. Sleep 32(3):311–321

    Article  PubMed  PubMed Central  Google Scholar 

  32. Sforza E, de Saint Hilaire Z, Pelissolo A, Rochat T, Ibanez V (2002) Personality, anxiety and mood traits in patients with sleep-related breathing disorders: effect of reduced daytime alertness. Sleep Med 3(2):139–145

    Google Scholar 

  33. Shen J, Moller HJ, Wang X, Chung SA, Shapiro GK, Li X, Shapiro CM (2009) Mirtazapine, a sedating antidepressant, and improved driving safety in patients with major depressive disorder: a prospective, randomized trial of 28 patients. J Clin Psychiatry 70(3):370–377

    Article  CAS  PubMed  Google Scholar 

  34. Shreter R, Peled R, Pillar G (2006) The 20-min trial of the maintenance of wakefulness test is profoundly affected by motivation. Sleep Breath 10(4):173–179

    Article  PubMed  Google Scholar 

  35. Wright KP Jr, Badia P, Myers BL, Plenzler SC (1997) Combination of bright light and caffeine as a countermeasure for impaired alertness and performance during extended sleep deprivation. J Sleep Res 6(1):26–35

    Article  PubMed  Google Scholar 

  36. Bonnet MH, Arand DL (2000) The impact of music upon sleep tendency as measured by the multiple sleep latency test and maintenance of wakefulness test. Physiol Behav 71(5):485–492

    Article  CAS  PubMed  Google Scholar 

  37. Kasravi N, Legault G, Jewell D, Murray BJ (2007) Minimal impact of inadvertent sleep between naps on the MSLT and MWT. J Clin Neurophysiol 24(4):363–365

    PubMed  Google Scholar 

  38. Zandieh S, Ramgopal S, Khatwa U, Sangiuliano M, Gunnuscio M, Zarowski M, Kothare SV (2013) The maintenance of wakefulness test in pediatric narcolepsy. Pediatr Neurol 48(6):443–446

    Article  PubMed  Google Scholar 

  39. Ionescu D, Driver HS, Heon E, Flanagan J, Shapiro CM (2001) Sleep and daytime sleepiness in retinitis pigmentosa patients. J Sleep Res 10(4):329–335

    Article  CAS  PubMed  Google Scholar 

  40. Orlikowski D, Chevret S, Quera-Salva MA, Laforêt P, Lofaso F, Verschueren A, Pouget J, Eymard B, Annane D (2009) Modafinil for the treatment of hypersomnia associated with myotonic muscular dystrophy in adults: a multicenter, prospective, randomized, double-blind, placebo-controlled, 4-week trial. Clin Ther 31(8):1765–1773

    Article  CAS  PubMed  Google Scholar 

  41. Stevens S, Cormella CL, Stepanski EJ (2004) Daytime sleepiness and alertness in patients with Parkinson disease. Sleep 27(5):967–972

    Article  PubMed  Google Scholar 

  42. Philip P, Chaufton C, Taillard J, Sagaspe P, Léger D, Raimondi M, Vakulin A, Capelli A (2013) Maintenance of Wakefulness Test scores and driving performance in sleep disorder patients and controls. Int J Psychophysiol [Epub ahead of print]

    Google Scholar 

  43. Pizza F, Contardi S, Mondini S, Trentin L, Cirignotta F (2009) Daytime sleepiness and driving performance in patients with obstructive sleep apnea: comparison of the MSLT, the MWT, and a simulated driving task. Sleep 32(3):382–391

    Article  PubMed  PubMed Central  Google Scholar 

  44. Sagaspe P, Taillard J, Chaumet G, Guilleminault C, Coste O, Moore N, Bioulac B, Philip P (2007) Maintenance of wakefulness test as a predictor of driving performance in patients with untreated obstructive sleep apnea. Sleep 30(3):327–330

    PubMed  Google Scholar 

  45. Hack M, Davies RJ, Mullins R, Choi SJ, Ramdassingh-Dow S, Jenkinson C, Stradling JR (2000) Randomised prospective parallel trial of therapeutic versus subtherapeutic nasal continuous positive airway pressure on simulated steering performance in patients with obstructive sleep apnoea. Thorax 55(3):224–231

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Banks S, Catcheside P, Lack LC, Grunstein RR, McEvoy RD (2005) The maintenance of wakefulness test and driving simulator performance. Sleep 28(11):1381–1385

    Article  PubMed  Google Scholar 

  47. Philip P, Sagaspe P, Taillard J, Chaumet G, Bayon V, Coste O, Bioulac B, Guilleminault C (2008) Maintenance of wakefulness test, obstructive sleep apnea syndrome, and driving risk. Ann Neurol 64(4):410–416

    Article  PubMed  Google Scholar 

  48. Kingshott RN, Cowan JO, Jones DR, Flannery EM, Smith AD, Herbison GP, Taylor DR (2004) The role of sleep-disordered breathing, daytime sleepiness, and impaired performance in motor vehicle crashes—a case control study. Sleep Breath 8(2):61–72

    PubMed  Google Scholar 

  49. Hartenbaum N, Collop N, Rosen IM et al (2006) Sleep apnea and commercial motor vehicle operators: statement from the joint task force of the Americal College of Chest Physicians, The American College of Occupational and Environmental Medicine, and The National Sleep Foundation. Chest 130:902–905

    Article  PubMed  Google Scholar 

  50. Drake C, Roehrs T, Breslau N, Johnson E, Jefferson C, Scofield H et al (2010) The 10-year risk of verified motor vehicle crashes in relation to physiological sleepiness. Sleep 33(6):745–752

    Google Scholar 

  51. Grossman A, Barenboim E, Azaria B, Sherer Y, Goldstein L (2004) The maintenance of wakefulness test as a predictor of alertness in aircrew members with idiopathic hypersomnia. Aviat Space Environ Med 75(3):281–283

    Google Scholar 

  52. Lagarde D, Batejat D (1994) Evaluation of drowsiness during prolonged sleep deprivation. Neurophysiol Clinics 24:35–44

    Article  CAS  Google Scholar 

  53. Browman C, Gujavarty K, Sampson M, Mitler M (1983) REM sleep episodes during the maintenance of wakefulness test in patients with sleep apnea syndrome and patients with narcolepsy. Sleep 6(1):23–28

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. University of Michigan Health System, Sleep Disorders Center, Ann Arbor, MI, USA

    Cathy Goldstein & Ronald Chervin

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  1. Cathy Goldstein
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  2. Ronald Chervin
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Correspondence to Cathy Goldstein .

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Editors and Affiliations

  1. School of Graduate Medical Education, Seton Hall University, South Orange, New Jersey, USA

    Sudhansu Chokroverty

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Goldstein, C., Chervin, R. (2017). Maintenance of Wakefulness Test. In: Chokroverty, S. (eds) Sleep Disorders Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-6578-6_23

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  • DOI: https://doi.org/10.1007/978-1-4939-6578-6_23

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-6576-2

  • Online ISBN: 978-1-4939-6578-6

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