MSLT and MWT criticism

Although MWT and MSLT are often used in practice, since years there is the assumption that its operationalization does not correspond to the tonic activation. Johns (1998) excludes that the MSLT is suitable as a predictor of daytime sleepiness in everyday situations, regardless how strict are implementation and evaluation standards. Although have the sleep latency on both tests satisfactory correlations as Sangal and colleagues (1992, 1997a) showed in subjects with various sleep disorders (r = .41, p < .001) and in Narcolepsy patients (r = .52, p < .001). However, the tests clarify maximum of 20-25% of common variance, indicating that the test methods measure different constructs of daytime sleepiness. Reasons for the average correlations according to Sangal et al. (1992) are that patients with pathological MSLT values were able to stay awake in the MWT, while others who fell asleep in the MWT were able to stay awake in the MSLT.

In addition, Johns described measurement error as reasons for the variability of individual test results. It argues that the measurements are depended on the situation character, internal attitude and physical condition of the patient. Kotterba and colleagues (2007) reported that the sleep latency of the MSLT corresponds to the individual property to switch off quickly. In the opinion of John (2000) was the MLST least suitable and is no longer regarded as the gold standard.

In handling the tests are very time-consuming and labour intensive (because of multiple tests during the day) as well as it is uneconomical. This would be calling in question the use of the method (Danker-Hopfe et al. 2006, Johns 2000). Because the claim of a standardized implementation and evaluation it could also be performed only by professionally-equipped sleep laboratories (Randerath 1997). Daytime sleepiness can be measured more easily and possibly more effectively with the ESS (Johns 2000).

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