Table 3.

Objective assessment tools for determining the risk of EDS

Tool	Description	Measure	Interpretation	Time
Actigraphy (as an objective supplement to sleep diary) [90]	Wristwatch-sized instrument that captures amplitude of movement over time that distinguishes sleeping versus wakeful activity in “home” scenarios	Sleep–wake patterns, including total wake time, total sleep time, efficiency, latency, number and length of arousal periods in 30–60-s intervals	Reader download and computer analysis of movement patterns over a 24-h period, especially reliable if worn for 7–14 days	7–14 days
MSLT [90, 116]	Tendency or ability to fall asleep during daytime in-laboratory PSG	Excessive sleepiness, idiopathic hypersomnia, and narcolepsy; not used routinely for medical or neurological sleepiness	< 5 min indicates excessively sleepy (normal, 10–20 min)	8 h
MWT [116]	Ability to remain awake in a dark, quiet environment	Sleep latency in 20- or 40-min MWT test, 4 or 5 trials, spaced 2 h apart	Normal 11–20 min; cutoff value usually < 12 min	8 h
In-laboratory PSG [90]	Uses PSG, recording devices and monitors; “gold standard” for evaluation of sleep	Sleep architecture and characteristics; diagnosis of OSA, etc.; titration of positive airway pressure	Determines sleep stages, duration, efficiency, sleep latency, arousals, REM sleep latency	Overnight
In-home sleep testing [90]	PSG, unattended, sleep technician or patient with training set up portable PSG, monitors in home environment	Sleep architecture and characteristics; diagnosis of OSA (with high probability of moderate-to-severe OSA); titration of positive airway pressure	Dependent on SCOPER channels; determines sleep stages, duration, efficiency, sleep latency, arousals, REM sleep latency [117]	At least overnight

EDS excessive daytime sleepiness, MSLT Multiple Sleep Latency Test, MWT Maintenance of Wakefulness Test, OSA obstructive sleep apnea, PSG polysomnography, REM rapid eye movement, SCOPER Sleep Cardiovascular Oximetry Position Effort and Respiratory