What is a Maintenance of Wakefulness test?
A maintenance of wakefulness test assesses your ability to stay awake during the day. Also known as MWT, it is designed to help your doctor diagnose your sleep issues. One of the problems medical professionals face when helping you with sleep disorders is understanding what the problem is. With many sleep disorders having similar symptoms, a sleep test is often the only way of diagnosing your issue.
During the MWT, you will usually be placed in a room with low light levels. Here, you sit in a comfortable chair or bed and stay still. The quiet, relatively dark space isolates you from outside factors affecting sleep patterns. These include temperature, light, sounds, and any activity in which you or the people around you are involved.
Photo courtesy of PankhTech
The goal is to see how long you can stay awake in these conditions. You will be connected to monitoring equipment that records brain activity. Your sleep time and time to fall asleep are also recorded. This is especially important with sleep issues because you may struggle to explain your feelings when falling asleep. Remembering what was happening can also be challenging, so independent observation is often essential. The maintenance of wakefulness test is unlike some other sleep test procedures with which you might be familiar. It is carried out over the day rather than a nighttime sleep test.
A maintenance of wakefulness test usually includes four sessions with two-hour breaks between them. During the sleep test, you will be woken after 90 seconds if you fall asleep. The test ends if you do not fall asleep within forty minutes.
There are some things to consider when taking an MWT. Ideally, wear comfortable, loose-fitting clothes or sleepwear. This minimises any outside factors that could keep you awake. Don’t put on makeup or use greasy skin care products. They can interfere with the monitoring equipment attached to you during the test. Avoid drinking caffeine or taking other stimulants before the test, too.
Who might want to take a maintenance of wakefulness test?
The maintenance of wakefulness test is helpful in many ways. If you have a sleep disorder, it can assist in diagnosing it. In particular, if you have symptoms of narcolepsy or sleep apnoea, this is a beneficial test. However, it is not just for finding specific issues.
Sleep disorders can be incredibly disruptive to your life, including making many tasks a problem. The maintenance of wakefulness test can also be used to assess capabilities. For instance, if you drive for a living, it can determine your safety on the road. Seeing how long you can stay awake illustrates the risks of driving even during the day.
It is not just driving, either. Any task where alertness is essential becomes dangerous if you are sleep-deprived. Narcolepsy is rare, but assessing your capabilities if you are suffering from it can prevent severe injury or worse.
What’s the difference between this test and the Multiple Sleep Latency Test?
The MSLT and wakefulness test maintenance are the exact opposite in many ways. While they follow the same format—four sessions with two-hour breaks in between—the test differs fundamentally. If you take an MWT, the test is about how long you can stay awake. The multiple sleep latency test is about how long it takes to fall asleep.
In other words, in the maintenance of wakefulness test, your goal is to stay awake, and in the MSLT, your goal is to fall asleep. They tell us very different things, too. If you take a multiple sleep latency test, doctors look to see how long you take to reach sleep. But also want to know the kind of sleep you experience. In particular, they want to see if you reach REM sleep. This is why, once asleep, you are left for fifteen minutes.
However, if you take a maintenance of wakefulness test and fall asleep, you will be woken after just 90 seconds. Then, the test will continue to see how long you can remain awake. The focus here is on wakefulness, not sleep.
How are the test results interpreted?
In general, around half of people without any sleep disorder will stay awake for 40 minutes. Of the rest, most will stay awake for thirty minutes or so. Just two and a half per cent will fall asleep in less than eight minutes.
The focus of the sleep test analysis is on this. It is a good indicator of a sleep disorder if you fall asleep in less than eight minutes. The primary sleep disorders that doctors would look at in this situation are narcolepsy and idiopathic hypersomnia.
However, there are other conclusions, such as whether you fall asleep after thirty minutes or so or don’t fall asleep at all. This would indicate that you don’t have an issue with daytime sleep. However, it doesn’t completely rule out sleep disorders. If you are taking a maintenance of wakefulness test to assess suitability for a job, it is positive, though.
As with every sleep test, there is no ‘pass’ or ‘fail’; it just indicates how your sleep is affected. This test also shows how a sleep problem is affecting you.
Conclusion
Taking a sleep test can be daunting, but knowing what is involved can help. The MWT is one of the less intrusive tests, designed to determine how long you can stay awake. It is used to help diagnose issues like narcolepsy and is also frequently employed to test for safety.
Pilots, doctors, truck drivers, etc., must be alert during their jobs. Otherwise, lives could be at risk. This sleep test can assess drowsiness if you do a job where alertness is crucial. This, in turn, can determine your safety in doing those tasks. If you are having issues with sleep in such a job, you may be required to take the test.
This is a very different type of sleep test, focusing on staying awake. It takes a day to complete but is not as intrusive as some processes. Notably, the maintenance of wakefulness test can identify sleep issues and help you stay safe.
Featured post pic courtesy of Ron Lach