The influence of antidepressants and actigraphy-derived sleep characteristics on pediatric multiple sleep latency testing

Meghna P. Mansukhani, Swati Dhankikar, Suresh Kotagal, Bhanu Prakash Kolla

Research output: Contribution to journalArticlepeer-review


Study Objectives: Research evaluating the influence of rapid eye movement suppressing antidepressants (REMS-AD) on multiple sleep latency test (MSLT) results and the value of performing actigraphy prior to this test in children and adolescents is lacking. We examined the impact of REMS-AD and actigraphy parameters on mean sleep latency (MSL) and sleep-onset REM episodes (SOREMs) on MSLT in a pediatric clinical sample. Methods: This was a retrospective chart review at a quarternary referral center. We identified 164 MSLTs conducted in patients aged less than 18 years between 2014 and 2017. Correlations between REMS-AD, self-reported sleep duration, actigraphy parameters, and each of the outcomes (MSL and SOREMs) were examined. Regression analyses accounting for clinical characteristics were performed. Results: Mean age of the sample was 11.9 ± 4.19 years, 62% were female, 28 (17%) were on REMS-AD (48% of whom were able to discontinue these medications prior to MSLT), and mean pediatric daytime sleepiness score was 21.7 ± 6.1. MSL was 11.27 ± 5.77 min and mean number of SOREMs 0.55 ± 1.04. Patients on a REMS-AD at initial assessment had fewer SOREMs compared to those not taking these medications (0.17 ± 0.19 vs 0.62 ± 0.09; P = .04); no difference was noted in MSL (10.36 ± 1.10 vs 11.47 ± 0.50; P = .36). Increased time in bed on actigraphy correlated with a longer MSL and fewer SOREMs (r = .23; P = .04 and r = .316; P = .004, respectively). Following regression analyses, use of REMS-AD continued to remain associated with fewer SOREMs; greater time in bed on actigraphy, but not self-reported sleep duration, was associated with a longer MSL (all P < .05). Conclusions: Clinicians should account for the use of REMS-AD and utilize actigraphy to determine time in bed while interpreting the results of a pediatric MSLT.

Original languageEnglish (US)
Pages (from-to)2179-2185
Number of pages7
JournalJournal of Clinical Sleep Medicine
Issue number11
StatePublished - Nov 1 2021


  • measurement
  • medications
  • objective
  • psychiatric
  • rapid eye movement suppressing
  • sleep duration
  • sleep time
  • sleep-onset rapid eye movement period

ASJC Scopus subject areas

  • Medicine(all)


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