From the Research
Yes, you typically need to stop certain medications before a Multiple Sleep Latency Test (MSLT), as they can interfere with test results by artificially altering your sleep patterns or ability to fall asleep. Medications that affect sleep or alertness should be discontinued, including stimulants like modafinil, methylphenidate, and amphetamines; antidepressants such as SSRIs, SNRIs, and tricyclics; antihistamines; benzodiazepines; sleep aids; and certain pain medications. The withdrawal period varies by medication but generally ranges from 2 weeks to a month before the test, with some medications like fluoxetine requiring a longer withdrawal period of 6 weeks 1.
Some key points to consider when stopping medications for an MSLT include:
- Never stop prescription medications without consulting your doctor first, as some medications require gradual tapering to avoid withdrawal symptoms 2.
- The sleep specialist will provide specific instructions about which medications to stop and when.
- It's crucial to follow these instructions precisely to ensure accurate test results.
- If you have concerns about stopping any medication, discuss alternative approaches with your sleep specialist and prescribing physician.
The most recent and highest quality study on this topic, published in 2020, found that discontinuing rapid eye movement-suppressing antidepressants (REMS-ADs) prior to MSLT increased the number of sleep-onset rapid eye movement periods and reduced mean sleep latency 1. This study suggests that clinicians should preferably withdraw REMS-ADs before MSLT, and if this is not done, the test interpretation should include a statement regarding the potential effect of the drugs on the results.