Eliot S Katz1, Kiran Maski2, Amanda J Jenkins3. 1. Division of Respiratory Diseases, Boston Children's Hospital; 2. Department of Neurology, Boston Children's Hospital; Harvard Medical School, Boston, MA; 3. Division of Clinical Pathology, UMASS Memorial Medical Center, Worcester, MA.
Abstract
STUDY OBJECTIVE: To determine the incidence of positive drug screens in children undergoing a multiple sleep latency test (MSLT) for evaluation of excessive daytime sleepiness (EDS). METHODS: A retrospective analysis was performed in children evaluated at the Boston Children's Hospital Sleep Center between 1998 and 2013 who underwent MSLT for EDS with a concurrent urine and/or serum drug screen. RESULTS: A total of 210 MSLTs were accompanied by drug testing. Children were 12.7 ± 3.7 years old (mean ± SD), 43% were female, and 24% had narcolepsy. Positive tests were obtained in 32% for caffeine, 5% for prescription medications, and 4% for over-the-counter drugs. No drugs of abuse were identified. Children testing positive for caffeine were older (13.8 ± 3.5 vs. 12.4 ± 3.7) and more likely female (59% vs. 36%), but did not differ in MSLT or overnight polysomnographic parameters compared to children without caffeine detected. Overall, only 14% had specific documentation regarding caffeine intake, though 90% were referred from a sleep clinic. Of the children testing positive for caffeine, 5% acknowledged use, 3% denied use, and 92% did not have a documented caffeine intake history during their sleep clinic visit. CONCLUSIONS: Routine drug testing for drugs of abuse during an MSLT for EDS yielded no positive results over a 15-year period, indicating that this routine practice is unnecessary in our pediatric population without specific concerns. However, objective evidence for caffeine exposure was found in 32% of tested children undergoing an MSLT. Sleep physicians rarely documented the caffeine intake history during clinic visits for EDS.
STUDY OBJECTIVE: To determine the incidence of positive drug screens in children undergoing a multiple sleep latency test (MSLT) for evaluation of excessive daytime sleepiness (EDS). METHODS: A retrospective analysis was performed in children evaluated at the Boston Children's Hospital Sleep Center between 1998 and 2013 who underwent MSLT for EDS with a concurrent urine and/or serum drug screen. RESULTS: A total of 210 MSLTs were accompanied by drug testing. Children were 12.7 ± 3.7 years old (mean ± SD), 43% were female, and 24% had narcolepsy. Positive tests were obtained in 32% for caffeine, 5% for prescription medications, and 4% for over-the-counter drugs. No drugs of abuse were identified. Children testing positive for caffeine were older (13.8 ± 3.5 vs. 12.4 ± 3.7) and more likely female (59% vs. 36%), but did not differ in MSLT or overnight polysomnographic parameters compared to children without caffeine detected. Overall, only 14% had specific documentation regarding caffeine intake, though 90% were referred from a sleep clinic. Of the children testing positive for caffeine, 5% acknowledged use, 3% denied use, and 92% did not have a documented caffeine intake history during their sleep clinic visit. CONCLUSIONS: Routine drug testing for drugs of abuse during an MSLT for EDS yielded no positive results over a 15-year period, indicating that this routine practice is unnecessary in our pediatric population without specific concerns. However, objective evidence for caffeine exposure was found in 32% of tested children undergoing an MSLT. Sleep physicians rarely documented the caffeine intake history during clinic visits for EDS.
Authors: Yeyetzi C Torres-Ugalde; Angélica Romero-Palencia; Alma D Román-Gutiérrez; Deyanira Ojeda-Ramírez; Rebeca M E Guzmán-Saldaña Journal: Int J Environ Res Public Health Date: 2020-04-05 Impact factor: 3.390