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The Maintenance of Wakefulness Test (MWT) is a medical test that measures how well you can stay awake during the day. It is often used to check for conditions that cause excessive daytime sleepiness, such as narcolepsy or idiopathic hypersomnia. During the test, you sit in a quiet, dimly lit room and try to remain awake for a set period while sensors track your brain activity.
Key facts
No, the MWT is not a common test. It is a specialist test used only for people with diagnosed or suspected sleep disorders that cause significant daytime sleepiness.
The test is typically recommended for adults who have already been diagnosed with narcolepsy, idiopathic hypersomnia, or other conditions that cause severe sleepiness. It may also be used for people whose jobs require high alertness (like pilots or truck drivers) to check if they can stay awake safely.
The MWT is a specific test used to measure your ability to stay awake. It is usually ordered by a sleep specialist after an overnight sleep study (polysomnography) has ruled out other conditions like sleep apnea.
On the day of the test, you will be asked to avoid caffeine, alcohol, and any stimulants. You will have small sensors placed on your scalp, face, and chin (like stickers) to record your brain activity. For each session, you will sit in a reclining chair, the lights will be dimmed, and you will be asked to stay awake. The test is recorded, and a technician watches from another room. Sessions are usually 2 hours apart. The whole test takes most of the day.
The MWT is a diagnostic test, not a treatment. If the test shows that you have difficulty staying awake, your doctor will work with you to treat the underlying cause of your sleepiness. Treatment may include lifestyle changes, medications, or devices.
Treatment depends on the condition causing the sleepiness. For conditions like narcolepsy, doctors may prescribe stimulant medications to help keep you awake during the day. For sleep apnea, continuous positive airway pressure (CPAP) therapy is often used. For idiopathic hypersomnia, medications that promote wakefulness may be recommended. Always discuss options with your healthcare provider.
If you have been diagnosed with a condition that causes excessive daytime sleepiness, you will need to plan your day around your energy levels. This may include scheduling short naps, avoiding driving when sleepy, and telling friends and family about your condition so they can support you.
A healthy diet with balanced meals can help keep your energy steady. Avoid heavy meals that can make you sleepy. Regular exercise, such as walking, swimming, or cycling, can improve sleep quality and alertness. However, avoid strenuous exercise close to bedtime.
You cannot prevent the need for an MWT if you have symptoms. However, you can reduce your risk of developing conditions that cause excessive daytime sleepiness by maintaining good sleep hygiene, managing stress, and seeking treatment for sleep apnea early.
There are no vaccines to prevent the need for an MWT or the conditions it tests for.
No routine screening exists. The MWT is only done when a doctor suspects a specific sleep disorder based on your symptoms.
With the right diagnosis and treatment, most people with excessive daytime sleepiness can manage their symptoms and lead full, safe lives. The MWT helps guide treatment, so many people find improvement once they and their doctor know what is going on. There is reason to be hopeful.
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Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: July 9, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.
Surgery is not typically needed for the conditions that the MWT helps diagnose. However, in some cases of sleep apnea caused by structural problems (like enlarged tonsils), surgery might be an option.
Living with chronic sleepiness can be frustrating and affect your mood, relationships, and self-esteem. It is normal to feel anxious or down. Talk to your doctor if you are struggling – they can refer you to a counsellor or support group. Your mental health is just as important as your physical health.