Can other medical conditions ruin MSLT results?

So desperate just for some support from fellow sleepy heads. Did the PSG/MSLT, and got a message from my sleep specialist 2 days later that everything came out negative (mean sleep onset 13.5 minutes, no REM. Fell asleep for 4/5 naps but I felt conscious the whole time). She said at our follow-up we’ll work on “optimizing my sleep”.

But what about the fact that I have POTS and my heart didn’t have enough time to calm down before each nap? Or that I have an overactive bladder so the urge to urinate kept me up? Or that I hallucinated the sound of the door knocking and it scared me and shook me awake for one nap? Or that I have endometriosis and my ovulation was causing lower back pain?

I’ve already tried “optimizing my sleep” for 10 years. I’ve tried everything you could imagine to help me get restorative sleep, but I’m always SLEEPY. And my knees buckled at a concert last week, and a few days ago I felt lots of positive emotions from taking Ritalin again (for ADHD) and suddenly I was feeling what I thought was a sleep attack while also feeling positive emotions and my knees/hips just failed me and I had to lean against a counter until I recovered. Also my left cheek kept twitching and my eyes were shaking like crazy (this is not usual for me when I take a stimulant).

How can I know it’s not a false negative? How can optimizing my sleep cause me to not fall? How can I know it’s cataplexy or not?

All these questions are rhetorical, and honestly, I would just love any advice on next steps or general thoughts about the MSLT and its accuracy.

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TL;DR I have POTS, overactive bladder, endometriosis, all of it contributing to poor sleep during sleep study. All results came back negative. Can I trust the MSLT, and any advice for next steps when my sleep specialist thinks I just need to “optimize my sleep”?

*not seeking medical advice, I have two follow-up appointments with two different medical professionals coming up