The Arousal Disorders Questionnaire: a new and effective screening tool for confusional arousals, Sleepwalking and Sleep Terrors in epilepsy and sleep disorders units.


Journal

Sleep medicine
ISSN: 1878-5506
Titre abrégé: Sleep Med
Pays: Netherlands
ID NLM: 100898759

Informations de publication

Date de publication:
04 2021
Historique:
received: 19 09 2020
revised: 21 01 2021
accepted: 25 01 2021
pubmed: 21 2 2021
medline: 6 7 2021
entrez: 20 2 2021
Statut: ppublish

Résumé

Arousal Disorders (DoA) include Confusional Arousals, Sleepwalking and Sleep Terrors. DoA diagnosis is mainly clinical but no validated questionnaires exist for DoA screening according to the criteria of the International Classification of Sleep Disorders, Third Edition. Recently our group proposed the Arousal Disorders Questionnaire (ADQ) as a new diagnostic tool for DoA diagnosis. The objective of this study was to evaluate the diagnostic accuracy of the ADQ in a sleep and epilepsy center. One interviewer blinded to clinical and video-polysomnographic (VPSG) data administered the ADQ to 150 patients consecutively admitted to our Sleep and Epilepsy Centers for a follow-up visit. The final diagnosis, according to VPSG recordings of at least one major episode, classified patients either with DoA (DoA group) or with other sleep-related motor behaviors confounding for DoA (nDoA group). 47 patients (31%) composed the DoA group; 56 patients with REM sleep behavior disorder, 39 with sleep-hypermotor epilepsy, six with night eating syndrome, and two with drug-induced DoA composed the nDoA group. The ADQ had a sensitivity of 72% (95% CI: 60-82) and a specificity of 96% (95% CI: 89-98) for DoA diagnosis; excluding the items regarding consciousness and episode recall, sensitivity was 83% (95% CI: 71-90) and specificity 93% (95% CI: 86-97). The ADQ showed good accuracy in screening patients with DoA in a sleep and epilepsy center setting. Diagnostic criteria related to cognition and episode recall reduced ADQ sensitivity, therefore a better definition of these criteria is required, especially in adults.

Sections du résumé

BACKGROUND
Arousal Disorders (DoA) include Confusional Arousals, Sleepwalking and Sleep Terrors. DoA diagnosis is mainly clinical but no validated questionnaires exist for DoA screening according to the criteria of the International Classification of Sleep Disorders, Third Edition. Recently our group proposed the Arousal Disorders Questionnaire (ADQ) as a new diagnostic tool for DoA diagnosis. The objective of this study was to evaluate the diagnostic accuracy of the ADQ in a sleep and epilepsy center.
METHODS
One interviewer blinded to clinical and video-polysomnographic (VPSG) data administered the ADQ to 150 patients consecutively admitted to our Sleep and Epilepsy Centers for a follow-up visit. The final diagnosis, according to VPSG recordings of at least one major episode, classified patients either with DoA (DoA group) or with other sleep-related motor behaviors confounding for DoA (nDoA group).
RESULTS
47 patients (31%) composed the DoA group; 56 patients with REM sleep behavior disorder, 39 with sleep-hypermotor epilepsy, six with night eating syndrome, and two with drug-induced DoA composed the nDoA group. The ADQ had a sensitivity of 72% (95% CI: 60-82) and a specificity of 96% (95% CI: 89-98) for DoA diagnosis; excluding the items regarding consciousness and episode recall, sensitivity was 83% (95% CI: 71-90) and specificity 93% (95% CI: 86-97).
CONCLUSIONS
The ADQ showed good accuracy in screening patients with DoA in a sleep and epilepsy center setting. Diagnostic criteria related to cognition and episode recall reduced ADQ sensitivity, therefore a better definition of these criteria is required, especially in adults.

Identifiants

pubmed: 33610075
pii: S1389-9457(21)00054-X
doi: 10.1016/j.sleep.2021.01.037
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

279-285

Informations de copyright

Copyright © 2021 Elsevier B.V. All rights reserved.

Auteurs

Giuseppe Loddo (G)

Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.

Giusy La Fauci (G)

Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.

Luca Vignatelli (L)

IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.

Corrado Zenesini (C)

IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.

Rosalia Cilea (R)

IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.

Francesco Mignani (F)

IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.

Annagrazia Cecere (A)

IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.

Susanna Mondini (S)

IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.

Luca Baldelli (L)

Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.

Francesca Bisulli (F)

Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Reference Center for Rare and Complex Epilepsies - EpiCARE, Bologna, Italy.

Laura Licchetta (L)

Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Reference Center for Rare and Complex Epilepsies - EpiCARE, Bologna, Italy.

Barbara Mostacci (B)

IRCCS Istituto delle Scienze Neurologiche di Bologna, Reference Center for Rare and Complex Epilepsies - EpiCARE, Bologna, Italy.

Pietro Guaraldi (P)

IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.

Giulia Giannini (G)

Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.

Paolo Tinuper (P)

Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Reference Center for Rare and Complex Epilepsies - EpiCARE, Bologna, Italy.

Federica Provini (F)

Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy. Electronic address: federica.provini@unibo.it.

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