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VOLUME 37, ISSUE 01

SCALE FOR ASSESSING THE SEVERITY OF AROUSAL DISORDERS
A Scale for Assessing the Severity of Arousal Disorders

http://dx.doi.org/10.5665/sleep.3322

Isabelle Arnulf, MD, PhD1; Bin Zhang, MD, PhD2; Ginevra Uguccioni, MS1; Mathilde Flamand, MD1; Alix Noël de Fontréaux, , MS1; Smaranda Leu-Semenescu, MD1; Agnès Brion, MD1

1Sleep Disorder Unit, Pitié-Salpêtrière Hospital, Centre de Recherche de l'Institut du Cerveau et de la Moëlle épinière – Pierre and Marie Curie University; Inserm UMR_S 975; CNRS UMR 7225, Paris, France; 2Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Mental Health Centre, Guangzhou 510120, China



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Background:

Arousal disorders may have serious health consequences.

Objective:

To develop a scale assessing the severity of arousal disorders (Paris Arousal Disorders Severity Scale, PADSS).

Setting:

University hospital.

Design:

Controlled study.

Participants:

Consecutive patients (older than 15 y), with sleepwalking (SW) and/or sleep terrors (ST), subjects with previous SW/ST, normal controls and patients with rapid eye movement sleep behavior disorder.

Intervention:

The self-rated scale listed 17 parasomniac behaviors (PADSS-A), assessed their frequency from never to twice or more per night (PADSS-B) and evaluated the consequences (PADSS-C: disturbed sleep, injuries, fatigue, and psychological consequences). The clinimetric properties and face validity of the scale were tested.

Results:

Half of the 73 patients with SW/ST (more men than women) had injured themselves or others, whereas 15% had concomitant sexsomnia and 23% had amnestic eating behaviors. The total PADSS score (range: 0-50) was 19.4 ± 6.3 (range: 8-36) in this group, 11.7 ± 5.9 in 26 subjects with previous SW/ST, 8.8 ± 3.2 in 26 patients with RBD, and 2.0 ± 3.5 in 53 normal controls (P < 0.05). The PADSS demonstrated high sensitivity (83.6%), specificity (87.8%), internal consistency, and test-retest reliability (0.79). The best cutoff for the total score was at 13/14. Exploratory factor analysis revealed two components: wandering and violence/handling. The complexity of behaviors emerging from N3 sleep (scored on videopolysomnography) positively correlated with scores for the PADSS-total, PADSS-A, PADSS-C, and the “violence/handling” factor.

Conclusion:

This scale had reasonable psychometric properties and could be used for screening and stratifying patients and for evaluating the effects of treatments.

Citation:

Arnulf I; Zhang B; Uguccioni G; Flamand M; Noël de Fontréaux A; Leu-Semenescu S; Brion A. A scale for assessing the severity of arousal disorders. SLEEP 2014;37(1):127-136.

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