Martinez-Martin Pablo, Visser Martine, Rodriguez-Blazquez Carmen, Marinus Johan, Chaudhuri K Ray, van Hilten Jacobus J
National Centre of Epidemiology, Carlos III Institute of Health, Madrid, Spain.
Mov Disord. 2008 Sep 15;23(12):1681-8. doi: 10.1002/mds.22110.
This study evaluated the comparative validity and usefulness of the Parkinson's Disease Sleep Scale (PDSS) and the Scales for Outcomes in PD-Sleep Scale (SCOPA-S), two disease-specific rating scales for assessing sleep disorders in Parkinson's disease (PD). Hoehn and Yahr staging (HY), SCOPA-Motor, Mini-Mental State Examination, Clinical Impression of Severity Index for PD, Hospital Anxiety and Depression Scale, EuroQoL, and SCOPA-Psychosocial, in addition to PDSS and SCOPA-S (night-time sleep (NS) and daytime sleepiness (DS) subscales), were applied to 187 consecutive PD patients. PDSS and SCOPA-S proved similar in acceptability, scaling assumptions, precision, and internal consistency (Cronbach's alpha = 0.82-0.84). Factor analysis revealed five separate factors for PDSS (67% of the variance) and one factor for each SCOPA-S subscale (60% of the variance for NS and 57% for DS). Correlation coefficient between PDSS and SCOPA-S NS was -0.60. Sleep scales correlated moderately with mood, low-to-moderate with HRQoL, and low with the rest of measures. PDSS and SCOPA-S DS discriminated between patients grouped by HY severity levels and disease duration. Cutoff points of 82/83 for PDSS and 6/7 for SCOPA-S NS were drawn to identify PD patients with sleep problems. Depression/anxiety scores explained 26% for PDSS and 22% for SCOPA-S NS scores. Both scales provide valid, reliable, and useful means to evaluate sleep disorders in PD. PDSS may be used to obtain a profile about potential causes of "bad sleep," but is barely useful to assess DS, whereas SCOPA-S assesses nocturnal sleep disorders and daytime somnolence at a similar extent, without exploring the potential causes.
本研究评估了帕金森病睡眠量表（PDSS）和帕金森病睡眠结局量表（SCOPA-S）这两种用于评估帕金森病（PD）睡眠障碍的疾病特异性评定量表的比较效度和实用性。除了PDSS和SCOPA-S（夜间睡眠（NS）和日间嗜睡（DS）子量表）外，还对187例连续的PD患者应用了霍恩和雅尔分期（HY）、SCOPA-运动量表、简易精神状态检查表、PD严重程度临床印象指数、医院焦虑抑郁量表、欧洲生活质量量表以及SCOPA-心理社会量表。PDSS和SCOPA-S在可接受性、量表假设、精确性和内部一致性方面（克朗巴哈系数=0.82 - 0.84）相似。因子分析显示PDSS有五个独立因子（占方差的67%），SCOPA-S每个子量表有一个因子（NS占方差的60%，DS占方差的57%）。PDSS与SCOPA-S NS的相关系数为-0.60。睡眠量表与情绪呈中度相关，与健康相关生活质量呈低至中度相关，与其他测量指标呈低度相关。PDSS和SCOPA-S DS能够区分按HY严重程度水平和病程分组的患者。得出PDSS的截断点为82/83，SCOPA-S NS的截断点为6/7，以识别有睡眠问题的PD患者。抑郁/焦虑评分对PDSS得分的解释率为26%，对SCOPA-S NS得分的解释率为22%。两种量表都为评估PD中的睡眠障碍提供了有效、可靠且有用的方法。PDSS可用于获取有关“睡眠不佳”潜在原因的概况，但几乎无法用于评估DS，而SCOPA-S在相似程度上评估夜间睡眠障碍和日间嗜睡情况，且不探究潜在原因。
