Dauvilliers Yves, Beziat Severine, Pesenti Carole, Lopez Regis, Barateau Lucie, Carlander Bertrand, Luca Gianina, Tafti Mehdi, Morin Charles M, Billiard Michel, Jaussent Isabelle
From CHU Montpellier (Y.D., S.B., C.P., R.L., L.B., B.C., M.B.), Hôpital Gui-de-Chauliac, Service de Neurologie, Unité du Sommeil, Centre National de Référence pour la Narcolepsie, Montpellier, France; Center for Integrative Genomics (G.L., M.T.), University of Lausanne; Centre Neuchâtelois de Psychiatrie (G.L.), Neuchâtel; Center for Investigation and Research in Sleep (M.T.), Lausanne University Hospital, Switzerland; Department of Psychology (C.M.M.), Université Laval, Quebec City, Quebec, Canada; Inserm (Y.D., S.B., C.P., R.L., I.J.), U1061; and Université Montpellier (Y.D., S.B., C.P., R.L., I.J.), France.
Neurology. 2017 Apr 4;88(14):1358-1365. doi: 10.1212/WNL.0000000000003787. Epub 2017 Mar 3.
To validate the Narcolepsy Severity Scale (NSS), a brief clinical instrument to evaluate the severity and consequences of symptoms in patients with narcolepsy type 1 (NT1).
A 15-item scale to assess the frequency and severity of excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, sleep paralysis, and disrupted nighttime sleep was developed and validated by sleep experts with patients' feedback. Seventy untreated and 146 treated adult patients with NT1 were evaluated and completed the NSS in a single reference sleep center. The NSS psychometric properties, score changes with treatment, and convergent validity with other clinical parameters were assessed.
The NSS showed good psychometric properties with significant item-total score correlations. The factor analysis indicated a 3-factor solution with good reliability, expressed by satisfactory Cronbach α values. The NSS total score temporal stability was good. Significant NSS score differences were observed between untreated and treated patients (dependent sample, 41 patients before and after sleep therapy; independent sample, 29 drug-free and 105 treated patients). Scores were lower in the treated populations (10-point difference between groups), without ceiling effect. Significant correlations were found among NSS total score and daytime sleepiness (Epworth Sleepiness Scale, Mean Sleep Latency Test), depressive symptoms, and health-related quality of life.
The NSS can be considered a reliable and valid clinical tool for the quantification of narcolepsy symptoms to monitor and optimize narcolepsy management.
验证发作性睡病严重程度量表（NSS），这是一种用于评估1型发作性睡病（NT1）患者症状严重程度及后果的简短临床工具。
开发了一个包含15个条目的量表，用于评估日间过度嗜睡、猝倒、入睡前幻觉、睡眠麻痹及夜间睡眠中断的频率和严重程度，并在睡眠专家的指导及患者反馈下进行了验证。70例未经治疗和146例接受治疗的成年NT1患者在单一参考睡眠中心接受评估并完成NSS量表。评估了NSS的心理测量学特性、治疗后的评分变化以及与其他临床参数的收敛效度。
NSS显示出良好的心理测量学特性，各条目与总分之间存在显著相关性。因子分析表明该量表有一个三因子结构，可靠性良好，Cronbach α值令人满意。NSS总分的时间稳定性良好。在未经治疗和接受治疗的患者之间观察到NSS评分存在显著差异（相关样本，41例患者接受睡眠治疗前后；独立样本，29例未用药患者和105例接受治疗患者）。治疗组的评分较低（两组间相差10分），无天花板效应。NSS总分与日间嗜睡（爱泼沃斯嗜睡量表、平均睡眠潜伏期测试）、抑郁症状及健康相关生活质量之间存在显著相关性。
NSS可被视为一种可靠且有效的临床工具，用于量化发作性睡病症状，以监测和优化发作性睡病的管理。
