From Département de neurologie (Y.D., E.E., L.B., R.L., S.C., C.D., S.B.), Unité du Sommeil, Centre National de Référence pour la Narcolepsie et Hypersomnie rares Hôpital Gui-de-Chauliac, CHU Montpellier; and INSERM 1061 (Y.D., E.E., L.B., R.L., S.B., I.J.), University Montpellier, France.
Neurology. 2019 Apr 9;92(15):e1754-e1762. doi: 10.1212/WNL.0000000000007264. Epub 2019 Mar 13.
To validate the Idiopathic Hypersomnia Severity Scale (IIHSS), a self-report measure of hypersomnolence symptoms, consequences, and responsiveness to treatment.
The 14-item IHSS (developed and validated by sleep experts with patients' feedback) was filled in by 218 participants (2.3% missing data). Among the 210 participants who fully completed the IHSS, there were 57 untreated and 43 treated patients with idiopathic hypersomnia (IH) aged 16 years or older, 37 untreated patients with narcolepsy type 1 (NT1), and 73 controls without sleepiness. IHSS psychometric properties, discriminant diagnostic validity, and score changes with treatment were assessed.
The IHSS showed good internal consistency and content validity. Factor analysis indicated a 2-component solution with good reliability expressed by satisfactory Cronbach α values. IHSS scores were reproducible without changes in the test-retest evaluation (13 treated and 14 untreated patients). Convergent validity analysis showed that IHSS score was correlated with daytime sleepiness, depressive symptoms, and quality of life in patients with IH. The IHSS score was lower in treated than untreated patients (5-8 unit difference, without ceiling effect). The cutoff value for discriminating between untreated and treated patients was 26/50 (sensitivity 55.8%, specificity 78.9%). IHSS scores were higher in drug-free IH patients than NT1 and controls. The best cutoff value to differentiate between untreated IH patients and controls was 22 (sensitivity 91.1%, specificity 94.5%), and 29 with NT1.
The IHSS is a reliable and valid clinical tool for the quantification of IH symptoms and consequences that might be useful for patient identification, follow-up, and management.
验证特发性嗜睡症严重程度量表（IIHSS），这是一种用于评估嗜睡症状、后果和对治疗反应的自我报告测量工具。
14 项 IHSS（由睡眠专家与患者反馈共同开发和验证）由 218 名参与者填写（2.3%的数据缺失）。在 210 名完整填写 IHSS 的参与者中，有 57 名未经治疗的特发性嗜睡症（IH）患者和 43 名经治疗的 IH 患者（年龄在 16 岁及以上）、37 名未经治疗的 1 型发作性睡病（NT1）患者和 73 名无嗜睡的对照组。评估了 IHSS 的心理测量特性、鉴别诊断有效性和治疗后的评分变化。
IHSS 显示出良好的内部一致性和内容有效性。因子分析表明，2 个成分解决方案具有良好的可靠性，通过令人满意的 Cronbach α 值表示。IHSS 评分在没有测试-重测评估变化的情况下具有可重复性（13 名治疗和 14 名未经治疗的患者）。收敛有效性分析表明，IHSS 评分与 IH 患者的日间嗜睡、抑郁症状和生活质量相关。治疗组的 IHSS 评分低于未经治疗的患者（5-8 个单位的差异，无天花板效应）。区分未经治疗和治疗患者的截止值为 26/50（敏感性 55.8%，特异性 78.9%）。无药物治疗的 IH 患者的 IHSS 评分高于 NT1 和对照组。区分未经治疗的 IH 患者和对照组的最佳截止值为 22（敏感性 91.1%，特异性 94.5%），与 NT1 相比为 29。
IHSS 是一种用于量化 IH 症状和后果的可靠有效的临床工具，对于患者识别、随访和管理可能很有用。
