Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, United States.
Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.
Psychiatry Res. 2019 Nov;281:112547. doi: 10.1016/j.psychres.2019.112547. Epub 2019 Aug 31.
Hypersomnia is common in psychiatric disorders, yet there are few self-report measures that adequately characterize this sleep disturbance. The objective of this study was to validate the Hypersomnia Severity Index (HSI), a tool designed to measure severity, distress and impairment of hypersomnia in psychiatric populations. Psychometric properties were evaluated in an undergraduate Scale Development sample (N = 381) and two psychiatric Scale Validation samples: euthymic bipolar participants with a range of sleep complaints (N = 89), and unmedicated unipolar depressed participants (N = 21) meeting operational criteria for hypersomnolence disorder. Exploratory factor analysis and confirmatory factor analysis in the Scale Development and Validation samples, respectively, suggested a two-factor structure representing Hypersomnia Symptoms and Distress/Impairment best fit the data. Convergent validity was established by significant associations with the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and the Sheehan Disability Scale in both samples. Construct validity was further supported by significant correlations between the Scale Validation sample and two weeks of diary- and actigraphy-determined total sleep time and time in bed. A cutoff score of 10 maximally discriminated between those with hypersomnia and those without. The HSI shows promise as a measure of hypersomnia that is commonly seen in psychiatric disorders, and may be of use to both researchers and clinicians. SUPPORT: This work is supported by grants from the American Sleep Medicine Foundation (76-JF-12), the Brain and Behavior Research Foundation (19193), and NIMHK23MH099234 (DTP); National Science Foundation Graduate Research Fellowship Program and Stanford Child Health Research Institute (KAK); and R34MH080958 and R01MH105513 (AGH).
嗜睡症在精神疾病中很常见，但很少有自我报告的措施能充分描述这种睡眠障碍。本研究的目的是验证嗜睡严重程度指数（HSI），这是一种旨在测量精神科人群中嗜睡严重程度、困扰和障碍的工具。在本科量表开发样本（N=381）和两个精神科量表验证样本中评估了心理测量学特性：伴有各种睡眠抱怨的轻躁狂双相情感障碍参与者（N=89）和符合嗜睡障碍操作性标准的未用药单相抑郁参与者（N=21）。在量表开发和验证样本中分别进行的探索性和验证性因子分析表明，代表嗜睡症状和困扰/障碍的两因素结构最符合数据。在两个样本中，与 Epworth 嗜睡量表（ESS）、匹兹堡睡眠质量指数（PSQI）和 Sheehan 残疾量表的显著关联确立了其聚合效度。在量表验证样本中，与两星期日记和活动记录仪确定的总睡眠时间和卧床时间之间的显著相关性进一步支持了其结构效度。临界值为 10 分可最大限度地区分嗜睡者和非嗜睡者。HSI 有望成为一种常用于精神疾病的嗜睡症测量工具，对研究人员和临床医生都可能有用。支持：这项工作得到了美国睡眠医学基金会（76-JF-12）、大脑与行为研究基金会（19193）和 NIMHK23MH099234（DTP）；国家科学基金会研究生研究奖学金计划和斯坦福儿童健康研究所（KAK）；以及 R34MH080958 和 R01MH105513（AGH）的资助。
