觉醒障碍问卷：癫痫和睡眠障碍单元中用于混乱性觉醒、梦游和夜惊的新型有效筛查工具。

The Arousal Disorders Questionnaire: a new and effective screening tool for confusional arousals, Sleepwalking and Sleep Terrors in epilepsy and sleep disorders units.

机构信息

Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.

IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.

出版信息

Sleep Med. 2021 Apr;80:279-285. doi: 10.1016/j.sleep.2021.01.037. Epub 2021 Jan 29.

DOI:10.1016/j.sleep.2021.01.037

PMID:33610075

Abstract

BACKGROUND

Arousal Disorders (DoA) include Confusional Arousals, Sleepwalking and Sleep Terrors. DoA diagnosis is mainly clinical but no validated questionnaires exist for DoA screening according to the criteria of the International Classification of Sleep Disorders, Third Edition. Recently our group proposed the Arousal Disorders Questionnaire (ADQ) as a new diagnostic tool for DoA diagnosis. The objective of this study was to evaluate the diagnostic accuracy of the ADQ in a sleep and epilepsy center.

METHODS

One interviewer blinded to clinical and video-polysomnographic (VPSG) data administered the ADQ to 150 patients consecutively admitted to our Sleep and Epilepsy Centers for a follow-up visit. The final diagnosis, according to VPSG recordings of at least one major episode, classified patients either with DoA (DoA group) or with other sleep-related motor behaviors confounding for DoA (nDoA group).

RESULTS

47 patients (31%) composed the DoA group; 56 patients with REM sleep behavior disorder, 39 with sleep-hypermotor epilepsy, six with night eating syndrome, and two with drug-induced DoA composed the nDoA group. The ADQ had a sensitivity of 72% (95% CI: 60-82) and a specificity of 96% (95% CI: 89-98) for DoA diagnosis; excluding the items regarding consciousness and episode recall, sensitivity was 83% (95% CI: 71-90) and specificity 93% (95% CI: 86-97).

CONCLUSIONS

The ADQ showed good accuracy in screening patients with DoA in a sleep and epilepsy center setting. Diagnostic criteria related to cognition and episode recall reduced ADQ sensitivity, therefore a better definition of these criteria is required, especially in adults.

摘要

背景

觉醒障碍（DoA）包括意识模糊性觉醒、梦游和睡惊症。DoA 的诊断主要是临床诊断，但根据国际睡眠障碍分类，第三版的标准，目前还没有经过验证的问卷用于 DoA 的筛查。最近，我们的团队提出了觉醒障碍问卷（ADQ），作为一种新的诊断工具用于 DoA 的诊断。本研究的目的是评估 ADQ 在睡眠和癫痫中心的诊断准确性。

方法

一名访谈者对临床和视频多导睡眠图（VPSG）数据进行盲法评估，对连续入住我们的睡眠和癫痫中心进行随访的 150 名患者进行 ADQ 问卷调查。根据至少一个主要发作的 VPSG 记录，最终诊断将患者分为觉醒障碍（DoA 组）或其他与睡眠相关的运动行为障碍（nDoA 组）。

结果

47 名患者（31%）构成了 DoA 组；56 名患者为 REM 睡眠行为障碍，39 名患者为睡眠过度运动性癫痫，6 名患者为夜间进食综合征，2 名患者为药物引起的 DoA 构成了 nDoA 组。ADQ 对 DoA 的诊断敏感性为 72%（95%CI：60-82），特异性为 96%（95%CI：89-98）；排除与意识和发作回忆相关的项目后，敏感性为 83%（95%CI：71-90），特异性为 93%（95%CI：86-97）。