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

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...

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Bibliographic Details
Published in:Sleep medicine 2021-04, Vol.80, p.279-285
Main Authors: Loddo, Giuseppe, La Fauci, Giusy, Vignatelli, Luca, Zenesini, Corrado, Cilea, Rosalia, Mignani, Francesco, Cecere, Annagrazia, Mondini, Susanna, Baldelli, Luca, Bisulli, Francesca, Licchetta, Laura, Mostacci, Barbara, Guaraldi, Pietro, Giannini, Giulia, Tinuper, Paolo, Provini, Federica
Format: Article
Language:English
Subjects:
Confusional arousal
NREM Parasomnias
Sleep terrors
Sleep walking
Sleep-related hypermotor epilepsy
Somnambulism
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Summary: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. 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). 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). 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. •DoA diagnosis is mainly clinical.•The ADQ is a new screening tool for DoA diagnosis.•The ADQ is the first questionnaire validated according to the ICSD-3 criteria.•The ADQ has good accuracy in screening DoA in sleep and epilepsy center.
ISSN:1389-9457
1878-5506
DOI:10.1016/j.sleep.2021.01.037