A scale for assessing the severity of arousal disorders.
BACKGROUND
Arousal disorders may have serious health consequences.


OBJECTIVE
To develop a scale assessing the severity of arousal disorders (Paris Arousal Disorders Severity Scale, PADSS).


METHODS
University hospital.


METHODS
Controlled study.


METHODS
Consecutive patients (older than 15 y), with sleepwalking (SW) and/or sleep terrors (ST), subjects with previous SW/ST, normal controls and patients with rapid eye movement sleep behavior disorder.


METHODS
The self-rated scale listed 17 parasomniac behaviors (PADSS-A), assessed their frequency from never to twice or more per night (PADSS-B) and evaluated the consequences (PADSS-C: disturbed sleep, injuries, fatigue, and psychological consequences). The clinimetric properties and face validity of the scale were tested.


RESULTS
Half of the 73 patients with SW/ST (more men than women) had injured themselves or others, whereas 15% had concomitant sexsomnia and 23% had amnestic eating behaviors. The total PADSS score (range: 0-50) was 19.4 ± 6.3 (range: 8-36) in this group, 11.7 ± 5.9 in 26 subjects with previous SW/ST, 8.8 ± 3.2 in 26 patients with RBD, and 2.0 ± 3.5 in 53 normal controls (P < 0.05). The PADSS demonstrated high sensitivity (83.6%), specificity (87.8%), internal consistency, and test-retest reliability (0.79). The best cutoff for the total score was at 13/14. Exploratory factor analysis revealed two components: wandering and violence/handling. The complexity of behaviors emerging from N3 sleep (scored on videopolysomnography) positively correlated with scores for the PADSS-total, PADSS-A, PADSS-C, and the "violence/handling" factor.


CONCLUSIONS
This scale had reasonable psychometric properties and could be used for screening and stratifying patients and for evaluating the effects of treatments.
Sleep Disorder Unit, Pitié-Salpêtrière Hospital, Centre de Recherche de l'Institut du Cerveau et de la Moëlle épinière - Pierre and Marie Curie University; Inserm UMR_S 975; CNRS UMR 7225, Paris, France.
Isabelle
I
Arnulf
Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Mental Health Centre, Guangzhou 510120, China.
Bin
B
Zhang
Sleep Disorder Unit, Pitié-Salpêtrière Hospital, Centre de Recherche de l'Institut du Cerveau et de la Moëlle épinière - Pierre and Marie Curie University; Inserm UMR_S 975; CNRS UMR 7225, Paris, France.
Ginevra
G
Uguccioni
Sleep Disorder Unit, Pitié-Salpêtrière Hospital, Centre de Recherche de l'Institut du Cerveau et de la Moëlle épinière - Pierre and Marie Curie University; Inserm UMR_S 975; CNRS UMR 7225, Paris, France.
Mathilde
M
Flamand
Sleep Disorder Unit, Pitié-Salpêtrière Hospital, Centre de Recherche de l'Institut du Cerveau et de la Moëlle épinière - Pierre and Marie Curie University; Inserm UMR_S 975; CNRS UMR 7225, Paris, France.
Alix
A
Noël de Fontréaux
Sleep Disorder Unit, Pitié-Salpêtrière Hospital, Centre de Recherche de l'Institut du Cerveau et de la Moëlle épinière - Pierre and Marie Curie University; Inserm UMR_S 975; CNRS UMR 7225, Paris, France.
Smaranda
S
Leu-Semenescu
Sleep Disorder Unit, Pitié-Salpêtrière Hospital, Centre de Recherche de l'Institut du Cerveau et de la Moëlle épinière - Pierre and Marie Curie University; Inserm UMR_S 975; CNRS UMR 7225, Paris, France.
Agnès
A
Brion
D000293:Adolescent; D000328:Adult; D005163:Factor Analysis, Statistical; D005221:Fatigue / Q000150:complications; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D020184:Night Terrors / Q000175:diagnosis* / Q000523:psychology*; D011594:Psychometrics / Q000379:methods*; D020187:REM Sleep Behavior Disorder / Q000175:diagnosis / Q000523:psychology; D015203:Reproducibility of Results; D057566:Self Report; D012890:Sleep; D013009:Somnambulism / Q000175:diagnosis* / Q000523:psychology*; D014754:Violence; D055815:Young Adult
Arousal disorders; confusional arousal; parasomnia; sexsomnia; sleep related eating disorder; sleep terror; sleepwalking