Validation of the Dutch translation of the Paris Arousal Disorders Severity Scale for non-REM parasomnias in a 1-year and 1-month version

Petra van Mierlo; Lieke W A Hermans; Isabelle Arnulf; Angelique Pijpers; Sebastiaan Overeem; Merel M van Gilst

doi:10.5664/jcsm.9830

Validation of the Dutch translation of the Paris Arousal Disorders Severity Scale for non-REM parasomnias in a 1-year and 1-month version

J Clin Sleep Med. 2022 Apr 1;18(4):1135-1143. doi: 10.5664/jcsm.9830.

Authors

Petra van Mierlo¹, Lieke W A Hermans², Isabelle Arnulf^{3

4}, Angelique Pijpers¹, Sebastiaan Overeem^{1

2}, Merel M van Gilst^{1

2}

Affiliations

¹ Sleep Medicine Center Kempenhaeghe, Heeze, The Netherlands.
² Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.
³ Sleep Disorder Unit, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.
⁴ Sorbonne University, and Paris Brain Institute (ICM), Paris, France.

Abstract

Study objectives: We created a Dutch version of the Paris Arousal Disorders Severity Scale (PADSS), which assesses non-rapid eye movement (NREM) parasomnia symptoms over the past year (PADSS-year). This questionnaire was previously validated in patients with sleep walking and/or sleep terrors (SW/ST). We validated the questionnaire in SW/ST patients, and in a broader population, including patients with confusional arousals, comorbidities, and medication users ("other NREM parasomnias"). Furthermore, we introduced a version covering the past month (PADSS-month), with the potential purpose of evaluating symptom evolution and treatment response.

Methods: We compared PADSS scores among 54 SW/ST patients, 34 age-matched controls, and 23 patients with other NREM parasomnias. We evaluated discriminative capacity, internal consistency, and construct validity. Furthermore, we assessed the test-retest reliability and treatment response of PADSS-month.

Results: Healthy controls scored significantly lower than both patient groups. We found an excellent diagnostic accuracy (area under the curve PADSS-year 0.990, PADSS-month 0.987) and an acceptable internal consistency. Exploratory factor analysis identified 3 components: "behaviors outside the bed," "behaviors in/around the bed," and "violent behaviors," with the former 2 factors reflecting the distinction between SW and ST. PADSS-month showed an acceptable test-retest reliability (0.75). Additionally, PADSS-month significantly decreased after pharmaceutical and/or behavioral treatment. This change was correlated with the clinical impression of the caregiver, implying that PADSS-month is sensitive to treatment effects.

Conclusions: The Dutch PADSS questionnaire can be used as a screening tool in a broad population of patients with NREM parasomnia, not only SW/ST. Furthermore, we validated a PADSS-month version to assess the evolution of symptoms and treatment effect.

Citation: van Mierlo P, Hermans L, Arnulf I, Pijpers A, Overeem S, van Gilst M. Validation of the Dutch translation of the Paris Arousal Disorders Severity Scale for non-REM parasomnias in a 1-year and 1-month version. J Clin Sleep Med. 2022;18(4):1135-1143.

Keywords: NREM parasomnia; sleep terror; sleepwalking.

MeSH terms

Arousal
Humans
Netherlands
Night Terrors* / diagnosis
Parasomnias* / diagnosis
Reproducibility of Results
Surveys and Questionnaires*
Translations