Parkinson's disease sleep scale—validation of the revised version PDSS‐2

Trenkwalder, Claudia; Kohnen, Ralf; Högl, Birgit; Metta, Vinod; Sixel‐Döring, Friederike; Frauscher, Birgit; Hülsmann, Julia; Martinez‐Martín, Pablo; Chaudhuri, K. Ray

doi:10.1002/mds.23476

Cited by 320 publications

(314 citation statements)

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“…Similarly to the original validation study 5 , we also observed high correlation between PDSS-2 and PDQ-39 Summary Index, an indicator of the contribution of sleep problems to impaired health-related quality of life. Similarly to the original PDSS-2 validation study, we also revealed low correlation between the PDSS-2 (nocturnal problems) with ESS (daytime sleepiness) and neurocognitive tests.…”

Section: Discussionsupporting

confidence: 81%

“…To overcome these disadvantages, a new scale, the Parkinson's Disease Sleep Scale 2 nd version (PDSS-2), was developed and published in 2011 5 . It is composed of 15 items evaluating three domains.…”

Section: Introductionmentioning

confidence: 99%

“…Each item has a 5 point Likert-type scale ranging from 0: "Never" to 4: "Very often" (except for item 1 which is reversed). Each domain consists of clusters of five questions (Motor symptoms at night: 4, 5, 6, 12 and 13; PD symptoms at night: 7, 9-11 and 15; and Disturbed sleep: 1-3, 8 and 14) 5 . Symptoms on each domain can be scored in the range of 0-20 points; whereas, the sum of the 15 responses gives the total score of PDSS-2 with the maximum value of 60 points and higher scores meaning more nocturnal disturbance.…”

Section: Introductionmentioning

confidence: 99%

“…Clinimetric properties of the scale were confirmed by factor analysis, internal consistency, test-retest reliability, convergent and discriminative validity, and precision analyses. Based on their findings, the authors stated that PDSS-2 was a reliable, valid, precise and potentially treatment-responsive tool for measuring sleep problems in PD 5 . Therefore, the usage of PDSS-2 is recommended for screening and grading the severity of sleep problems in PD 6 .…”

Section: Introductionmentioning

confidence: 99%

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Independent validation of Parkinson’s disease Sleep Scale 2nd version (PDSS-2)

Kovács

Horváth

Aschermann

et al. 2015

Sleep Biol. Rhythms

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Sleep problems are one of the most common non-motor symptoms of Parkinson's disease (PD). The Parkinson's disease Sleep Scale 2 nd version (PDSS-2) was published in 2011 showing satisfactory clinimetric results. We performed an independent testing of the scale adding further information on its clinimetric properties.In this nationwide study 537 PD patients were enrolled. Besides PDSS-2, we assessed Patient's Global Impression-Severity (PGI) scale on sleep disturbances, Non-motor Symptoms Scale and MDS-UPDRS.Following the Classical Theory of Tests we performed descriptive data analysis, factor analysis, reliability, validity and precision measurements. Subsequently, we evaluated cut-off value for detecting clinically meaningful sleep problems based on receiver operating characteristics analysis.Based on the PGI scale, 161 patients (30.0%) did not reported any sleep problems. Factor analysis revealed almost the same factor structure described by the original PDSS-2 validation study. Cronbach's alpha was 0.863 and all item had good item-total correlation. PDSS-2 demonstrated high convergent validity with Non-Motor Symptoms Scale and Clinical Global Impression-Severity and non-motor part of MDS-UPDRS, and divergent validity with age, gender, education-level, disease-duration and Hoehn-Yahr Stages.Presence of sleep problems was identified by scores >10.5 points on PDSS-2 (sensitivity: 85.3%, specificity: 60.8%, diagnostic accuracy: 78.1%); whereas scores >19.5 points indicated marked sleep-related problems (specificity: 68.5%, sensitivity: 78.0%, diagnostic accuracy: 74.3%).Independent and cross-cultural validation of patient reported outcomes is essential to confirm or reject the findings obtained by the developers of the scale. Our results demonstrate that fundamental clinimetric properties of the PDSS-2 are satisfactory.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Independent validation of Parkinson’s disease Sleep Scale 2nd version (PDSS-2)

Kovács

Horváth

Aschermann

et al. 2015

Sleep Biol. Rhythms

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“…Frequently used scales for assessment of sleep disorders include the Parkinson Disease Sleep Scale (PDSS) 4 , Parkinson Disease Sleep Scale -2 (PDSS-2) 5 , Scales for Outcomes in PD-Sleep (SCOPA-Sleep scale) 6 , Epworth Sleepiness Scale (ESS) 7 and the Pittsburgh sleep quality index (PSQI) 8 . Clinical evaluation may be not enough to accurately diagnose sleep disorders.…”

mentioning

confidence: 99%

Prevalence and correlates of sleep disorders in Parkinson’s disease: a polysomnographic study

Alatriste-Booth

Rodríguez-Violante

Camacho-Ordóñez

et al. 2015

Arq. Neuro-Psiquiatr.

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Objective: Sleep disorders in Parkinson's disease are very common. Polysomnography (PSG) is considered the gold standard for diagnosis. The aim of the present study is to assess the prevalence of nocturnal sleep disorders diagnosed by polysomnography and to determine the associated clinical factors. Method: A total of 120 patients with Parkinson's disease were included. All patients underwent a standardized overnight, single night polysomnography. Results: Ninety-four (78.3%) patients had an abnormal PSG. Half of the patients fulfilled criteria for sleep apnea-hypopnea syndrome (SAHS); rapid eye movement behavior disorder (RBD) was present in 37.5%. Characteristics associated with SAHS were age (p = 0.049) and body mass index (p = 0.016). Regarding RBD, age (p , 0.001), left motor onset (p = 0.047) and levodopa equivalent dose (p = 0.002) were the main predictors. Conclusion: SAHS and RBD were the most frequent sleep disorders. Higher levodopa equivalent dose and body mass index appear to be risk factors for RBD and SAHS, respectively.Keywords: Parkinson's disease, sleep disorders, polysomnography. RESUMOObjetivo: Os distúrbios do sono na doença de Parkinson são muito comuns. A polissonografia é considerada o padrão-ouro para o diagnóstico. O objetivo do presente estudo é avaliar a prevalência de distúrbios de sono noturno diagnosticados por polissonografia. Método: 120 pacientes com doença de Parkinson foram incluídos. Todos os pacientes foram submetidos a uma única noite, polissonografia de noite. Resultados: 94 (78,3%) pacientes tiveram uma polissonografia anormal e 50% preencheram a síndrome da apneia e hipopneia do sono (SAHOS); distúrbio de comportamento do movimento rápido dos olhos (RBD) esteve presente em 37,5%. As características associadas com SAHOS foram idade (p = 0,049) e índice de massa corporal (p = 0,016). Quanto RBD, idade (p , 0,001), deixou início motor (p = 0,047) e levodopa dose equivalente (p = 0,002) foram os preditores. Conclusão: SAHOS e RBD foram os distúrbios do sono mais frequente. Dose superior equivalente de levodopa e índice de massa corporal parecem ser fatores de risco, respectivamente.Palavras-chave: doença de Parkinson, distúrbios do sono, polissonografia.

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Sodium Oxybate for Excessive Daytime Sleepiness and Sleep Disturbance in Parkinson Disease

et al. 2018

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IMPORTANCE Sleep-wake disorders are a common and debilitating nonmotor manifestation of Parkinson disease (PD), but treatment options are scarce.OBJECTIVE To determine whether nocturnal administration of sodium oxybate, a first-line treatment in narcolepsy, is effective and safe for excessive daytime sleepiness (EDS) and disturbed nighttime sleep in patients with PD. DESIGN, SETTING, AND PARTICIPANTS Randomized, double-blind, placebo-controlled, crossover phase 2a study carried out between January 9, 2015, and February 24, 2017. In a single-center study in the sleep laboratory at the University Hospital Zurich, Zurich, Switzerland, 18 patients with PD and EDS (Epworth Sleepiness Scale [ESS] score >10) were screened in the sleep laboratory. Five patients were excluded owing to the polysomnographic diagnosis of sleep apnea and 1 patient withdrew consent. Thus, 12 patients were randomized to a treatment sequence (sodium oxybate followed by placebo or placebo followed by sodium oxybate, ratio 1:1) and, after dropout of 1 patient owing to an unrelated adverse event during the washout period, 11 patients completed the study. Two patients developed obstructive sleep apnea during sodium oxybate treatment (1 was the dropout) and were excluded from the per-protocol analysis (n = 10) but included in the intention-to-treat analysis (n = 12).INTERVENTIONS Nocturnal sodium oxybate and placebo taken at bedtime and 2.5 to 4.0 hours later with an individually titrated dose between 3.0 and 9.0 g per night for 6 weeks with a 2-to 4-week washout period interposed. MAIN OUTCOMES AND MEASURESPrimary outcome measure was change of objective EDS as electrophysiologically measured by mean sleep latency in the Multiple Sleep Latency Test. Secondary outcome measures included change of subjective EDS (ESS), sleep quality (Parkinson Disease Sleep Scale-2), and objective variables of nighttime sleep (polysomnography).RESULTS Among 12 patients in the intention-to-treat population (10 men, 2 women; mean [SD] age, 62 [11.1] years; disease duration, 8.4 [4.6] years), sodium oxybate substantially improved EDS as measured objectively (mean sleep latency, +2.9 minutes; 95% CI, 2.1 to 3.8 minutes; P = .002) and subjectively (ESS score, −4.2 points ; 95% CI, −5.3 to −3.0 points; P = .001). Thereby, 8 (67%) patients exhibited an electrophysiologically defined positive treatment response. Moreover, sodium oxybate significantly enhanced subjective sleep quality and objectively measured slow-wave sleep duration (+72.7 minutes; 95% CI, 55.7 to 89.7 minutes; P < .001). Differences were more pronounced in the per-protocol analysis. Sodium oxybate was generally well tolerated under dose adjustments (no treatment-related dropouts), but it induced de novo obstructive sleep apnea in 2 patients and parasomnia in 1 patient, as detected by polysomnography, all of whom did not benefit from sodium oxybate treatment. CONCLUSIONS AND RELEVANCEThis study provides class I evidence for the efficacy of sodium oxybate in treating EDS and nocturnal sleep disturbance in patie...

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Parkinson's disease sleep scale—validation of the revised version PDSS‐2

Abstract: The PDSS-2, with an extended spectrum of nocturnal disabilities and easier use for patients, is a reliable, valid, precise, and potentially treatment-responsive tool for measuring sleep disorders in PD.

Cited by 320 publications

References 38 publications

Independent validation of Parkinson’s disease Sleep Scale 2nd version (PDSS-2)

Independent validation of Parkinson’s disease Sleep Scale 2nd version (PDSS-2)

Prevalence and correlates of sleep disorders in Parkinson’s disease: a polysomnographic study

Sodium Oxybate for Excessive Daytime Sleepiness and Sleep Disturbance in Parkinson Disease

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