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Chen PY, Kuo TM, Chen SH, Huang HC, Chen TJ, Wang TH, Wang HL, Chiu HY. Psychometric properties and structural validity of traditional Chinese version of the Richards-Campbell Sleep Questionnaire in intensive care unit patients without physical restraint. Aust Crit Care 2024:S1036-7314(23)00194-7. [PMID: 38182530 DOI: 10.1016/j.aucc.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/15/2023] [Accepted: 11/17/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Sleep assessment in the intensive care unit (ICU) is difficult and often unreliable. The most commonly used questionnaire for assessing ICU sleep, the Richards-Campbell Sleep Scale (RCSQ), has not been tested for reliability and construct validity in the Mandarin-Taiwanese speaking population. OBJECTIVE The objective of this study was to test the construct validity and criterion validity of the traditional Chinese version of RCSQ (TC-RCSQ) in critically ill patients without physical restraint. METHODS We adopted a cross-sectional study design. Adults aged 20 years and above were recruited from a plastic surgery ICU of a medical center. The Cronbach's alpha was used to test internal consistency; the validity testing included content validity, criterion validity, and construct validity. Criterion validity was analysed by testing the association of TC-RCSQ with the Chinese version of Verran and Snyder-Halpern Sleep Questionnaire and sleep parameter of actigraphy using the Pearson correlation coefficient; construct validity was analysed using exploratory factor analysis. RESULTS A total of 100 patients were included with a mean age of 49.78 years. Internal consistency reliability suggested Cronbach's alpha of 0.93. Moderate to strong correlations of TC-RCSQ with Verran-Snyder-Halpern Sleep Questionnaire were identified (r = 0.36 to 0.80, P < 0.05). We found significant correlations of actigraphic sleep efficiency with difficulty of falling sleep, awakening times, sleep quality, and total score of the TC-RCSQ (r = 0.23, 0.23, 0.20, and 0.23, P < 0.05). One factor (named as overall sleep quality) was extracted by exploratory factor analysis with a total variance explained of 78.40 %, which had good construction validity. CONCLUSIONS The TC-RCSQ yields satisfactory reliability and validity in critically ill patients. Actigraphic sleep efficiency may be a single index for objectively sleep assessment of sleep quality in patients without physical restraint. Both the TC-RCSQ and actigraphy can aid nurses to evaluate the sleep quality in critically ill patients without physical restraint.
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Affiliation(s)
- Pin-Yuan Chen
- Department of Neurosurgery, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan; School of Medicine, College of Medicine, Chang-Gung University, Taoyuan, Taiwan
| | - Tsui-Mien Kuo
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shih-Heng Chen
- Department of Plastic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Hui-Chuan Huang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Ting-Jhen Chen
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Ave, Wollongong, NSW 2522, Australia
| | - Tzu-Hao Wang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Hsiang-Ling Wang
- Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan
| | - Hsiao-Yean Chiu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan; Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Research Center of Sleep Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
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Wachinou AP, Fiogbe AA, Totah T, Salanon E, Solelhac G, Berger M, Haba-Rubio J, Amidou S, Agodokpessi G, Houinato D, Heinzer R. PERFORMANCE OF SIX SCREENING SCORES FOR OBSTRUCTIVE SLEEP APNOEA IN AN AFRICAN POPULATION. West Afr J Med 2023; 40:S38-S39. [PMID: 38071469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Introduction A screening tool for obstructive sleep apnoea (OSA) is useful in low-income countries where it may be difficult to access sleep recordings. The objective of this study was to assess the performance of six screening scores compared with objective sleep recording in an African population sample. Methods This analysis is based on the "Benin Sleep and Society" (BeSAS) populational study in which respiratory polygraphy (PG) was performed using a type III device and OSA screening questionnaires (STOP, STOP-Bang, Berlin, NOSAS [≥ 8 and ≥ 5), No-Apnea, GOAL) were administered to participants. PG-defined OSA severity categories were defined according to the apnoea-hypopnoea index (AHI): mild (AHI 5 to <15/h), moderate (AHI 15 to <30/h) or severe (AHI≥30/h), and these were compared to score findings. Results A total of 1810 subjects (mean age 45.4±14.6 years; 57.3% women) were included. For moderate to severe OSA, the area under the receiving operating characteristic (ROC) curve was greatest for GOAL and No-Apnea (0.70), followed by NoSAS5 (0.69). The highest sensitivity values were for NoSAS5 (0.73), No-Apnea (0.72), and GOAL (0.69), while NoSAS8 had the highest specificity (0.91), followed by Berlin (0.88) and GOAL (0.71). All scores performed poorly with respect to the positive predictive value (PPV), which was highest with NoSAS8 (0.38). Conclusion: This study provides the first comparison of the performance of screening scores for OSA in an African population. Although still low, PPV was highest with NoSAS8. Hence, NoSAS8 would be the screening method of choice for OSA in resource-constrained settings where formal sleep recordings are not accessible.
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Affiliation(s)
- A P Wachinou
- Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
- National Teaching Hospital for Tuberculosis and Pulmonary Diseases, Cotonou, Benin
- Laboratory of Epidemiology of Chronic and Neurologic Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - A A Fiogbe
- National Teaching Hospital for Tuberculosis and Pulmonary Diseases, Cotonou, Benin
| | - T Totah
- Laboratory of Epidemiology of Chronic and Neurologic Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - E Salanon
- Laboratory of Epidemiology of Chronic and Neurologic Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - G Solelhac
- Center of Investigation and Research on Sleep, Lausanne, Switzerland
| | - M Berger
- Center of Investigation and Research on Sleep, Lausanne, Switzerland
| | - J Haba-Rubio
- Center of Investigation and Research on Sleep, Lausanne, Switzerland
| | - S Amidou
- Laboratory of Epidemiology of Chronic and Neurologic Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - G Agodokpessi
- Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
- National Teaching Hospital for Tuberculosis and Pulmonary Diseases, Cotonou, Benin
| | - D Houinato
- Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
- Laboratory of Epidemiology of Chronic and Neurologic Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - R Heinzer
- Center of Investigation and Research on Sleep, Lausanne, Switzerland
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Puretić H, Bosnar Puretić M, Pavliša G, Jakopović M. Revisiting the Epworth sleepiness scale : Is excessive daytime sleepiness still a valid screening tool for obstructive sleep apnea in a population at risk? Wien Klin Wochenschr 2023:10.1007/s00508-023-02213-4. [PMID: 37273017 DOI: 10.1007/s00508-023-02213-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 04/20/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Obstructive sleep apnea (OSA) is a common medical problem with numerous comorbidities and high costs. Since the introduction of the Epworth sleepiness scale (ESS), excessive daytime sleepiness (EDS) has been considered the most common and prominent symptom of OSA. Aim of this study was to re-evaluate the ESS for detection of OSA in a population at risk compared to the gold standard overnight polysomnography (PSG). METHODS A total of 266 patients (mean age 57.9 ± 11.6 years; 189 men and 77 women), referred to our sleep laboratory for probable OSA, were given ESS followed by an overnight PSG. The ESS values were compared to PSG apnea hypopnea index (AHI) with sensitivity (SE), specificity (SP), positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy (DA) calculated for ESS. The positive cut-off value for ESS was ≥ 10 and for AHI ≥ 5. RESULTS Only 92 (34.6%) subjects had a positive ESS. An OSA was diagnosed by PSG in 213 (80.1%) subjects: 46 having mild, 37 moderate and 130 severe apnea. Most subjects with positive ESS (88.0%) were found to have OSA but most subjects with a negative ESS (75.9%) were also positive for OSA (42% with AHI ≥ 30). The area under the receiver operating characteristic (ROC) curve for ESS was 0.60 (95% confidence interval, CI 0.54-0.66; p = 0.020) with SE 38.0%, SP 79.3%, PPV 88.0%, NPV 24.1% and DA 46.2%. CONCLUSION It was found that excessive daytime sleepiness, measured by ESS, is not a valuable screening tool for OSA, especially when the test is negative. Other screening tests that involve additional parameters, beside daytime sleepiness alone, should be considered.
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Affiliation(s)
- Hrvoje Puretić
- University Department of Pulmonology, University Hospital Centre Zagreb, Zagreb, Croatia.
- Laboratory for sleep-related breathing disorders, University Department of Pulmonology, University Hospital Centre Zagreb, Jordanovac 104, Zagreb, 10000, Croatia.
| | - Marijana Bosnar Puretić
- University Department of Neurology , Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
- Faculty of Education and Rehabilitation Sciences , University of Zagreb, Zagreb, Croatia
| | - Gordana Pavliša
- University Department of Pulmonology, University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Marko Jakopović
- University Department of Pulmonology, University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
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Kundermann B, Müller MJ, Speier C, Cabanel N. [Sleep in patients of a memory clinic : Clinical characteristics of the discrepancy between subjective and objective assessment]. Z Gerontol Geriatr 2022; 55:680-688. [PMID: 34609633 DOI: 10.1007/s00391-021-01977-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 09/09/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Dementia is often accompanied by sleep disturbances, whereby the diagnostics with subjective procedures and objective methods can produce discrepant results. The frequency and clinical characteristics of patients, whose subjective sleep efficiency was unimpaired and was in contrast to an objectively conspicuous sleep efficiency in the sense of an overestimation, were investigated in a memory consultation. METHODS On 2 consecutive days, patients underwent guideline-oriented diagnostics for dementia (including mini-mental status examination, MMSE and clinical dementia rating, CDR), supplemented by a subjective (Pittsburgh sleep quality index, PSQI) and objective (overnight actigraphy) sleep assessment. Overestimation of sleep efficiency was defined as a subjective sleep efficiency (SSE) of ≥85% with an actigraphic sleep efficiency (ASE) of <85%. RESULTS Of 45 patients (74.4 ± 7.8 years; 26 f/19 m; CDR < 1: n = 16, CDR = 1: n = 28; diagnostic groups according to ICD-10: F0: n = 39, F3: n = 5, Z03.x: n = 1) 10 showed an overestimation of sleep efficiency, who showed a lower MMSE score and a higher proportion of patients with a dementia syndrome (CDR = 1) when compared with the other three groups of SSE and ASE ≥85% (n = 17), SSE and ASE <85% (n = 9) and SSE <85% with ASE ≥85% (n = 9). Binary regression showed that MMSE remained an important predictor for overestimation of sleep efficiency. CONCLUSION Cognitive deficits in memory clinic patients appear to contribute to a poorer perception and/or an underreporting of objectively disturbed sleep. This could promote false negative subjective screening results in a diagnostic process in which a comprehensive sleep assessment is not routinely considered.
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Affiliation(s)
- B Kundermann
- Vitos Klinik für Psychiatrie und Psychotherapie Gießen, Akademisches Lehrkrankenhaus, Justus-Liebig-Universität Gießen, Licher Str. 106, 35394, Gießen, Deutschland.
- Klinik für Psychiatrie und Psychotherapie, Philipps-Universität Marburg, Marburg, Deutschland.
| | - M J Müller
- Oberberg Gruppe, Berlin, Deutschland
- Fachbereich Medizin, Justus-Liebig-Universität Gießen, Gießen, Deutschland
| | - C Speier
- Vitos Klinik für Psychiatrie und Psychotherapie Gießen, Akademisches Lehrkrankenhaus, Justus-Liebig-Universität Gießen, Licher Str. 106, 35394, Gießen, Deutschland
| | - N Cabanel
- Klinik für Psychiatrie und Psychotherapie, Philipps-Universität Marburg, Marburg, Deutschland
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Li L, Sheehan CM, Valiente C, Eisenberg N, Doane LD, Spinrad TL, Johns SK, Diaz A, Berger RH, Southworth J. Similarities and differences between actigraphy and parent-reported sleep in a Hispanic and non-Hispanic White sample. Sleep Med 2021; 83:160-167. [PMID: 34022492 DOI: 10.1016/j.sleep.2021.04.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/25/2021] [Accepted: 04/26/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Despite concerns about the inaccuracy of parents' reports of children's sleep, it remains unclear whether the bias of parents' reports varies across racial/ethnic groups. To address this limitation, the current study systematically investigated the concordance among parent-reported sleep questionnaires, sleep diaries, and actigraphy-based sleep in a sample of Hispanic and non-Hispanic White children. METHODS Parents of 51 Hispanic and 38 non-Hispanic White children (N = 89; Mage = 6.46, SD = 0.62; 50.6% male) reported their child's bedtime and wake time on school days using sleep diaries and questionnaires. Children's sleep also was assessed with actigraphy for five consecutive school days. RESULTS Parents reported longer sleep duration, earlier bedtime, and later wake time using sleep diaries and questionnaires compared to actigraphy-based assessments. Larger discrepancies between diaries and actigraphy of sleep duration, and between questionnaires and actigraphy of wake time were found in non-Hispanic White children, compared to Hispanic children. CONCLUSIONS Although parents tended to overestimate their child's sleep as compared to actigraphy, parents of Hispanic children may be more accurate in some estimates of children's sleep than parents of non-Hispanic White children. Researchers, clinicians, and parents should be aware of the potential biases in parents' reports and estimates of their child's sleep and that the degree of bias could vary across racial/ethnic groups.
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Affiliation(s)
- Longfeng Li
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, USA
| | - Connor M Sheehan
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, USA
| | - Carlos Valiente
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, USA.
| | - Nancy Eisenberg
- Department of Psychology, Arizona State University, Tempe, USA
| | - Leah D Doane
- Department of Psychology, Arizona State University, Tempe, USA
| | - Tracy L Spinrad
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, USA
| | - Sarah K Johns
- Department of Psychology, Arizona State University, Tempe, USA
| | - Anjolii Diaz
- Department of Psychological Science, Ball State University, Muncie, USA
| | - Rebecca H Berger
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, USA; NORC at the University of Chicago, USA
| | - Jody Southworth
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, USA
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Abstract
Sleep affects physiologic and psychological recovery throughout critical illness. Patients often describe poor sleep as a major source of distress while hospitalized in an intensive care unit. The intensive care unit environment poses unique challenges for sleep assessment and monitoring. The purpose of this literature review is to discuss methods of assessment and monitoring of sleep within the intensive care unit setting. The advantages and disadvantages of physiologic monitoring of sleep (eg, polysomnography, bispectral index, and actigraphy) are compared with those of subjective measures of sleep quality (eg, validated patient-oriented sleep questionnaires, and informal nursing assessments).
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Liu J, Wu Y, Wu P, Xu Z, Ni X. Analysis of the impact of allergic rhinitis on the children with sleep disordered breathing. Int J Pediatr Otorhinolaryngol 2020; 138:110380. [PMID: 33152971 DOI: 10.1016/j.ijporl.2020.110380] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/09/2020] [Accepted: 09/09/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES We assessed the influence of allergic rhinitis (AR) on sleep disordered breathing (SDB) in children with adenotonsillar hypertrophy (ATH), and compared sleep quality and polysomnographic data in habitually snoring children with or without AR. METHODS Children with snoring resulting from adenoid/tonsils hypertrophy were recruited between Jan 1st, 2018 and Jun 30th, 2018. The exclusion criteria were congenital disorders, metabolic disorders, neurological disorders and pulmonary diseases, such as, asthma etc. Overnight polysomnography (PSG) and Sleep Questionnaire (SQ) were assessed on each participant to identify children with obstructive sleep apnea (OSA). Cross-sectional study design was used to examine PSG and SQ data. The diagnosis of AR was based upon history of allergies and positive clinical examinations, then confirmed by allergen test. Participants were categorized into four groups (AR and Non-OSA group; AR and OSA group; Non-AR and Non-OSA group; Non-AR and OSA group). Non-parametric rank sum test was used for statistical analysis. RESULTS Six hundred and sixty children (age between 3yrs and 14yrs) with SDB were enrolled in the study (mean age 6.7 ± 2.1yrs, 67.4% male). The number of children diagnosed with OSA was 495 (74.3%). The prevalence of AR among all participating SDB children was 25.8%, and AR with OSA was19.4%. The behavioral problems scores in SQ showed significant difference among SDB children with AR (P<.0001). No difference was observed in the OAHI (obstructive apnea-hypopnea index) and AHI (apnea-hypopnea index) between the groups of children with and without AR regardless whether OSA was coexisting. The percentage of time spent in the rapid eye movement (REM) sleep stage was shortened among children with AR without OSA (P = 0.031), however, the percentage of time spent in the REM sleep stage was not different among children with OSA (P = 0.98). The total sleep time was shorter among children with AR (OSA P = 0.02; without OSA P = 0.03). CONCLUSIONS Despite the high prevalence of AR in patients with SDB, AR is not an aggravating factor for the severity of AHI. High risk behavioral problems link to SDB with AR. AR is associated with shortened REM sleep stage in children with SDB without sleep apnea, and shortened total sleep time in children with SDB.
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Affiliation(s)
- Jianhui Liu
- Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, People's Republic of China
| | - Yunxiao Wu
- Beijing Key Laboratory of Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, People's Republic of China
| | - Panting Wu
- Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, People's Republic of China
| | - Zhifei Xu
- Department of Respiratory Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, People's Republic of China.
| | - Xin Ni
- Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, People's Republic of China.
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Shteinberg YH, Eisenbach N, Sela E, Gruber M, Ronen O. Translation and cultural adaptation of the Hebrew version of the Pediatric Sleep Questionnaire: a prospective, non-randomized control trial. Sleep Breath 2020; 25:399-410. [PMID: 32394315 DOI: 10.1007/s11325-020-02073-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/09/2020] [Accepted: 03/23/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Left untreated, obstructive sleep-disordered breathing (OSDB) are associated with adverse effects on growth and development. History and physical examination alone are used for diagnosing children with OSDB, as polysomnography is not always feasible. Our objective was to develop and validate a Hebrew version of the Pediatric Sleep Questionnaire (PSQ) to help to diagnose and follow-up children before and after adenotonsillectomy surgery for OSDB. METHODS We conducted a prospective, nonrandomized, controlled trial in an academic medical center. We enrolled parents of children younger than 5 years of age planned for tonsillectomy with or without adenoidectomy due to obstructive airway indication. The parents completed the validated Hebrew version of PSQ questionnaire before and after surgery. We translated the questionnaire through forward-backward translation method. Our main outcome measures were reliability, validity, and responsiveness of the Hebrew version of PSQ. RESULTS Overall, 45 parents of children with OSDB and 34 controls filled out the questionnaires. We found significant differences between the PSQ scores before and after surgery (p < 0.001). The Hebrew version of PSQ results after surgery were similar to those of the control group (p = 0.206), as expected. We found high reliability of the Hebrew version of PSQ before surgery (α = 0.931). The translated PSQ had a high specificity (87.9%) and sensitivity (77.3%) to identify children with OSDB. CONCLUSION The Hebrew version of the validated PSQ for parents to children with OSDB can be used as a reliable screening and diagnostic tool to identify children suffering from OSDB, when polysomnography is not feasible.
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Affiliation(s)
| | - Netanel Eisenbach
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.,Department of Otolaryngology - Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel
| | - Eyal Sela
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.,Department of Otolaryngology - Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel
| | - Maayan Gruber
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.,Department of Otolaryngology - Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel
| | - Ohad Ronen
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel. .,Department of Otolaryngology - Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel.
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Steur LMH, Grootenhuis MA, Terwee CB, Pillen S, Wolters NGJ, Kaspers GJL, van Litsenburg RRL. Psychometric properties and norm scores of the sleep self report in Dutch children. Health Qual Life Outcomes 2019; 17:15. [PMID: 30651118 PMCID: PMC6335798 DOI: 10.1186/s12955-018-1073-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 12/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Psychometrically robust questionnaires to assess self-reported sleep problems in children are important since sleep problems can have a major impact on child development. The Sleep Self Report (SSR) is a 26-item self-report tool measuring different sleep domains in children aged 7-12 years. This study aims to evaluate the psychometric properties of the SSR and to provide Dutch norm scores. METHODS Children aged 7-12 years from the general population were recruited through a professional market research agency. In this population, structural validity was assessed with confirmatory and exploratory factor analyses, internal consistency was assessed with the Cronbach's alpha coefficient and norm scores were provided. Additionally, children attending outpatient sleep clinics (clinical population) were invited to participate. SSR scores of the general population and the clinical population were compared to establish discriminative validity. RESULTS In total, 619 children (mean age: 9.94 ± 1.72 years) from the general population and 34 children (mean age: 9.21 ± 1.63 years) from sleep clinics participated. The 1-factor structure of the SSR was not confirmed with factor analysis. Exploratory analyses did also not yield an appropriate multidimensional structure. Internal consistency of the total score was adequate (Cronbach's alpha: 0.76). The total score distinguished the clinical population from the general population (39.07 ± 5.31 versus 31.61 ± 5.31; P < 0.01). CONCLUSIONS An appropriate structure of the SSR was not found with factor analyses in this Dutch population. The adequate internal consistency indicates that the total score can be interpreted as a measure of overall sleep problems. The SSR also shows good discriminative validity. We recommend the total score to assess overall sleep problems and item scores to evaluate specific sleep issues and to follow up children's sleep longitudinally, as opposite changes in different item scores may not reflect in the total score. Further research on the development of multidimensional psychometrically sound pediatric sleep self-reports is of major importance.
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Affiliation(s)
- L M H Steur
- Department of Pediatric Oncology, Amsterdam UMC, Emma Children's Hospital, Vrije Universiteit, PO BOX 7057, 1007 MB, Amsterdam, The Netherlands
| | - M A Grootenhuis
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584, CS, Utrecht, The Netherlands
| | - C B Terwee
- Department of Epidemiology and Biostatistics and the Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, PO BOX 7057, 1007 MB, Amsterdam, The Netherlands
| | - S Pillen
- Center for Sleep Medicine, Kempenhaeghe, PO BOX 61, 5590 AB, Heeze, The Netherlands
| | - N G J Wolters
- Department of Pediatrics, Center for Sleep Medicine ZGT, PO BOX 546, 7550 AM, Hengelo, The Netherlands
| | - G J L Kaspers
- Department of Pediatric Oncology, Amsterdam UMC, Emma Children's Hospital, Vrije Universiteit, PO BOX 7057, 1007 MB, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584, CS, Utrecht, The Netherlands
| | - R R L van Litsenburg
- Department of Pediatric Oncology, Amsterdam UMC, Emma Children's Hospital, Vrije Universiteit, PO BOX 7057, 1007 MB, Amsterdam, The Netherlands. .,Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584, CS, Utrecht, The Netherlands.
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Dias CC, Figueiredo B, Pinto TM. Children's Sleep Habits Questionnaire - Infant Version. J Pediatr (Rio J) 2018; 94:146-154. [PMID: 28842258 DOI: 10.1016/j.jped.2017.05.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 02/15/2017] [Accepted: 03/06/2017] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES This study proposed a version of the Children's Sleep Habits Questionnaire for infants under 12 months (CSHQ-I). METHODS The sample was comprised of 299 infants, aged between 2 weeks and 12 months. RESULTS Exploratory factor analysis revealed four subscales: Bedtime Resistance, Sleep Anxiety, Positive Sleep Habits, and Daytime Sleepiness. The CSHQ-I total scale presented good test-retest reliability and internal consistency. The CSHQ-I also showed good concurrent validity, with significant associations found between the CSHQ-I total scale and subscales and a measure of infant sleep-wake behaviors. CONCLUSIONS The present study suggested the CSHQ-I as a reliable instrument to assess sleep problems in infants during the first year of life.
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Okada M, Kitamura S, Iwadare Y, Tachimori H, Kamei Y, Higuchi S, Mishima K. Reliability and validity of a brief sleep questionnaire for children in Japan. J Physiol Anthropol 2017; 36:35. [PMID: 28915845 PMCID: PMC5602844 DOI: 10.1186/s40101-017-0151-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 09/07/2017] [Indexed: 11/13/2022] Open
Abstract
Background There is a dearth of sleep questionnaires with few items and confirmed reliability and validity that can be used for the early detection of sleep problems in children. The aim of this study was to develop a questionnaire with few items and assess its reliability and validity in both children at high risk of sleep disorders and a community population. Methods Data for analysis were derived from two populations targeted by the Children’s Sleep Habits Questionnaire (CSHQ): 178 children attending elementary school and 432 children who visited a pediatric psychiatric hospital (aged 6–12 years). The new questionnaire was constructed as a subset of the CSHQ. Results The newly developed short version of the sleep questionnaire for children (19 items) had an acceptable internal consistency (0.65). Using the cutoff value of the CSHQ, the total score of the new questionnaire was confirmed to have discriminant validity (27.2 ± 3.9 vs. 22.0 ± 2.1, p < 0.001) and yielded a sensitivity of 0.83 and specificity of 0.78 by receiver operator characteristic curve analysis. Total score of the new questionnaire was significantly correlated with total score (r = 0.81, p < 0.001) and each subscale score (r = 0.29–0.65, p < 0.001) of the CSHQ. Conclusions The new questionnaire demonstrated an adequate reliability and validity in both high-risk children and a community population, as well as similar screening ability to the CSHQ. It could thus be a convenient instrument to detect sleep problems in children.
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Affiliation(s)
- Masakazu Okada
- Department of Kansei Science, Graduate School of Integrated Frontier Science, Kyushu University, 4-9-1 Shiobaru, Minami-ku, Fukuoka, 815-8540, Japan
| | - Shingo Kitamura
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan.
| | - Yoshitaka Iwadare
- Department of Child and Adolescent Psychiatry, National Center of Global Health and Medicine, Kohnodai Hospital, 1-7-1 Kohnodai, Ichikawa, Chiba, 272-8516, Japan
| | - Hisateru Tachimori
- Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, 187-8553, Japan
| | - Yuichi Kamei
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
| | - Shigekazu Higuchi
- Department of Human Science, Faculty of Design, Kyushu University, 4-9-1 Shiobaru, Minami-ku, Fukuoka, 815-8540, Japan
| | - Kazuo Mishima
- Department of Psychophysiology, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
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Scullin MK, Harrison TL, Factor SA, Bliwise DL. A Neurodegenerative Disease Sleep Questionnaire: principal component analysis in Parkinson's disease. J Neurol Sci 2014; 336:243-6. [PMID: 24074551 PMCID: PMC3947083 DOI: 10.1016/j.jns.2013.09.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 08/07/2013] [Accepted: 09/05/2013] [Indexed: 11/24/2022]
Abstract
Sleep disturbances are common in many neurodegenerative diseases and may include altered sleep duration, fragmented sleep, nocturia, excessive daytime sleepiness, and vivid dreaming experiences, with occasional parasomnias. Although representing the "gold standard," polysomnography is not always cost-effective or available for measuring sleep disturbance, particularly for screening. Although numerous sleep-related questionnaires exist, many focus on a specific sleep disturbance (e.g., restless legs, REM Behavior Disorder) and do not capture efficiently the variety of sleep issues experienced by such patients. We administered the 12-item Neurodegenerative Disease Sleep Questionnaire (NDSQ) and the Epworth Sleepiness Scale to 145 idiopathic Parkinson's disease patients. Principal component analysis using eigenvalues greater than 1 suggested five separate components: sleep quality (e.g., sleep fragmentation), nocturia, vivid dreams/nightmares, restless legs symptoms, and sleep-disordered breathing. These results demonstrate construct validity of our sleep questionnaire and suggest that the NDSQ may be a useful screening tool for sleep disturbances in at least some types of neurodegenerative disorders.
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Affiliation(s)
| | | | - Stewart A Factor
- Department of Neurology, Emory University School of Medicine, USA
| | - Donald L Bliwise
- Department of Neurology, Emory University School of Medicine, USA.
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