Abstract
Purpose
Disorders of arousal include confusional arousals, sleepwalking and sleep terrors. The diagnosis of disorders of arousal is based on the clinical criteria established in the International Classification of Sleep Disorders, third edition, although the interobserver reliability of these criteria has never been investigated. The aim of this study was to estimate the inter-rater reliability of the diagnostic criteria for disorders of arousal throughout the whole life in order to understand their feasibility in clinical daily activity and in multicenter observational studies.
Methods
Three raters interviewed 126 subjects (patients complaining of sleep disorders, headache, and healthy subjects), aged 18–80 years, with a standardized questionnaire created by applying the International Diagnostic Criteria for Disorders of Arousal.
Results
An “almost perfect” inter-rater reliability for disorders of arousal criteria and the final diagnosis was found among the raters (kappa 0.89 for confusional arousals, 0.87 for sleepwalking, and 0.87 for sleep terrors).
Conclusions
The International Classification of Sleep Disorders, Third Edition criteria are adequate for a reliable diagnosis of disorders of arousal. Further validation studies, confirming DOA diagnosis with video polysomnography, are needed to investigate the predictive value of ICSD-3 criteria.
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The authors wish to thank Cecilia Baroncini and Anne Collins for English editing.
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Dr. Loddo, Dr. Vignatelli, Dr. Zenesini, Dr. Lusa, Dr. Sambati, Dr. Baldelli, Dr. Favoni, Dr. Pisani, Dr. Pierangeli, Dr. Cevoli report no disclosures. Dr. Provini received honoraria for speaking engagements or consultancies from Sanofi, Bial, Fidia, Vanda Pharmaceutical, Zambon, Eisai Japan, Italfarmaco.
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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and national research committee (Bologna-Imola Ethics Committee, no. 17175) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Loddo, G., Vignatelli, L., Zenesini, C. et al. Interobserver reliability of ICSD-3 diagnostic criteria for disorders of arousal in adults. Sleep Breath 23, 1309–1314 (2019). https://doi.org/10.1007/s11325-019-01937-w
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DOI: https://doi.org/10.1007/s11325-019-01937-w