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Validation of the Hypersomnia Severity Index

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SLEEP, Volume 38, Abstract Supplement, 2015 A432
B. Clinical Sleep Science XIII. Instrumentation and Methodology
cantly different across groups. Given our group sizes, these analyses
could only detect large effect sizes (Cohen’s d = 0.77) and therefore
should be replicated in a larger sample.
Conclusion: In sum, parent-report sleep estimates were comparable
to videosomnography estimates and families (regardless of risk-status)
were adequate reporters of their child’s sleep. These findings support
the use of parent-report diaries in high-risk samples and have direct
clinical and research implications.
1217
ACCURACY OF THE ODDS-RATIO-
PRODUCT OBTAINED FROM FRONTAL
ELECTROENCEPHALOGRAPHY
Younes M
1
, Younes M
2
, Giannouli E
1
1
Sleep Disorders Centre, Misericordia Health Centre, University
of Manitoba, Winnipeg, MB, Canada,
2
YRT Ltd, Winnipeg, MB,
Canada
Introduction: Odds-Ratio-Product (ORP) is a recently introduced
continuous index of sleep state. It ranges from 0 to 2.5. In validation
studies an ORP2.0 was found in wakefulness. The ORP scale was
developed from central electroencephalography electrode signals. Be-
cause of its potential utility in home studies and the greater ease of
applying frontal electrodes in such studies we wondered if the ORP
derived from frontal electrodes agreed with values obtained from cen-
tral electrodes.
Methods: Forty-two clinical polysomnography records were digitally
analyzed to obtain ORP in consecutive 30-second epochs. Analysis
was performed once using C3/M2 and C4/M1 electrodes and again us-
ing F3/M2 and F4/M1 electrodes. Twenty-five studies showed a range
from mild to severe OSA, eleven had no pathology and four showed in-
somnia. Intra-class correlation was used to compare 30-second frontal
and central ORP values on the same side (700–900 data pairs per side
per record). Average ORP values across the whole record (ORPAVE)
were also compared.
Results: C4 and F3 electrodes were not used in one and 3 studies, re-
spectively, because of excessive beta noise. For the remaining 80 com-
parisons, ICCs averaged 0.93 ± 0.07 for C3 vs. F3 and 0.95 ± 0.05 for
C4 vs. F4. ORPAVE was 1.02 ± 0.36 in all four electrodes with a range
of 0.44 to 2.05, reflecting the range of overall sleep quality among pa-
tients. The difference between average ORP in the two electrodes be-
ing compared was 0.00 ± 0.11 for both C3 vs. F3 (n = 39) and C4 vs. F4
(n = 41) comparisons.
Conclusion: Odds-Ratio-Product measured from frontal electrodes is
nearly identical to that measured from central electrodes. This should
facilitate obtaining sleep information in home studies.
Support (If Any): YRT Ltd
1218
VALIDATION OF THE HYPERSOMNIA SEVERITY
INDEX (HSI)
Kaplan KA
1
, Plante DT
2
, Cook JD
2
, Soehner AM
3
, Harvey AG
4
1
Department of Psychiatry and Behavioral Sciences, Stanford
University School of Medicine, Stanford, CA,
2
University of
Wisconsin School of Medicine and Public Health, Madison, WI,
3
Department of Psychiatry, University of Pittsburgh School of
Medicine, Pittsburgh, PA,
4
Department of Psychology, University of
California Berkeley, Berkeley, CA
Introduction: Hypersomnia is common in psychiatric disorders, yet
there are few self-report measures that characterize this sleep distur-
bance. The objective of this study was to validate the Hypersomnia
Severity Index (HSI), a tool designed to measure severity, distress and
impairment of hypersomnia in psychiatric populations.
Methods: Psychometric properties were evaluated in an undergradu-
ate scale development sample (N = 380) and two psychiatric validation
samples: euthymic bipolar participants with a range of sleep complaints
(N = 103), and unmedicated unipolar depressed participants (N = 19)
meeting operational criteria for hypersomnia disorder derived from
epidemiologic survey data of the US the general population. Construct
validity was established against the Epworth Sleepiness Scale (ESS),
Pittsburgh Sleep Quality Index (PSQI), and measures of functional im-
pairment, along with two weeks of sleep diaries and actigraphy from
which total sleep time (TST) and time in bed (TIB) were extracted.
Results: The HSI demonstrated good internal reliability (development
sample Cronbach α = 0.82, combined psychiatric sample α = 0.85).
Convergent validity was supported by significant correlations with
ESS total scores (development r = 0.41, p < 0.001; psychiatric r = 0.41,
p < 0.001) and the PSQI daytime dysfunction subscale (development
r = 0.39, p < 0.001; psychiatric r = 0.31, p < 0.01). Construct validity
was further supported by correlations between the psychiatric sample
and actigraphy-determined TST and TIB (r ≥ 0.40, p < 0.05 for both)
and diary-reported TIB (r = 0.26, p < 0.01). HSI scores correlated with
functional impairment measures in both the development (r = 0.59,
p < 0.001) and bipolar (r = 0.59, p < 0.01) samples. One-month test-
retest reliability (ICC) in the bipolar sample was 0.69.
Conclusion: The HSI shows promise as a measure of hypersomnia that
is commonly seen in psychiatric disorders, and may be of use to both
researchers and clinicians.
Support (If Any): This work is supported by grants from the Ameri-
can Sleep Medicine Foundation, the Brain and Behavior Research
Foundation, and NIMH K23MH099234 (DTP) and R34MH080958
(AGH).
1219
VALIDATION OF THE ALLIANCE SLEEP
QUESTIONNAIRE (ASQ) RESTLESS LEGS SYNDROME
MODULE IN SLEEP DISORDERED PATIENTS
Leary EB
1
, Malunjkar S
1
, Ruoff C
1
, Walsh JK
2
, Mignot E
1
1
Stanford University, Palo Alto, CA,
2
St. Luke’s Hospital, Chesterfield,
MO
Introduction: In 2012, the Stanford Sleep Disorders Clinic (SSDC)
adopted the Alliance Sleep Questionnaire (ASQ) as standard of care
for new patients. The ASQ is an on-line questionnaire designed by a
multi-disciplinary team to evaluate sleep disorders and complaints. It
uses branching logic to deliver validated measures and novel questions
for research or clinical purposes. It outputs a customizable Summary
Report to streamline clinical appointments. In this study, we validated
the ASQ’s ability to predict individuals with Restless Legs Syndrome
(RLS) in SSDC patients.
Methods: The population was patients (treated and untreated) seen at
the SSDC. Individuals had to consent to participate in research, com-
plete the ASQ RLS section and have clinical information in the elec-
tronic medical record (EMR) to be included in analysis. Using the ASQ,
we selected two patterns of responses apriori to indicate RLS using the
first four 2012 Revised International Restless Legs Syndrome Study
Group (IRLSSG) Diagnostic Essential Criteria (urge to move, worse
during rest and evening and improved with movement) as a starting
point. Since our population includes treated patients, the ASQ primary
definition for RLS was either positive endorsement of the 4 IRLSSG
essential criteria or self-reported previous RLS diagnosis. To avoid
missing severe cases, a frequency criteria of symptoms occurring at
least 3 times/week was added to the primary ASQ definition. The ASQ
score cannot be calculated with a “don’t know” response on whether