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. 2020 Sep 15;16(9):1507-1515.
doi: 10.5664/jcsm.8574.

Observation and Interview-based Diurnal Sleepiness Inventory for measurement of sleepiness in patients referred for narcolepsy or idiopathic hypersomnia

Laure Peter-Derex  1   2   3 , Fabien Subtil  2   4   5 , Guillaume Lemaitre  2 , François Ricordeau  1 , Hélène Bastuji  1   3 , Agathe Bridoux  1 , Fannie Onen  6   7   8 , S-Hakki Onen  1   3
Affiliations

Observation and Interview-based Diurnal Sleepiness Inventory for measurement of sleepiness in patients referred for narcolepsy or idiopathic hypersomnia

Laure Peter-Derex et al. J Clin Sleep Med. .

Abstract

Study objectives: First, to determine whether the 3-item Observation and Interview-based Diurnal Sleepiness Inventory (ODSI) measures the degree of excessive daytime sleepiness in patients with suspected narcolepsy or idiopathic hypersomnia (IH). Second, to assess the correlation between the ODSI and the Epworth Sleepiness Scale (ESS) as well as objective polysomnographic measurements. Third, to test the accuracy of the ODSI to detect narcolepsy or IH (narcolepsy/IH) compared with the ESS.

Methods: A total of 181 patients complaining of excessive daytime sleepiness filled in the ESS and the ODSI and underwent measurements including actigraphy, full-night polysomnography, Multiple Sleep Latency Test, and 24-hour bedrest sleep recording.

Results: Narcolepsy or IH was diagnosed in 76 patients. The ODSI found excessive daytime sleepiness in 92.3% of all patients and in 98.7% of those diagnosed with narcolepsy/IH. In the whole population, the ODSI was significantly positively correlated with the ESS (R = .547; 95% confidence interval: .436, .642; P < .001) and weakly with 24-hour total sleep time on bedrest recording (R = .208; 95% confidence interval: .056, .350; P = .047) but not with the Multiple Sleep Latency Test. The ODSI offered a higher negative (92.9%) and positive (44.9%) predictive value to detect narcolepsy/IH than did the ESS (66.7% and 43.3%, respectively). In the IH group, the ODSI's third-item score (daily sleepiness duration) was significantly higher in patients with than without increased 24-hour total sleep time (P = .023).

Conclusions: The ODSI is a brief, simple first-line questionnaire that explores both intensity and duration of daytime sleepiness and offers a high sensitivity to detect narcolepsy and IH.

Keywords: ESS; MSLT; ODSI; bedrest; hypersomnia; narcolepsy.

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Figures

Figure 1
Figure 1. Correlations between self-reported and objective tools.
The ODSI and ESS are significantly positively correlated with each other in the whole population (R = .547; 95% CI: .436, .642; P < .001) (A) and in patients with narcolepsy/IH (R = .562; 95% CI: .386, .699; P < .001) (B). In the whole population, the MSLT mean latency is significantly but weakly negatively correlated with the ESS (R = −.208, 95% CI: −.344, −.063; P = .021) (C) and the ODSI is significantly but weakly positively correlated with the total sleep time assessed by 24-hour Holter recording (R = .208; 95% CI: .056, .350; P = .047) (D). P values are adjusted for multiple comparisons. CI = confidence interval; ESS = Epworth Sleepiness Scale; IH = idiopathic hypersomnia; MSLT = Multiple Sleep Latency Test; ODSI = Observation and Interview-based Diurnal Sleepiness Inventory.
Figure 2
Figure 2. Accuracy of self-reported tools alone to detect narcolepsy/IH.
ROC curves of the ODSI and ESS; both questionnaires exhibit a high sensitivity. ESS = Epworth Sleepiness Scale; IH = idiopathic hypersomnia; ODSI = Observation and Interview-based Diurnal Sleepiness Inventory; ROC = receiver operating characteristic.
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