The narcolepsy severity scale (NSS) is reliable, valid, and sensitive to changes in the severity of type 1 narcolepsy and should be...
The narcolepsy severity scale (NSS) is reliable, valid, and sensitive to changes in the severity of type 1 narcolepsy and should be used more often in clinical settings and in future narcolepsy studies, the results of the study published in Dors .
According to the researchers, a small proportion of patients with type 1 narcolepsy have the same 5 symptoms (excessive daytime fatigue, cataplexy, hypnagogic hallucinations, sleep paralysis and interrupted night sleep); However, it is not clear whether these symptoms affect daily functioning and quality of life in type 1 narcolepsy. SSN was recently developed to evaluate the severity, frequency, and impact of the 5 main symptoms of narcolepsy in patients with this sleep disorder. The aim of this study was to define clinically relevant NSS scoring areas, confirm their main performance, assess whether their elements should be weighted, and re-evaluate their reactivity to narcolepsy medication in patients with narcolepsy type 1.
In this study, the researchers recruited 381 patients with type 1 narcolepsy (143 untreated patients and 238 treated patients) at the National Reference Center for Narcolepsy in Montpellier, France. All patients ended the SSN based on the last month of their experience with the sleep disorder and were asked about the frequency and intensity of the symptoms and the impact of the symptoms on daily life. The Epworth Sleepiness Scale (ESS) was used to assess the presence and severity of excessive daytime fatigue , and logistic regression models were used to compare the ESS with various elements of the NSS.
The researchers showed that the overall NSS score was higher in patients who received no treatment than in the treated patients (33.34 ± 9.40 vs. 24.26 ± 10.24, P <0.0001) all elements of the NSS were less severe in patients who received no treatment. were treated compared to those treated without treatment except for the elements n. ° 2 and n ° 5 (irresistible need to sleep during the day and worry about falling asleep during the day). The treated patients had fewer symptoms than the untreated patients ( P <0.0001).
The number of symptoms was associated with late diagnosis, age at onset of type 1 narcolepsy, and ESS and Beck depression inventory values. The entire NSS score was divided into 4 degrees of severity (easy, moderate, difficult and very difficult), with the differences between the individual groups relating to the treatment. The likelihood of receiving a high score in the depression inventory of ESS and Beck and achieving a low quality of life increased with the severity. The researchers found that weighting the elements of the NSS was not necessary to highlight the differences between the groups.
The study's researchers concluded that the NSS is valid, reliable, and sensitive to changes in the severity of type 1 narcolepsy and has clinimetric properties that are suitable for continuous use in clinical and research environments.
Disclosure: Several authors of the study reported connections to the pharmaceutical industry. The full list of authors' details can be found in the original reference.
reference
Dauvilliers Y., Barateau L., Lopez R., et al. Severity scale for narcolepsy: A reliable tool for assessing the severity and consequences of symptoms [published online 29 January 2020]. Sleep doi: 10.1093 / sleep / zsaa009
