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Interobserver reliability of ICSD-3 diagnostic criteria for disorders of arousal in adults

  • Neurology • Original Article
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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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Acknowledgements

The authors wish to thank Cecilia Baroncini and Anne Collins for English editing.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy

    Giuseppe Loddo, Francesco Lusa, Luisa Sambati, Luca Baldelli, Valentina Favoni, Giulia Pierangeli & Federica Provini

  2. IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy

    Luca Vignatelli, Corrado Zenesini, Luisa Sambati, Valentina Favoni, Giulia Pierangeli, Sabina Cevoli & Federica Provini

  3. UOC di Neurologia, Ospedale Cutroni Zodda, Barcellona PG, Messina, Italy

    Laura Rosa Pisani

Authors
  1. Giuseppe Loddo
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  2. Luca Vignatelli
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  3. Corrado Zenesini
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  4. Francesco Lusa
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  5. Luisa Sambati
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  6. Luca Baldelli
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  7. Valentina Favoni
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  8. Laura Rosa Pisani
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  9. Giulia Pierangeli
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  10. Sabina Cevoli
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  11. Federica Provini
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Corresponding author

Correspondence to Federica Provini.

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Conflict of interest

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.

Ethical approval

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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Informed consent was obtained from all individual participants included in the study.

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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

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