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Advantages of single step over step-by-step screening for sleep disorders

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journal contribution
posted on 2017-10-17, 11:46 authored by Lorenzo Tonetti, Marco Filardi, Giuseppe Plazzi, Vincenzo Natale

Two secondary analyses of previously collected data were carried out to detect the best screening strategy for primary insomnia (Study 1) and narcolepsy type 1 (Study 2) between two different approaches: (A) step-by-step (i.e. first step: subjective assessment through mini sleep questionnaire – MSQ; second step: objective assessment through actigraphic assessment only for those positive at the first step) and (B) single step (i.e. simultaneous subjective and objective assessment). Forty-six healthy controls (HC) and 46 primary insomnia patients (PI) were analyzed in Study 1; 40 HC and 40 narcolepsy type-1 patients (NT1) were analyzed in Study 2. All participants originally wore the Micro Motionlogger Watch actigraph (Ambulatory Monitoring, Inc., Ardlsey, NY) around the non-dominant wrist for seven consecutive days, and upon completing the actigraphic assessment filled in the MSQ. In Study 1, the single-step approach correctly identified 93.48% of PI, while only 50% of PI were correctly identified by the step-by-step approach. In Study 2, 100% of NT1 was correctly classified through the single-step approach, while 72.5% according to the step-by-step approach. The result of both studies highlights the higher appropriateness of single step (i.e. bi-dimensional assessment) compared to step-by-step approach to screen primary insomnia and narcolepsy type-1 patients.

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