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Mills RJ, Tennant A, Young CA. The Neurological Sleep Index: A suite of new sleep scales for multiple sclerosis. Mult Scler J Exp Transl Clin. 2016;2:2055217316642263doi: 10.1177/2055217316642263.
Mills, R. J., Tennant, A., & Young, C. A. (2016). The Neurological Sleep Index: A suite of new sleep scales for multiple sclerosis. Multiple sclerosis journal - experimental, translational and clinical, 22055217316642263. https://doi.org/10.1177/2055217316642263
Mills, R J, et al. "The Neurological Sleep Index: A suite of new sleep scales for multiple sclerosis." Multiple sclerosis journal - experimental, translational and clinical vol. 2 (2016): 2055217316642263. doi: https://doi.org/10.1177/2055217316642263
Mills RJ, Tennant A, Young CA. The Neurological Sleep Index: A suite of new sleep scales for multiple sclerosis. Mult Scler J Exp Transl Clin. 2016 Apr 07;2:2055217316642263. doi: 10.1177/2055217316642263. eCollection 2016. PMID: 28607724; PMCID: PMC5453626.
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Mult Scler J Exp Transl Clin. 2016 Apr 07;2:2055217316642263. doi: 10.1177/2055217316642263. eCollection 2016.

The Neurological Sleep Index: A suite of new sleep scales for multiple sclerosis.

Multiple sclerosis journal - experimental, translational and clinical

R J Mills, A Tennant, C A Young

Affiliations

  1. Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK.
  2. Swiss Paraplegic Research, Nottwil, Switzerland.
  3. The Walton NHS Foundation Trust, Liverpool, UK University of Liverpool, Liverpool, UK.

PMID: 28607724 PMCID: PMC5453626 DOI: 10.1177/2055217316642263

Abstract

OBJECTIVE: The objective of this study was to develop patient-reported outcome measures for sleep dysfunction and sleepiness in multiple sclerosis (MS), since there are currently no MS-specific measurement tools for these clinically important entities.

METHODS: Items were generated from semi-structured interviews followed by cognitive debrief. A 42-item pool was administered to patients with MS at three neuroscience centres in the UK. Comparator scales were co-administered. Constructs were validated by Rasch analysis, guided by initial exploratory factor analysis.

RESULTS: There were two supraordinate qualitative themes of diurnal sleepiness and non-restorative nocturnal sleep. Rasch analysis on 722 records produced three scales, which corresponded to diurnal sleepiness, non-restorative nocturnal sleep and fragmented nocturnal sleep. All had excellent fit parameters, were unidimensional and were free from differential item functioning. A summed raw score cut-point of 31/48 in the Diurnal Sleepiness Scale equated to the standard cut-point of 10 on the Epworth Sleepiness Scale (ESS).

CONCLUSION: Three high-quality measurement scales were developed, and together they compose the Neurological Sleep Index for MS (NSI-MS). The Diurnal Sleepiness Scale might provide an alternative to the ESS. The Non-Restorative Nocturnal Sleep Scale and the Fragmented Nocturnal Sleep Scale appear to be the only such measures for use in MS.

Keywords: Epworth; Multiple sclerosis; Rasch analysis; fragmentation; non-restorative; scale; sleep; sleepiness

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