Ullanlinna Narcolepsy Scale in diagnosis of narcolepsy. Issue 3 (26th November 2018)

• Record Type: Journal Article
• Authors: Sarkanen, Tomi; Alakuijala, Anniina; Partinen, Markku
• Is Part Of: Sleep. Volume 42:Issue 3(2019)
• Publication Date: 2018-11-26
• Subjects: narcolepsy -- cataplexy -- hypersomnolence -- idiopathic -- sleep apnea -- disorders of excessive somnolence -- surveys and questionnaires -- Ullanlinna Narcolepsy Scale -- Swiss Narcolepsy Scale -- hypersomnolence; Sleep -- Physiological aspects -- Periodicals; Sleep disorders -- Periodicals; Sommeil -- Aspect physiologique -- Périodiques; Sommeil, Troubles du -- Périodiques; Sleep disorders; Sleep -- Physiological aspects; Sleep -- physiological aspects; Sleep Wake Disorders; Psychophysiology; Electronic journals; Periodicals; 616.8498
• DOI: 10.1093/sleep/zsy238
• Languages: English
• ISSNs: 0161-8105

Abstract

Abstract: Study objectives: To validate Ullanlinna Narcolepsy Scale (UNS) as a screening tool for narcolepsy in a clinical population and to compare it with Swiss Narcolepsy Scale (SNS) and Epworth Sleepiness Scale (ESS). Methods: UNS questionnaires of 267 participants visiting Helsinki Sleep Clinic were analyzed. The diagnoses of the participants were narcolepsy type 1 (NT1, n = 89), narcolepsy type 2 (NT2, n = 10), other hypersomnias ( n = 24), sleep apnea ( n = 37), restless legs syndrome or periodic limb movement disorder ( n = 56), and other sleep-related disorders ( n = 51). In addition, ESS and SNS scores in a subset of sample (total N = 167) were analyzed and compared to UNS. Results: Mean UNS score in NT1 was 22.0 (95% confidence interval [CI] = 20.4 to 23.6, range 9–43), which was significantly higher than in other disorders, including NT2 (mean 13.7, 95% CI = 10.3 to 17.1, range 7–21, p = .0013). Sensitivity and specificity of UNS in separating NT1 from other disorders were 83.5% and 84.1%, respectively. Positive and negative predictive values were 82.5% and 85.1%, respectively. Sensitivities of SNS and ESS in NT1 were 77.2% and 88.6%, and specificities 88.6% and 45.5%, respectively. There were no differences in receiver operating characteristic curves between UNS and SNS. UNS had moderate negative correlation with hypocretin-1 levels ( r s = –.564, p < .001), and mean sleep latency in multiple sleep latency test ( r s = –.608, p < .001). Conclusions: UNS has high specificity and sensitivity for NT1 in a sleep clinic setting. UNS scores below 9 strongly suggest against the diagnosis of narcolepsy.