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| |  Simplified Tool Effectively Screens for Sleep Disorders NEW YORK, NY -- April 3, 2002 -- Results of a new study suggest that an 11-item, self-administered patient questionnaire can aid physicians in screening for the most common sleep disorders, including insomnia, sleep apnea and restless legs syndrome. The study, which was published in the March issue of the journal Sleep Medicine, will simplify the sleep disorder screening process so that primary-care doctors can reliably assess patients for specific disorders in minutes with only a handful of targeted questions. Experts hope that the practical test, known as the Global Sleep Assessment Questionnaire (GSAQ), will encourage more aggressive screening and help identify millions of Americans who suffer from untreated sleep problems. "Many patients with sleep problems fail to receive treatment because the sleep screening process is far too time-consuming for the average physician to administer during a brief office visit," said Thomas Roth, Ph.D., lead study author and chief of the Sleep Disorders and Research Center at Henry Ford Sleep Center in Detroit, Michigan. "Our research demonstrates that a simple tool helps make preliminary screening more accessible to the general practitioner and can identify quickly and reliably those patients who require treatment or who would benefit most from further evaluation." The National Sleep Foundation estimates that at least 40 million Americans suffer from sleep disorders. Additionally, sleeplessness has been associated with a broad range of complications, including depression, heart disease, lost productivity and an increased risk of highway- and work-related accidents. Despite these facts, more than 60 percent of adults have never been asked about the quality of their sleep by a physician. "Adequate sleep is critical to good health, yet many adults have undiagnosed sleep disorders that prevent them from getting adequate sleep," remarked Daniel J. Buysse, MD, study investigator and associate professor of psychiatry, Western Psychiatric Institute and Clinic at the University of Pittsburgh School of Medicine. "Undiagnosed sleep disorders are a national health priority, one that the GSAQ can hopefully help to address." The GSAQ was developed at several of the nation’s leading accredited sleep centers. Through several tiers of research, GSAQ investigators evaluated dozens of questions used in standard sleep screeners to identify those that are most predictive for a positive sleep disorder diagnosis. Researchers were able to hone the list of questions down to a list of 11, believed to be the foundation for screening of a broad range of sleep-related conditions. The questions range from general inquiries relating to falling asleep, staying asleep, or feeling rested, to more specific questions, such as "During the past four weeks, how often did you have restless or 'crawling' feelings in your legs at night that went away if you moved your legs?" and "During the past four weeks, how often did you have nightmares, or did you scream, walk, punch, or kick in your sleep?" Each question required an answer of "Never," "Sometimes," "Usually," or "Always." Specific questions are weighted for particular disorders. Some conditions, such as parasomnia, a disorder characterized by sleepwalking, screaming, bedwetting and/or other abnormal sleep behaviors, can be effectively screened for with a single question from the 11-item list. A total of 212 adults completed the study at five sleep centers and two primary-care clinics. Diagnoses were confirmed by complete evaluations performed by sleep specialists. Of the 212 patients, 139 (65.6 percent) had at least one sleep disorder, 60 (28.3 percent) had two or more sleep disorders, and 13 (6.1 percent) had no confirmed sleep disorder. The GSAQ demonstrated a sensitivity of 79 percent for primary insomnia, 83 percent for insomnia associated with a mental disorder, 93 percent for both obstructive sleep apnea and periodic limb movement, 96 percent for restless legs syndrome, and fully 100 percent for parasomnia. "Given the ambiguities of sleep disorders and the lack of biochemical markers typical to other disorders, the sensitivity of this screening tool is impressive," Dr. Roth explained. "The GSAQ shows great promise as an instrument that can help primary-care physicians identify with confidence individuals who need further diagnostic evaluation and, if appropriate, treatment." Investigators are currently planning the next phase of research for the GSAQ, which will involve evaluating its performance in the actual primary-care setting. A sleep disorder is a disruptive pattern of sleep that may include difficulty falling or staying asleep, falling asleep at inappropriate times, excess total sleep time, or abnormal behaviors associated with sleep. It may be caused by stress, a poor sleeping environment and/or underlying medical or psychiatric problems. Insomnia is the most common sleep disorder. In the 2001 Sleep in America Poll, 51 percent of adults surveyed reported experiencing insomnia at least a few nights per week. In this poll, insomnia was defined as difficulty in falling or staying asleep, waking too early and being unable to get back to sleep, and waking up feeling unrefreshed. Most sufferers have a mixture of these symptoms. Sleep apnea is a serious condition that affects as many as 18 million Americans. It is characterized by brief interruptions of breathing during sleep. Periodic limb movement disorder usually involves repetitive lower limb movements that occur about every 20 to 40 seconds and can interfere with an individual’s ability to stay asleep. Restless legs syndrome is an uncomfortable, crawling sensation in the legs, which occurs when an individual is sitting or lying down. The syndrome’s name comes from the irresistible urge to move the legs. The GSAQ study was sponsored by Pharmacia Corporation and is being further developed by Sanofi-Synthelabo Inc. SOURCE: Sanofi-Synthelabo Inc.
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