The Role of Patient-Reported Outcomes in Sleep Measurements

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As sleep disorders are highly prevalent, many patients seek appropriate medical help for their sleep problems. Although the medical interview is essential for establishing a diagnostic working hypothesis, questionnaires are valuable add-on tools with respect to clinical subtyping, differential diagnosis, identification of comorbidities, and assessing response to treatment. The term “patient-reported outcome measures” (PROMs) is standard for questionnaires that are validated along a spectrum of different measurement properties. PROMs must comply with rigorous psychometric standards and should be evaluated carefully before release. Sleep disorders can be assessed with generic or disease-specific questionnaires. The latter category comprises PROMs for specific sleep disorders such as OSA, insomnia, and RLS, among others. There are certain limitations to the use of PROMs. The composing traits are often nonspecific and overlap among different nosologic entities. Moreover, PROMs may not capture the full spectrum of disease heterogeneity. Therefore, inappropriate use may yield spurious diagnoses and ineffective treatment. Besides the use of disease-specific instruments, the field of sleep medicine may envisage the introduction of domain-specific questionnaires—free from diagnostic preconceptions—targeting traits that are unique to the patient’s condition. This observation may open up perspectives for innovative research on still better PROMs.