Validation of an Arabic version of the Cambridge-Hopkins diagnostic questionnaire for restless legs syndrome.

PURPOSE: To validate an Arabic version of the short form of the Cambridge-Hopkins diagnostic questionnaire for restless legs syndrome (CH-RLSq13). METHODS: The Arabic version was created using a standard forward-backward translation method. A pre-final Arabic version was administered with the original English version to a group of bilingual subjects as a pretest. The inter-rater agreement between these two versions was measured. A finalized Arabic version was obtained. For the validation, the Arabic version of the CH-RLSq13 was administered to Lebanese subjects, above 18 years old, selected upon a clinical interview. The diagnosis provided by the Arabic version of the CH-RLSq13 was compared to the clinical diagnosis made by a neurologist at Hotel-Dieu de France hospital. Inter-rater agreement was assessed using Cohen's kappa coefficient. Sensitivity, specificity, and positive and negative predictive values of the translated questionnaire were calculated. RESULTS: Inter-rater agreement, between the 2 versions, for the entire questionnaire, was excellent (κ = 0.950). All items showed a substantial level of agreement between the two versions. In the validation process, 91 participants were included (17 patients diagnosed with RLS and 74 control subjects). The mean age was 40 years, with female predominance. The final Arabic version of the CH-RLSq13 had a sensitivity of 71%, a specificity of 100%, and with negative and positive predictive values of 94% and 100% respectively. CONCLUSION: The Arabic version of the CH-RLSq13 is a reliable tool for the screening and diagnosis of RLS in Lebanese and Arabic-speaking populations.

The Effects of the COVID-19 Confinement on Screen Time, Headaches, Stress and Sleep Disorders among Adolescents: A Cross Sectional Study.

Background: Headache is a common symptom affecting children and adolescents. The medical literature over the last three decades reveals a variable prevalence and triggers in different countries, regions, circumstances and times. This study aims to assess the prevalence, frequency and quality of headaches in the Lebanese adolescent population under the COVID-19 confinement and study its triggers and relationship to screen time, self-reported anxiety, and sleep. Methods: A cross sectional design was used to collect two survey results by snowball distribution using social media targeting adolescents aged 15 to 17 years of age. The first survey included 13 questions with a single best answer about screen time, feeling anxious, sleep time, schedule and consistency, and headaches. The second survey included 3 questions about the quality of the headaches, anxiety and its triggers. Results: Among 433 responders to the first survey, the prevalence of headaches, especially pressure points and band-like pressure was higher than any previously reported among adolescents in the literature, reaching 93.4%. Screen time was also higher than any previous reports with 95.6% spending 9 hours or more on screen while 64% of adolescents spending at least 12 hours a day on screen. In addition, the majority (82%) don't have consistent sleep habits and 41.8% consider themselves anxious. School was considered the main source of stress by 82.8% of the responders. The frequency of headache correlated significantly with increased screen time, self-reported anxiety and inconsistent sleep habits. Conclusions: Headaches among adolescents are associated with increased screen use, sleep disorders, and self-reported anxiety. It is one of the primary somatization symptoms in this group expressing their extreme stress under the current economic, political, and health crisis. The present trends are likely to have major long term implications on adolescents' health and academic achievements and should alarm educators and health officials to intervene in this situation.

Validity and reliability of an Arabic version of the Sleep Hygiene Index.

AIM: this study aims to assess the reliability and validity of an Arabic version of the Sleep Hygiene Index (SHI). METHODS: A methodological study was carried out in four stages: initial translation by 2 professional translators, evaluation and synthesis of the initial translation by project managers, back-translation and validation. The Arabic (SHI-AR) and English (SHI-ENG) versions of the SHI were administered across Lebanon as an anonymous online survey in April 2020. Internal consistency of the SHI-AR and inter-rater reliability were assessed by calculating Cronbach alpha (α) and Intraclass Correlation Coefficient (ICC) respectively. Inter-rater agreement for each item of the SHI was measured using Cohen's Kappa coefficient. Construct validity was investigated by exploratory factor analysis (EFA). RESULTS: 363 participants were enrolled in the study (129 men, 234 women, mean age 30 ± 11 years). There was no statistically significant difference between mean overall scores on the 2 versions of the SHI with mean scores of 19.16 ± 7.4 and 19.25 ± 7.6 on SHI-AR and SHI-ENG respectively (p = 0.265). Internal consistency was satisfactory (α = 0.749), and the inter-rater agreement for the total scores of the 2 versions of the SHI was excellent (ICC = 0.980). All items of the SHI showed substantial to high level of agreement between the 2 versions. EFA established four factors underlying the questionnaire. CONCLUSION: The Arabic version of the SHI is a valid tool to assess sleep hygiene in Arabic speaking populations.