Article2020

The European Portuguese version of the insomnia severity index

Vanda Clemente · Daniel Ruivo Marques · Mariana Miller‐Mendes · Charles M. Morin · Joana Serra · Ana Allen Gomes

38 citations0/0 files storedJournal of Sleep Research

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Abstract

Summary Insomnia is the most prevalent sleep complaint, but remains largely an unidentified public health issue. The Insomnia Severity Index (ISI) is a brief self‐report questionnaire to assess insomnia, long‐established both in clinical and research settings. The present study aimed to analyse the reliability, validity, and accuracy of the ISI European Portuguese version. After the translation protocol, 1,274 participants (65.54% female), with a mean (SD, range) age of 37.52 (16.82, 18–95) years, completed the ISI. This sample included 250 patients with insomnia from a Sleep Medicine Centre, presenting a diagnosis of insomnia disorder (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; International Classification of Sleep Disorders, Third Edition), and 1,024 individuals from the community. A group of 30 patients with obstructive sleep apnea (OSA) was also recruited. Cronbach’s α was 0.88 (internal consistency), and corrected item‐total correlations ranged from 0.56 to 0.83. An exploratory factor analysis (oblique rotation) revealed a two‐factor solution for both clinical and community samples. The ISI total score significantly differentiated insomnia disorder, no insomnia, and OSA subgroups with a large effect size (η 2 = 0.42). The correlation between ISI and Pittsburgh Sleep Quality Index supported concurrent validity (0.82), and discriminant validity was confirmed by a moderate correlation between ISI and Beck Depression Inventory Second Edition (0.32). The area under the curve was 0.88, and the optimal cut‐off to detect clinical insomnia was 14 (82.1% sensitivity, 79.5% specificity). In conclusion, the Portuguese version of the ISI is a reliable and valid measure of insomnia in clinical and non‐clinical populations. Our present study also contributes to relevant data for the international literature regarding the cut‐off score of the scale for the detection of clinical insomnia.

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References

1989The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research 2012Diagnostic and Statistical Manual of Mental Disorders 2001Validation of the Insomnia Severity Index as an outcome measure for insomnia research 2011The Insomnia Severity Index: Psychometric Indicators to Detect Insomnia Cases and Evaluate Treatment Response 2002Epidemiology of insomnia: what we know and what we still need to learn 1993Insomnia: Psychological Assessment and Management 2012The Consensus Sleep Diary: Standardizing Prospective Sleep Self-Monitoring 2017European guideline for the diagnosis and treatment of insomnia

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