The Insomnia Severity Index: Psychometric Indicators to Detect Insomnia Cases and Evaluate Treatment Response

Morin, Charles M.; Belleville, Geneviève; Bélanger, Lynda; Ivers, Hans

doi:10.1093/sleep/34.5.601

Cited by 3,446 publications

(2,870 citation statements)

References 30 publications

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“…The Berlin Sleep Questionnaire was used to determine the prevalence of a high‐risk phenotype for OSA, using responses to questions about snoring, daytime somnolence, hypertension, and BMI 28. The presence of insomnia was ascertained using the Insomnia Severity Index (ISI) Questionnaire29 and categorized as (1) no clinically significant insomnia; (2) subthreshold insomnia; (3) clinical insomnia with moderate severity; or (4) severe clinical insomnia.…”

Section: Methodsmentioning

confidence: 99%

Effects of Inadequate Sleep on Blood Pressure and Endothelial Inflammation in Women: Findings From the American Heart Association Go Red for Women Strategically Focused Research Network

Aggarwal

Makarem

Shah

et al. 2018

JAHA

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BackgroundInsufficient sleep increases blood pressure. However, the effects of milder, highly prevalent but frequently neglected sleep disturbances, including poor sleep quality and insomnia, on vascular health in women are unclear. We investigated whether poor sleep patterns are associated with blood pressure and endothelial inflammation in a diverse sample of women.Methods and ResultsWomen who participated in the ongoing American Heart Association Go Red for Women Strategically Focused Research Network were studied (n=323, 57% minority, mean age=39±17 years, range=20–79 years). Sleep duration, sleep quality, and time to sleep onset were assessed using the Pittsburgh Sleep Quality Index (score ≥5=poor sleep quality). Risk for obstructive sleep apnea was evaluated using the Berlin questionnaire, and insomnia was assessed using the Insomnia Severity Index. In a subset of women who participated in the basic study (n=26), sleep duration was assessed objectively using actigraphy, and endothelial inflammation was assessed directly in harvested endothelial cells by measuring nuclear translocation of nuclear factor kappa B. Vascular reactivity was measured by brachial artery flow‐mediated dilation (n=26). Systolic and diastolic blood pressure were measured by trained personnel (n=323). Multivariable linear regressions were used to evaluate associations between sleep patterns and blood pressure, nuclear factor kappa B, and flow‐mediated dilation. Mean sleep duration was 6.8±1.3 hours/night in the population study and 7.5±1.1 hour/night in the basic study. In the population study sample, 50% had poor sleep quality versus 23% in the basic study, and 37% had some level of insomnia versus 15% in the basic study. Systolic blood pressure was associated directly with poor sleep quality, and diastolic blood pressure was of borderline significance with obstructive sleep apnea risk after adjusting for confounders (P=0.04 and P=0.08, respectively). Poor sleep quality was associated with endothelial nuclear factor kappa B activation (β=30.6; P=0.03). Insomnia and longer sleep onset latency were also associated with endothelial nuclear factor kappa B activation (β=27.6; P=0.002 and β=8.26; P=0.02, respectively). No evidence was found for an association between sleep and flow‐mediated dilation.ConclusionsThese findings provide direct evidence that common but frequently neglected sleep disturbances such as poor sleep quality and insomnia are associated with increased blood pressure and vascular inflammation even in the absence of inadequate sleep duration in women.Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT02835261.

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Section: Methodsmentioning

confidence: 99%

Effects of Inadequate Sleep on Blood Pressure and Endothelial Inflammation in Women: Findings From the American Heart Association Go Red for Women Strategically Focused Research Network

Aggarwal

Makarem

Shah

et al. 2018

JAHA

View full text Add to dashboard Cite

show abstract

“…Scores on this measure are summed and may be categorized into 4 levels of insomnia severity: 0-7 indicates no clinically significant insomnia, [8][9][10][11][12][13][14] indicates the presence of subthreshold insomnia symptoms, 15-21 indicates the presence of moderate insomnia symptoms, and 22-28 indicates severe insomnia symptoms. 27,33 Thus, participants with a score of 8 or higher on this measure were classified as scoring positive for insomnia symptoms. We chose a cutoff of 8 to capture people with subthreshold symptoms because screening measures are useful not only to identify patients who already have a diagnosis, but those who have subthreshold symptoms, and who could still benefit from an intervention to prevent the full development of the disorder.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of the PHQ-9 Item 3 as a Screen for Sleep Disturbance in Primary Care

et al. 2011

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“…onset, maintenance, and terminal), or factors that causes insomnia symptoms (e.g. daytime stress, anxiety, jetlag, and diet) [1], [2], [21]. Therefore, training sleep/wake detection models that are specified according to these categories based on a larger data set merits further exploration.…”

Section: Resultsmentioning

confidence: 99%

Actigraphy-based sleep/wake detection for insomniacs

Long

Fonseca

Haakma

et al. 2017

2017 IEEE 14th International Conference on Wearable and Implantable Body Sensor Networks (BSN)

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The Insomnia Severity Index: Psychometric Indicators to Detect Insomnia Cases and Evaluate Treatment Response

Abstract: These findings provide further evidence that the ISI is a reliable and valid instrument to detect cases of insomnia in the population and is sensitive to treatment response in clinical patients.

Cited by 3,446 publications

References 30 publications

Effects of Inadequate Sleep on Blood Pressure and Endothelial Inflammation in Women: Findings From the American Heart Association Go Red for Women Strategically Focused Research Network

Effects of Inadequate Sleep on Blood Pressure and Endothelial Inflammation in Women: Findings From the American Heart Association Go Red for Women Strategically Focused Research Network

Evaluation of the PHQ-9 Item 3 as a Screen for Sleep Disturbance in Primary Care

Actigraphy-based sleep/wake detection for insomniacs

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