The Usefulness of the Athens Insomnia Scale for Evaluating Sleep Disturbance in Patients with Chronic Liver Disease Comparing with Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale

Abstract

Background and Objectives: Sleep disturbance due to muscle cramps or hepatic encephalopathy in patients with chronic liver disease (CLD) can lead to a reduced quality of life. The Pittsburgh sleep quality index (PSQI) is commonly used for evaluating sleep disturbance; however, this questionnaire is time-consuming owing to the large number of questions. As the usefulness of the Athens insomnia scale (AIS) in patients with CLD is not sufficiently known, the present study aimed to determine whether the AIS and Epworth sleepiness scale (ESS) could be used as simple alternative questionnaires for evaluating sleep disturbances in patients with CLD. Materials and Methods: A total of 117 patients with CLD were retrospectively evaluated. Patients with overt hepatic encephalopathy were excluded. All patients were examined using the AIS, PSQI, and ESS, and their responses to these questionnaires were statistically analyzed. Results: The number of patients diagnosed with sleep disturbance using the AIS, PSQI, and ESS were 39 (33.3%), 37 (31.6%), and 9 (7.7%), respectively. There was no correlation between PSQI and ESS scores (r = 0.011, p = 0.910); in contrast, the AIS scores showed a significant correlation with the PSQI scores (r = 0.689, p < 0.001). When the PSQI was considered as the standard for evaluating sleep disturbance, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the AIS were 76.9%, 91.0%, 81.1%, and 88.8%, respectively. In the sleep medication group, the sensitivity, specificity, PPV, and NPV of the AIS were 100%, 70%, 78.6%, and 100%, respectively. Conclusions: This is the first report to indicate that the AIS is an alternative questionnaire to the PSQI and that it can be a useful tool for detecting cirrhosis-related complications in patients with CLD.

Clinical effect of sound sleep support sound player “Lullaby reverberation” for sleep quality

“…Mutual relationship among PSQI, Athens insomnia scale (AIS) and Epworth sleepiness scale (ESS) was investigated as simple alternative questionnaires. 16 For patients with chronic liver disease (CLD) (n=117), sleep disturbance was diagnosed as 33.3% in AIS, 31.6% in QSQI and 7.7% in ESS. No correlation was observed between PSQI and ESS scores.…”

Safety and efficacy of remimazolam tosilate combined with low-dose fentanyl for procedural sedation in obese patients undergoing gastroscopy: study protocol for a single-centre, double-blind, randomised controlled trial

“…Currently, both the Pittsburgh Sleep Quality Index (PSQI) and AIS are used to assess sleep quality. It is worth mentioning that PSQI involves subjective content while the AIS is more objective, 50 less complicated and user-friendly. 42 Limitations This protocol has several critical issues.…”

Reliability and validity of the Chinese version of the Athens insomnia scale for non-clinical application in Chinese athletes

“…AIS-NCA arose from this background and need ( Sattler et al, 2021 ). The scale was adapted from the Athens Insomnia Scale (AIS), which has been shown to be a useful substitute for the Pittsburgh Sleep Quality Index ( Kawaratani et al, 2022 ). Due to its excellent quality, the AIS was chosen as the starting point for developing a sleep scale suitable for non-clinical settings.…”