Abbreviated versions of the insomnia severity index to screen for comorbid insomnia among obstructive sleep apnea patients

IF 3.8 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine Pub Date : 2024-11-26 DOI:10.1016/j.sleep.2024.11.035

Marcela Yanagimori , Mariana D. Fernandes , Gustavo F. Grad , Aline B. Monare , Bianca M.S.P. Garcia , Ivana Rosanelli , Paulo M.M.S. Mariano , Sean P.A. Drummond , Denise M. O'Driscoll , Bradley A. Edwards , Geraldo Lorenzi-Filho , Pedro R. Genta

{"title":"Abbreviated versions of the insomnia severity index to screen for comorbid insomnia among obstructive sleep apnea patients","authors":"Marcela Yanagimori , Mariana D. Fernandes , Gustavo F. Grad , Aline B. Monare , Bianca M.S.P. Garcia , Ivana Rosanelli , Paulo M.M.S. Mariano , Sean P.A. Drummond , Denise M. O'Driscoll , Bradley A. Edwards , Geraldo Lorenzi-Filho , Pedro R. Genta","doi":"10.1016/j.sleep.2024.11.035","DOIUrl":null,"url":null,"abstract":"<div><h3>Study objectives</h3><div>The comorbidity of insomnia and obstructive sleep apnea (COMISA) is common and associated with adverse clinical consequences. While insomnia is often underdiagnosed among individuals with OSA, the identification of insomnia among these individuals may lead to improved medical care. Our objective was to assess the performance of two simplified tools (insomnia severity index-2 (ISI-2) and ISI-3) to identify insomnia among individuals with OSA. We hypothesized that the ISI-2 and ISI-3 perform well to diagnose insomnia among individuals with OSA.</div></div><div><h3>Methods</h3><div>Four different cohorts of individuals with sleep disorders were studied. Cohorts 1,2 and 3 included individuals with OSA. Cohort 4 included individuals with insomnia only. The performance of ISI-2 and ISI-3 was compared to ISI-7-based diagnosis of insomnia using receiving operating characteristic curve analysis.</div></div><div><h3>Results</h3><div>Cohorts 1, 2, 3 and 4 included 490, 124, 39 and 118 individuals, respectively. Individuals from cohorts 1, 2 and 3 were middle-aged, obese and had severe OSA on average. Individuals from cohort 2 were predominantly male while from cohorts 3 and 4 were predominantly female. Individuals from cohort 4 were slightly younger, and eutrophic on average. Cohorts 3 and 4 had higher insomnia severity (ISI-7) than cohorts 1 and 2. Using cohort 1, the best cut-offs for ISI-2 and ISI-3 were ≥6 and ≥8, respectively. Area under the curve (AUC) for ISI-2 was .900, .951 and .893 among cohorts 1, 2 and 4, respectively. AUC for ISI-3 was .924, .961 and .936 among cohorts 1, 2 and 4, respectively.</div></div><div><h3>Conclusion</h3><div>ISI-2 and ISI-3 are accurate screening tools for insomnia among individuals with sleep disorders. Easy recognition of insomnia among individuals with COMISA may improve clinical outcomes.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"126 ","pages":"Pages 19-24"},"PeriodicalIF":3.8000,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sleep medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1389945724005380","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Study objectives

The comorbidity of insomnia and obstructive sleep apnea (COMISA) is common and associated with adverse clinical consequences. While insomnia is often underdiagnosed among individuals with OSA, the identification of insomnia among these individuals may lead to improved medical care. Our objective was to assess the performance of two simplified tools (insomnia severity index-2 (ISI-2) and ISI-3) to identify insomnia among individuals with OSA. We hypothesized that the ISI-2 and ISI-3 perform well to diagnose insomnia among individuals with OSA.

Methods

Four different cohorts of individuals with sleep disorders were studied. Cohorts 1,2 and 3 included individuals with OSA. Cohort 4 included individuals with insomnia only. The performance of ISI-2 and ISI-3 was compared to ISI-7-based diagnosis of insomnia using receiving operating characteristic curve analysis.

Results

Cohorts 1, 2, 3 and 4 included 490, 124, 39 and 118 individuals, respectively. Individuals from cohorts 1, 2 and 3 were middle-aged, obese and had severe OSA on average. Individuals from cohort 2 were predominantly male while from cohorts 3 and 4 were predominantly female. Individuals from cohort 4 were slightly younger, and eutrophic on average. Cohorts 3 and 4 had higher insomnia severity (ISI-7) than cohorts 1 and 2. Using cohort 1, the best cut-offs for ISI-2 and ISI-3 were ≥6 and ≥8, respectively. Area under the curve (AUC) for ISI-2 was .900, .951 and .893 among cohorts 1, 2 and 4, respectively. AUC for ISI-3 was .924, .961 and .936 among cohorts 1, 2 and 4, respectively.

Conclusion

ISI-2 and ISI-3 are accurate screening tools for insomnia among individuals with sleep disorders. Easy recognition of insomnia among individuals with COMISA may improve clinical outcomes.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.