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

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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.

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失眠严重程度指数的缩写版本筛选共病失眠在阻塞性睡眠呼吸暂停患者

失眠和阻塞性睡眠呼吸暂停（COMISA）的合并症很常见，并与不良临床后果相关。虽然失眠在OSA患者中经常被误诊，但在这些患者中识别失眠可能会改善医疗保健。我们的目的是评估两种简化工具（失眠严重程度指数-2 （ISI-2）和ISI-3）的性能，以识别OSA患者的失眠。我们假设ISI-2和ISI-3可以很好地诊断OSA患者的失眠。方法对四组不同的睡眠障碍患者进行研究。队列1、2和3包括OSA患者。队列4只包括失眠患者。采用接收工作特征曲线分析，比较isi2、isi3与isi7对失眠症的诊断效果。结果组1、组2、组3、组4分别有490人、124人、39人和118人。队列1、2和3的个体为中年人，肥胖，平均患有严重的阻塞性睡眠呼吸暂停。来自队列2的个体以男性为主，而来自队列3和4的个体以女性为主。队列4的个体稍年轻，平均富营养化。队列3和4的失眠严重程度（ISI-7）高于队列1和2。在队列1中，ISI-2和ISI-3的最佳临界值分别为≥6和≥8。在队列1、2和4中，ISI-2的曲线下面积（AUC）分别为0.900、0.951和0.893。在队列1、2和4中，ISI-3的AUC分别为0.924、0.961和0.936。结论i -2和i -3是筛查睡眠障碍患者失眠的准确工具。易识别COMISA患者的失眠症可改善临床结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.