Reliability and validity of the Athens Insomnia Scale in chronic pain patients

Abstract

PurposeTo confirm the psychometric properties of the Athens Insomnia Scale (AIS) among Japanese chronic pain patients.Patients and methodsIn total, 144 outpatients were asked to complete questionnaires comprising the AIS and other study measures. According to the original article, the AIS has 2 versions: the AIS-8 (full version) and the AIS-5 (brief version). To validate the AIS-8 and AIS-5 among chronic pain patients, we confirmed: 1) factor structure by confirmatory factor analysis; 2) internal consistency by Cronbach’s a; 3) test–retest reliability using with interclass correlation coefficients; 4) known-group validity; 5) concurrent validity; and 6) cut-off values by receiver operating characteristic analysis. In addition, semi-structured interviews were conducted to assess the participants’ sleep disturbance. If the participants had any sleep complaints, including difficulty in initiating sleep, difficulty in maintaining sleep, and early morning awakening, they were defined as insomnia symptoms.ResultsA 2-factor model of the AIS-8 and 1-factor model of the AIS-5 demonstrated good fit. The AIS had adequate internal consistency and test–retest reliability. Patients with insomnia had a higher AIS score than those without insomnia. The sleep disturbance measured by the AIS was positively associated with pain intensity, disability, depression, anxiety, and pain catastrophizing, and negatively associated with pain-related self-efficacy. The cut-off values for detecting insomnia were estimated at 8 points in the AIS-8 and 4 points in the AIS-5.ConclusionThe AIS-8 and AIS-5 had adequate reliability and validity in chronic pain patients.

A thorough psychometric comparison between Athens Insomnia Scale and Insomnia Severity Index among patients with advanced cancer

“…First, all the patients with advanced cancer were recruited in Iran using a convenience sampling method. Although patients were recruited in different oncology units, the results are not necessarily generalizable to other ethnicities, other disease groups, or early stage of cancer, especially since different AIS and ISI structures have been reported across different populations in previous studies (Chung et al, 2011;Enomoto et al, 2018;Fernandez-Mendoza et al, 2012;Gerber et al, 2016;Gómez-Benito et al, 2011). Second, the different early treatments may also contribute to different sleep performance among the patients with advanced cancer.…”

“…More specifically, the CFA and Rasch analysis findings supported the unidimensional structure for both the AIS and ISI. Previous studies have reported different factorial structures for AIS (one or two factors) (Enomoto et al, 2018;Gómez-Benito et al, 2011) and ISI (one to three factors) (Chung et al, 2011;Fernandez-Mendoza et al, 2012;Gerber et al, 2016) across different populations (e.g., adolescents and people with chronic pain). However, the different findings in the factorial structures could be contributing to the different sample characteristics.…”

“…Another consideration in the AIS and ISI is whether such subjective measures can accurately assess and quantify the insomnia. However, to the best of the present authors' knowledge, most previous studies have used clinical insomnia diagnosis or subjective measures (e.g., self-reported depression) as the external criteria to examine the criterion-related validity for the AIS and ISI (Enomoto et al, 2018;Gómez-Benito et al, 2011;Jeong et al, 2015;Morin et al, 2011). Therefore, empirical data on an objective sleep measure (i.e., actigraphy) is needed to verify the psychometric properties of such subjective measures (Lin et al, 2018).…”

Insomnia and caregiver burden in chronic pain patients: A cross-sectional clinical study

“…Three items assess consequences of insomnia for the next day: sense of wellbeing during the day, physical and mental functioning during the day, and sleepiness during the day. The AIS � 8 was defined as insomnia among individuals with chronic pain [33].…”

Частота И Факторы Развития Послеоперационной Инсомнии

“…Оцінку сну проводили о 18:00 на другий день після перенесеного оперативного втручання шляхом оцінювання за Афінською шкалою інсомнії (AIS) [11,12]. Рівень болю оцінювали у спокої о 9-й ранку після першої післяопераційної ночі за допомогою візуальної аналогової шкали (ВАШ) з урахуванням максимального рівня болю за ніч [13].…”