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Chronic Insomnia / Insomnia Disorder

Assessment – Questionnaires

Assessment of insomnia disorder is based upon history and the use of questionnaires.


The following questionnaires may be of use to determine symptoms of insomnia disorder:

The Sleep Condition Indicator (SCI) is an eight‐item self-report rating scale that was developed to screen for insomnia disorder based on DSM‐5 diagnostic criteria; a score of 16 or less indicates probable insomnia.2

The Insomnia Severity Index (ISI) is a seven-item self-report questionnaire used to assess the severity of the insomnia disorder (score 8-14 is mild and 15 or more moderate to severe insomnia), impact on daily life and treatment response. It is not used to diagnose insomnia but can be useful to assess response to treatment.3, 4

The brief version of the Dysfunctional Beliefs and Attitudes about Sleep (DBAS-16) Scale Scale is a 16-item self-report scale, which evaluates sleep-related beliefs, expectations and attitudes regarding the causes, consequences, and potential treatments of sleep issues. The scale may be particularly valuable in the formation of cognitive approaches to treatment.5, 6

The Flinders Fatigue Scale is a seven-item self-report questionnaire which measures daytime symptoms of fatigue at several times throughout the day – as insomnia disorder is more commonly associated with daytime fatigue than sleepiness.7, 8

The Daytime Insomnia Symptom Scale (DISS) allows to assess daytime impairments associated with nocturnal sleep complaints (e.g. concentration difficulties, physical or mental lethargy, poor mood or reduced motivation and energy),9 of which fatigue is a very common complaint.10

Abbreviations

AHI - Apnoea-Hypopnoea Index
BBTi - Brief Behavioural Therapy for Insomnia
BMI - Body Mass Index (kg/m2)
BQ - Berlin Questionnaire
CBTi - Cognitive Behavioural Therapy for Insomnia
CELL - Coblation Endoscopic Lingual Lightening
COPD - Chronic Obstructive Pulmonary Disease
CVA - Cerebrovascular Accident
CPAP - Continuous Positive Airway Pressure
CSA - Central Sleep Apnoea
DASS - Depression Anxiety Stress Scale
DBAS - Dysfunctional Beliefs and Attitudes about Sleep
DBP - Diastolic Blood Pressure
DIMS - Difficulties Initiating and/or Maintaining Sleep
DISE - Drug-Induced Sleep Endoscopy
DISS - Daytime Insomnia Symptom Scale
ENT - Ear Nose and Throat
ESS - Epworth Sleepiness Scale
FOSQ - Functional Outcomes of Sleep Questionnaire
FSH - Follicle-Stimulating Hormone
FTP - Friedman Tong Position
GP - General Practitioner
HANDI - RACGP Handbook of Non-Drug Interventions
HGNS - Hypoglossal Herve Htimulation
ISI - Insomnia Severity Index
K10 - Kessler Psychological Distress Scale
MAD - Mandibular Advancement Device
MAS - Mandibular Advancement Rplint
MBS - Medicare Benefits Schedule
MMA - Maxillomandibular Advancement Surgery
MRA - Mandibular Repositioning Appliance
ODI - Oxygenation Desaturation Index
OSA - Obstructive Sleep Apnoea
PLMD - Periodic Limb Movement Disorder
PT - Positional Therapy
PTSD - Post-Traumatic Stress Disorder
PSG - Polysomnography
QSQ - Quebec Sleep Questionnaire
REM - Rapid Eye Movement
RFTB - Radiofrequency Thermotherapy of the Tongue Base
SBP - Systolic Blood Pressure
SCI - Sleep Condition Indicator
SE - Sleep Efficiency
SF36 - Short-Form (36) Health Survey
SMILE - Submucosal Minimally Invasive Lingual Excision
SNRIs - Serotonin-Norepinephrine Reuptake Inhibitors
SOL - Sleep Onset Latency
SSRI - Selective Serotonin Reuptake Inhibitors
TFTs - Thyroid Function Tests
TIB - Time In Bed
TORS - Transoral Robotic Surgery
TST - Total Sleep Time
UPPP - Uvulopalatopharyngoplasty
WASO - Wake After Sleep Onset

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References

  1. Buysse DJ, et al. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry research 1989:28(2);193-213
  2. Espi C, et al. The Sleep Condition Indicator: a clinical screening tool to evaluate insomnia disorder. BMJ Open 2014b;4:e004183
  3. Morin CM. Insomnia: psychological assessment and management. New York: Guilford Press 1993
  4. Bastien C, et al. Validation of the Insomnia Severity Index (ISI) as an outcome measure for insomnia research. Sleep medicine 2001:2;297-307
  5. Morin CM, et al. Dysfunctional beliefs and attitudes about sleep (DBAS): validation of a brief version (DBAS-16). Sleep 2007;30(11):1547-54
  6. Morin CM, et al. Dysfunctional beliefs and attitudes about sleep among older adults with and without insomnia complaints. Psychology and Aging 1993:8(3);463–7
  7. Gradisar M, et al. The Flinders Fatigue Scale: Preliminary psychometric properties and clinical sensitivity of a new scale for measuring daytime fatigue associated with insomnia. Journal Of Clinical Sleep Medicine 2007;3(7):722-8
  8. Cameron K, et al. Validation of the Flinders Fatigue Scale as a measure of daytime fatigue 2017;30:105-12
  9. Buyssea DJ, et al. Daytime symptoms in primary insomnia: A prospective analysisusing ecological momentary assessment. Sleep Med 2007;8(3):198–208
  10. Sweetman A, et al. Insomnia treatment Improved access to effective nondrug options. Medicine Today 2020;21(11);14-20