Sleep Medicine and Psychophysiology (수면정신생리)

KOREAN ACADEMY OF SLEEP MEDICINE (대한수면의학회)
권호 표지
DOI QR코드

DOI QR Code

Validation and Reliability of the Sleep Problem Screening Questionnaire: Focusing on Insomnia Symptoms

수면 문제 선별 질문지의 신뢰도, 타당도 연구: 불면증상을 중심으로

  • Received : 2023.05.27
  • Accepted : 2023.07.04
  • Published : 2023.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: The purpose of this study was to develop a screening tool that is simple and easy to use for assessing sleep problems, including hypersomnolence, restless legs syndrome, and insomnia. We also examined the reliability and validity of this tool. Methods: We developed the Sleep Problem Screening Questionnaire (SPSQ), which consists of three sub-sections: insomnia (SPSQi), hypersomnolence (SPSQh), and restless legs syndrome (SPSQr). Subsequently, the participants, consisting of 222 patients with insomnia disorder and 78 healthy individuals, completed both the SPSQ and the comparative scale (Korean version of the Insomnia Severity Index). The analysis was then conducted using this data. Results: The SPSQ demonstrated good convergent and discriminant validity, as well as satisfactory internal consistency. A cutoff score of 6 on the SPSQi was found to be optimal for distinguishing individuals with insomnia. Conclusion: The results of this study suggest that the SPSQ is a reliable and valid tool for screening sleep problems among general adult population. However, there is a limitation as a comparison and validation with scales related to restless legs syndrome and hypersomnolence were not conducted.

목 적: 본 연구에서는 불면증상 뿐만 아니라 과다수면, 하지불안증후군을 포함하여 수면 문제를 포괄적으로 평가하기 위한 수면 문제 선별 설문지(Sleep Problem Screening Questionnaire, SPSQ)를 개발하고, 신뢰도와 타당도를 검증하고자 하였다. 방 법: 불면증상(SPSQi), 과다수면(SPSQh), 하지불안증후군(SPSQr)의 세 가지 하위 영역을 포함하는 SPSQ를 개발하였다. 다음으로, 불면장애 임상군 222명 및 건강군 78명을 대상으로 SPSQ와 비교 척도인 불면증 심각도 척도(Korean version of Insomnia Severity Index)를 진행하고, 해당 데이터를 분석에 사용하였다. 결 과: SPSQ는 수용할만한 내적 일관성과 수렴·변별 타당도를 보여 수면장애의 측정에 타당한 도구로 평가되었다. ROC curve 분석 결과, 불면장애의 임상적 유의미성 판단을 위한 절단점은 SPSQi 6점, 민감도와 특이도는 각각 0.94, 0.96이었다. 결 론: 해당 연구결과는 SPSQ가 일반 성인 인구의 수면 문제를 선별하는데 있어 신뢰할 수 있고 유효한 도구임을 시사한다. 단, 하지불안증후군 및 과다수면 관련 척도와 비교 검증이 수행되지 못한 점을 고려해야겠다.

Keywords

Acknowledgement

본 연구는 중소벤처기업부의 2021년도 창업성장기술개발사업(팁스 프로그램[No. S3198339])의 지원에 의한 연구임.

References

  1. Ahn DH. Insomnia: causes and diagnosis. Hanyang Med Rev 2013;33:203-209. https://doi.org/10.7599/hmr.2013.33.4.203
  2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington DC: American Psychiatric Publishing;2013. p.361-422.
  3. Benca RM, Peterson MJ. Insomnia and depression. Sleep Medicine 2008;9:S3-S9. https://doi.org/10.1016/S1389-9457(08)70010-8
  4. Bhaskar S, Hemavathy D, Prasad S. Prevalence of chronic insomnia in adult patients and its correlation with medical comorbidities. J Family Med Prim Care 2016;5:780-784. https://doi.org/10.4103/2249-4863.201153
  5. Bland JM, Altman DG. Statistic notes: Cronbach's alpha. BMJ 1997;314:572.
  6. Cho YW, Song ML, Morin CM. Validation of a Korean version of the insomnia severity index. J Clin Neurol 2014;10:210-215. https://doi.org/10.3988/jcn.2014.10.3.210
  7. Cho YW, Lee JH, Son HK, Lee SH, Shin C, Johns MW. The reliability and validity of the Korean version of the Epworth sleepiness scale. Sleep and Breathing 2011;15:377-384. https://doi.org/10.1007/s11325-010-0343-6
  8. Cook JD, Rumble ME, Plante DT. Identifying subtypes of hypersomnolence disorder: a clustering analysis. Sleep Medicine 2019;64:71-76. https://doi.org/10.1016/j.sleep.2019.06.015
  9. Foley D, Ancoli-Israel S, Britz P, Walsh J. Sleep disturbances and chronic disease in older adults: results of the 2003 National Sleep Foundation Sleep in America Survey. J Psychosom Res 2004;56:497-502. https://doi.org/10.1016/j.jpsychores.2004.02.010
  10. Health Insurance Review and Assessment Service, National Health Insurance Service. 2021 National Health Insurance Statistical Yearbook. National Health Insurance Service;2022. p.691.
  11. Kaplan KA, Plante DT, Cook JD, Harvey AG. Development and validation of the Hypersomnia Severity Index (HSI): a measure to assess hypersomnia severity and impairment in psychiatric disorders. Psychiatry Res 2019;281:112547.
  12. LaMonica HM, Hickie IB, Ip J, Ireland C, Mowszowski L, English A, et al. Disability in older adults across the continuum of cognitive decline: unique contributions of depression, sleep disturbance, cognitive deficits and medical burden. Int Psychogeriatr 2019;31:1611-1625. https://doi.org/10.1017/S1041610218002144
  13. Lee S, Cheong YS, Park EW, Choi EY, Yoo HK, Kang KH, et al. Prevalence of sleep disorder and associated factors in family practice. Korean J Fam Med 2010;31:837-844 https://doi.org/10.4082/kjfm.2010.31.11.837
  14. Li Y, Zhang X, Winkelman JW, Redline S, Hu FB, Stampfer M, et al. Association between insomnia symptoms and mortality: a prospective study of US men. Circulation 2014;129:737-746. https://doi.org/10.1161/CIRCULATIONAHA.113.004500
  15. Mai E, Buysse DJ. Insomnia: prevalence, impact, pathogenesis, differential diagnosis, and evaluation. Sleep Med Clin 2008;3:167-174. https://doi.org/10.1016/j.jsmc.2008.02.001
  16. Manconi M, Garcia-Borreguero D, Schormair B, Videnovic A, Berger K, Ferri R, et al. Restless legs syndrome. Nat Rev Dis Primers 2021;7:80.
  17. Okun ML, Kravitz HM, Sowers MF, Moul DE, Buysse DJ, Hall M. Psychometric evaluation of the Insomnia Symptom Questionnaire: a self-report measure to identify chronic insomnia. J Clin Sleep Med 2009;5:41-50. https://doi.org/10.5664/jcsm.27391
  18. R Core Team. R: A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2020. Available from: https://www.R-project.org/.
  19. Shin S, Kim SH. The reliability and validity testing of Korean version of the Pittsburgh Sleep Quality Index. J Converg Inf Technol 2020;10:148-155.
  20. Yu ES, Ko YG, Sung GH, Kwon JH. Validation of the Korean Version of Dysfunctional Beliefs and Attitudes about Sleep (K-DBAS-16). Kor J Clin Psychol 2009;28:309-320. https://doi.org/10.15842/kjcp.2009.28.1.018
  21. Silber MH, Ehrenberg BL, Allen RP, Buchfuhrer MJ, Earley CJ, Hening WA, et al. An algorithm for the management of restless legs syndrome. Mayo Clinic Proceedings 2004;79:916-922. https://doi.org/10.4065/79.7.916
  22. Sowa NA. Idiopathic hypersomnia and hypersomnolence disorder: a systematic review of the literature. Psychosomatics 2016;57:152-164. https://doi.org/10.1016/j.psym.2015.12.006