Assessing insomnia in adolescents: comparison of Insomnia Severity Index, Athens Insomnia Scale and Sleep Quality Index

Chung, Ka-Fai; Kan, Katherine Ka-Ki; Yeung, Wing-Fai

doi:10.1016/j.sleep.2010.09.019

Cited by 454Sleep and related disordersObstructive Sleep Apnea ResearchAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Assessing insomnia in adolescents: comparison of Insomnia Severity Index, Athens Insomnia Scale and Sleep Quality Index

Chung, Ka-Fai, Kan, Katherine Ka-Ki, Yeung, Wing-Fai·2011·Sleep Medicine

DOI 10.1016/j.sleep.2010.09.019

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Abstract

Objectives To compare the psychometric properties of the Chinese versions of Insomnia Severity Index (ISI), Athens Insomnia Scale (AIS) and Sleep Quality Index (SQI) for assessment and screening of insomnia in adolescents.Methods This is a school-based survey of 1516 adolescents aged 12-19 years. Sleep-wake habit questionnaire, ISI, AIS, SQI, Epworth Sleepiness Scale (ESS) and 12-item General Health Questionnaire (GHQ-12) were administered. Insomnia Interview Schedule was used to assess the severity of insomnia symptoms and DSM-IV-TR diagnosis of insomnia.Results The Cronbach's alpha of ISI, AIS and SQI were 0.83, 0.81 and 0.65, respectively, and the 2-week test-retest reliability were 0.79, 0.80 and 0.72. All three scales had a 2-factor structure, and their scores were significantly correlated with sleep-wake variables, ESS and GHQ-12 scores, smoking and drinking habits, and academic performance. The areas under curve of ISI, AIS and SQI for detecting clinical insomnia were 0.85, 0.80 and 0.85, respectively. The optimal cut-offs for ISI, AIS and SQI were a total score of nine (sensitivity/specificity: 0.87/0.75), seven (sensitivity/specificity: 0.78/0.74) and five (sensitivity/specificity: 0.83/0.79), respectively.Conclusion The Chinese versions of ISI, AIS and SQI are reliable and valid instruments. The ISI and AIS appear to have better psychometric properties than the SQI.

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In one adolescent validation study, the Insomnia Severity Index had strong reliability (Cronbach's α=0.83) and acceptable test-retest reliability (r=0.79).
“In one adolescent validation study, reliability was strong (Cronbach’s α=0.83), and test–retest reliability was acceptable, r=0.79.25”
From Pilot evaluation of the Sleep Ninja: A smartphone application for adolescent insomnia symptoms (2019) · cites this paper as [25]
The Insomnia Severity Index has been validated in adolescent samples.
“The ISI was designed for use in adults but has been widely administered to, and validated in, adolescent samples.25–27”
From Pilot evaluation of the Sleep Ninja: A smartphone application for adolescent insomnia symptoms (2019) · cites this paper as [25]
The Chinese version of the Insomnia Severity Index demonstrated satisfactory internal consistency (Cronbach α=.83), 2-week test-retest reliability (r=0.79), and concurrent validity.
“The Chinese version of the Insomnia Severity Index demonstrated satisfactory internal consistency (Cronbach α=.83), 2-week test-retest reliability (r=0.79), and concurrent validity [50].”
From Delivering Mindfulness-Based Interventions for Insomnia, Pain, and Dysfunctional Eating Through a Text Messaging App: Three Randomized Controlled Trials Investigating the Effectiveness and Mediating Mechanisms. (2022) · cites this paper as [50]

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Authors: Chung, K.-F., Kan, K. K.-K., & Yeung, W.-F.
Affiliations: University of Hong Kong (HK)
Corresponding author: Chung, Ka-Fai
ORCID: Chung, Ka-Fai
Yeung, Wing-Fai
Venue: Sleep Medicine
Publisher: Elsevier BV
Published: 2011-05
Volume: 12
Issue: 5
Pages: 463-470
ISSN: 1389-9457 (ISSN-L)
DOI: 10.1016/j.sleep.2010.09.019
OpenAlex: W2138508006
Cited by: 454
References: 55
Citations by year: 2026: 36 · 2025: 61 · 2024: 64 · 2023: 42 · 2022: 45 · 2021: 53 · 2020: 43 · 2019: 24 · 2018: 25 · 2017: 20 · 2016: 14 · 2015: 8 · 2014: 10 · 2013: 4 · 2012: 4
FWCI: 7.76
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Sleep Medicine (publishedVersion)
PubMed (publishedVersion)
The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: insomnia, adolescents, Insomnia Severity Index, Athens Insomnia Scale, sleep quality index, Chinese version, psychometric properties, screening, test-retest reliability, factor structure, cut-off values, sleep quality, Epworth Sleepiness Scale, GHQ-12, academic performance
MeSH terms: Adolescent, Child, Female, Health Surveys, Humans, Sleep Initiation and Maintenance Disorders, Male, Mass Screening, Psychometrics, Surveys and Questionnaires, Sensitivity and Specificity, Severity of Illness Index, Sleep, Reproducibility of Results, Asian People, Young Adult

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Assessing insomnia in adolescents: comparison of Insomnia Severity Index, Athens Insomnia Scale and Sleep Quality Index

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About these checks