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Assessing insomnia in adolescents: Comparison of Insomnia Severity Index, Athens Insomnia Scale and Sleep Quality Index
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, 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]
In the citing paper
“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]
In the citing paper
“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].”
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Metadata
- Authors
- Chung, K.-F., Kan, K. K.-K., & Yeung, W.-F.
- Affiliations
- University of Hong Kong (HK)
- Corresponding author
- Chung, Ka-Fai
- Venue
- Sleep Medicine
- Publisher
- Elsevier BV
- Published
- 2011-05
- Volume
- 12
- Issue
- 5
- Pages
- 463-470
- ISSN
- 1389-9457 (ISSN-L)
- 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
- 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 (medical) › 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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