Cited by 1,754Sleep and related disordersAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychometric Methodologies and Testing

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Athens Insomnia Scale: validation of an instrument based on ICD-10 criteria

Soldatos, Constantin R, Dikeos, Dimitris G, Paparrigopoulos, Thomas J·2000·Journal of Psychosomatic Research

DOI 10.1016/s0022-3999(00)00095-7

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Abstract

Objectives To describe and validate the Athens Insomnia Scale (AIS).Methods The AIS is a self-assessment psychometric instrument designed for quantifying sleep difficulty based on the ICD-10 criteria. It consists of eight items: the first five pertain to sleep induction, awakenings during the night, final awakening, total sleep duration, and sleep quality; while the last three refer to well-being, functioning capacity, and sleepiness during the day. Either the entire eight-item scale (AIS-8) or the brief five-item version (AIS-5), which contains only the first five items, can be utilized. The validation of the AIS was based on its administration to 299 subjects: 105 primary insomniacs, 144 psychiatric patients and 50 non-patient controls.Results Regarding internal consistency, for both versions of the scale, the Cronbach's alpha was around 0. 90 and the mean item-total correlation coefficient was about 0.70. Moreover, in the factor analysis, the scale emerged as a sole component. The test-retest reliability correlation coefficient was found almost 0.90 at a 1-week interval. As far as external validity is concerned, the correlations of the AIS-8 and AIS-5 with the Sleep Problems Scale were 0.90 and 0.85, respectively.Conclusion The high measures of consistency, reliability, and validity of the AIS make it an invaluable tool in sleep research and clinical practice.

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“Abbreviations ADL basic activities of daily living IADL instrumental activities of daily living MNA-SF mini nutritional assessment short form SSRS social support rating scale GAD-7 generalized anxiety disorder-7 GDS-4 geriatric depression scale-4 AIS Athens insomnia scale LASSO Least absolute shrinkage and selection o…”
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“Participants were provided with questionnaires including the Brief COPE (Carver 1997), the Athens Insomnia Scale (AIS) (Soldatos et al. 2000), and the two-question casefinding instrument (TQ) (Whooley et al.”
BackgroundMethodInfluential
Effects of cognitive behavioral therapy for depression on improving insomnia and quality of life in Chinese women with breast cancer: results of a randomized, controlled, multicenter trial
Qiu, H.-H., Ren, W.-W., Yang, Y.-J., Zhu, X.-Z., Mao, G.-Y., Mao, S.-P., Lin, Y., Shen, S.-S., Li, C., Shi, H.-Y., et al. (2018) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s171297 · Cited by 32
“Severity of sleep problems was measured at baseline, 4, 12, and 24 weeks using Athens Insomnia Scale (AIS), 29 which is a self-report measure of sleep quality.”
School burnout and sleep in Finnish secondary school students
Lehto, J. E., Kortesoja, L., & Partonen, T. (2019) · Sleep Science · doi:10.5935/1984-0063.20190051 · Cited by 39
“Poor sleep quality was assessed using the following four items of the Athens Insomnia Scale 29 : sleep induction, awakenings during the night, final awakening earlier than desired, and overall quality of sleep.”
Method
Sleep Perception in Obstructive Sleep Apnea: A Study Using Polysomnography and the Multiple Sleep Latency Test
Nam, H., Lim, J., Kim, J.-S., Lee, K., Koo, D. L., & Lee, C. (2016) · Journal of Clinical Neurology · doi:10.3988/jcn.2016.12.2.230 · Cited by 38
A randomized, double-blind, placebo-controlled trial investigating the effects of an Ocimum tenuiflorum (Holy Basil) extract (HolixerTM) on stress, mood, and sleep in adults experiencing stress
Lopresti, A. L., Smith, S. J., Metse, A. P., & Drummond, P. D. (2022) · Frontiers in Nutrition · doi:10.3389/fnut.2022.965130 · Cited by 37
Insomnia, Daytime Sleepiness, and Quality of Life among 20,139 College Students in 60 Countries around the World—A 2016–2021 Study
Babicki, M., Piotrowski, P., & Mastalerz–Migas, A. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12020692 · Cited by 44
“827 [33,34]; ESS (Epworth sleepiness scale) is a tool for assessing daytime sleepiness based on 8 questions that assess the likelihood of falling asleep in specific situations.”
Method
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Zhang, M., Li, Q., Zhang, D., Tao, M., Han, K., Chi, C., Zhang, Z., Tao, X., & Liu, H. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04556-8 · Cited by 37
“Athens Insomnia Scale (AIS) The entire 8-item Athens Insomnia Scale (AIS-8) [21] was developed by Soldatos and colleagues in 2000 to assess the degree of insomnia in subjects based on the International Classification of Diseases Tenth Revision (ICD-10) diagnostic criteria for insomnia.”
Method
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Han, X., Yang, Y., Chen, Y., Gao, L., Yin, X., Li, H., Qiu, J., Wang, Y., Zhou, Y., & Xia, Y. (2017) · Clinical Cardiology · doi:10.1002/clc.22731 · Cited by 37
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“Positive results are evaluated from the cumulative score of all factors and reported as an individual’s sleep outcome [40].”
Background
Gender differences in food craving among overweight and obese patients attending low energy diet therapy: a matched case–control study
Imperatori, C., Innamorati, M., Tamburello, S., Continisio, M., Contardi, A., Tamburello, A., & Fabbricatore, M. (2013) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-013-0054-7 · Cited by 37
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“COVID-19 N = 252 adults with COVID-19 Mild to moderate depressive or anxiety symptoms (HAMD, score ≥ 7; HAMA score ≥7) Age (range: 18–75 years) cCBT + TAU (n = 126): 56% female TAU (n = 126): 46% female Online Primary outcomes: Symptoms of depression: Hamilton Depression Rating Scale, HAMD [64] Symptoms of Anxiety: Ha…”
MethodInfluential
Psychosocial Correlates of Insomnia in An Adolescent Population
Siomos, K. E., Avagianou, P. ‐., Floros, G. D., Skenteris, N., Mouzas, O. D., Theodorou, K., & Angelopoulos, N. V. (2009) · Child Psychiatry & Human Development · doi:10.1007/s10578-009-0166-5 · Cited by 36
“All participants completed the AIS, which is a concise self-evaluation tool for the estimation of the seriousness of insomnia complaints in clinical and general populations, based on the ICD-10 criteria for insomnia [ 18 ].”
Method
Validation of the Athens Insomnia Scale for screening insomnia in South Korean firefighters and rescue workers
Jeong, H. S., Jeon, Y., Ma, J., Choi, Y., Ban, S., Lee, S., Lee, B., Im, J. J., Yoon, S. J., Kim, J. E., et al. (2015) · Quality of Life Research · doi:10.1007/s11136-015-0986-7 · Cited by 36
Instruments to study sleep disorders in climacteric women
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“Scores that are higher than six define the presence of insomnia [17].”
Frequency of sleep disorders in patients with rheumatoid arthritis
Mustafa, M. Z., Bawazir, Y. M., Merdad, L., Wali, S., Attar, S. M., Fathaldin, O. A., Bahlas, S. M., Alhejaili, F. F., Aljohaney, A. A., Jan, A. M., et al. (2019) · Open Access Rheumatology Research and Reviews · doi:10.2147/oarrr.s201556 · Cited by 36
“Athens Insomnia Scale (AIS) The AIS is a validated scale used to assess the severity of insomnia using diagnostic criteria set forth by the International Classification of Diseases (ICD-10).(14) This eight-item questionnaire evaluates sleep onset, night and early-morning waking, sleep time, sleep quality, frequency an…”
Method
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“The Athens Insomnia Scale (AIS) is a self-administered questionnaire to assess the patient's sleep difficulties according to the ICD-10 criteria [37].”
Method
Assessment of insomnia and related risk factors in postmenopausal women screened for the metabolic syndrome
Chedraui, P. A., Miguel, G. S., Villacreses, D., Domínguez, A., Jaramillo, W., Escobar, G. S., Pérez-López, F. R., Genazzani, A. R., & Simoncini, T. (2012) · Maturitas · doi:10.1016/j.maturitas.2012.10.017 · Cited by 35
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Guiteras, A. R., Planas, J., Farriols, C., Mojal, S., Miralles, R., Silvent, M. A., & Ripoll, A. I. R. (2014) · BMC Palliative Care · doi:10.1186/1472-684x-13-40 · Cited by 35
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Liu, Y., Zhang, J., Gao, X., Wu, X., Yu, J., Chen, J., Bian, S., Ding, X., & Huang, L. (2014) · Military Medical Research · doi:10.1186/2054-9369-1-19 · Cited by 35
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“Sleep disturbances were evaluated with a self-reported questionnaire—Athens Insomnia Scale 8 [22].”
Method
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Piantoni, G., Cheung, B. L. P., Veen, B. D. V., Romeijn, N., Riedner, B. A., Tononi, G., van der Werf, Y. D., & Someren, E. J. W. V. (2013) · NeuroImage · doi:10.1016/j.neuroimage.2013.04.103 · Cited by 35
“…met the following criteria: (1) no self-reported sleep complaints, assessed using validated questionnaires (Buysse et al., 1989; Johns, 1991; Soldatos et al., 2000), (2) non-smoking, (3) no use of medication, including hormonal contraceptives, and (4) no neurological or psychiatric…”
Method
Validation of sleep-staging accuracy for an in-home sleep electroencephalography device compared with simultaneous polysomnography in patients with obstructive sleep apnea
Seol, J., Chiba, S., Kawana, F., Tsumoto, S., Masaki, M., Tominaga, M., Amemiya, T., Tani, A., Hiei, T., Yoshimine, H., et al. (2024) · Scientific Reports · doi:10.1038/s41598-024-53827-1 · Cited by 34
“Finally, subjective sleep parameters were measured using the Epworth Sleepiness Scale 39 and the Athens Insomnia Scale 40 .”
Method
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Insomnia affects future development of depression in workers: a 6-year cohort study.
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The potential of biomarkers for diagnosing insomnia: Consensus statement of the WFSBP Task Force on Sleep Disorders
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“Consequently, five studies reporting on an equal number of psychometric instruments (Pittsburgh Sleep Quality Index, Buysse et al. 1989; Athens Insomnia Scale, Soldatos et al. 2000 As presented in Table 2(a), the diagnostic validity of all five psychometric instruments was quite satisfactory, based on measures of sens…”
Background
Effects of Oral Supplementation with Pyrroloquinoline Quinone on Stress, Fatigue, and Sleep
Nakano, M., Yamamoto, T., Okamura, H., Tsuda, A., & Kowatari, Y. (2012) · Functional Foods in Health and Disease · doi:10.31989/ffhd.v2i8.81 · Cited by 33
“Seventeen volunteers were selected from adult male and female workers with a diagnosed sleep disorder or complaint and fatigue using as selection criteria the Athens Insomnia Scale (AIS), a scale of insomnia [12], and the Profile of Mood States-Short Form (POMS-S) [13] .”
Method
Interaction between serotonin transporter gene-linked polymorphic region (5-HTTLPR) and job-related stress in insomnia: a cross-sectional study in Sichuan, China
Huang, C., Li, J., Lu, L., Ren, X., Li, Y., Huang, Q., Lan, Y., & Wang, Y. (2014) · Sleep Medicine · doi:10.1016/j.sleep.2014.01.023 · Cited by 33
“Insomnia was screened based on the brief five-item version of Athens Insomnia Scale (AIS-5), which is an international sleep measurement instrument with a guideline introduction and five questions [31].”
Method
Effects of Enzyme-Treated Asparagus Extract on Heat Shock Protein 70, Stress Indices, and Sleep in Healthy Adult Men
Ito, T., Goto, K., Takanari, J., Miura, T., Wakame, K., NISHIOKA, H., TANAKA, A., & Nishihira, J. (2014) · Journal of Nutritional Science and Vitaminology · doi:10.3177/jnsv.60.283 · Cited by 33
Effect of dietary heat-killed Lactobacillus brevis SBC8803 (SBL88™) on sleep: a non-randomised, double blind, placebo-controlled, and crossover pilot study
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Cardiovascular Effect and Symptom Profile of Obstructive Sleep Apnea: Does Sex Matter?
Bouloukaki, I., Mermigkis, C. M., Markakis, M., Pataka, A., Alexaki, I., Ermidou, C., Moniaki, V., Mauroudi, E., Michelakis, S., & Schiza, S. E. (2019) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.8074 · Cited by 34
Randomized Controlled Trial on the Effects of a Combined Sleep Hygiene Education and Behavioral Approach Program on Sleep Quality in Workers with Insomnia
Kaku, A., Nishinoue, N., Takano, T., Eto, R., Kato, N., Ono, Y., & Tanaka, K. (2011) · Industrial Health · doi:10.2486/indhealth.ms1318 · Cited by 33
Lack of association between objectively assessed sleep disorders and inflammatory markers among kidney transplant recipients
Fornadi, K., Lindner, A., Czira, M. E., Szentkiralyi, A., Lazar, A. S., Zoller, R., Turanyi, C. Z., Veber, O., Novak, M., Mucsi, I., et al. (2012) · International Urology and Nephrology · doi:10.1007/s11255-011-0095-7 · Cited by 32

Authors: Soldatos, C. R., Dikeos, D. G., & Paparrigopoulos, T. J.
Affiliations: National and Kapodistrian University of Athens (GR)
Corresponding author: Soldatos, Constantin R
ORCID: Soldatos, Constantin R
Dikeos, Dimitris G
Paparrigopoulos, Thomas J
Venue: Journal of Psychosomatic Research
Publisher: Elsevier BV
Published: 2000-06
Volume: 48
Issue: 6
Pages: 555-560
ISSN: 0022-3999 (ISSN-L)
DOI: 10.1016/s0022-3999(00)00095-7
OpenAlex: W2021553431
Cited by: 1,754
References: 34
Citations by year: 2026: 196 · 2025: 187 · 2024: 194 · 2023: 184 · 2022: 155 · 2021: 174 · 2020: 110 · 2019: 89 · 2018: 69 · 2017: 54 · 2016: 54 · 2015: 35 · 2014: 41 · 2013: 30 · 2012: 39
FWCI: 5.96
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Psychosomatic Research (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Keywords: Athens Insomnia Scale, insomnia, sleep disorders, ICD-10 diagnostic criteria, self-report questionnaire, psychometric validation, sleep induction, nocturnal awakenings, sleep quality, daytime sleepiness, psychiatric patients, short-form scale
MeSH terms: Adolescent, Adult, Aged, Mental Disorders, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Personality Inventory, Psychiatric Status Rating Scales, Psychometrics, Reproducibility of Results, Comorbidity

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Athens Insomnia Scale: validation of an instrument based on ICD-10 criteria

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