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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“Although the authors of the AIS did not explicitly propose this two-factor structure, they did suggest, at an operational level, that the items belonging to the first dimension be used separately as short scales (Soldatos et al., 2000).”
BackgroundMethod
Content analysis of insomnia questionnaires: A step to better evaluate the complex and multifaceted construct of insomnia disorder
Coelho, J., Sánchez-Ortuño, M. M., Martin, V., Gauld, C., Richaud, A., Lopez, R., Pelou, M., Abi-Saab, P., Philip, P., Geoffroy, P. A., et al. (2023) · Psychiatry Research · doi:10.1016/j.psychres.2023.115584 · Cited by 14
Insomnia, Fatigue, Bladder Disorders and Mood Disorders among Polish Patients with Multiple Sclerosis: Cross-Sectional Study
Rzepka, M., Chmiela, T., Kaczmarczyk, A., & Krzystanek, E. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13041043 · Cited by 12
“…eight-item tool designed to assess sleep difficulty based on the diagnostic criteria of insomnia of the 10th revision of the international statistical classification of diseases and related health problems (ICD-10) and has been validated in a Polish population with Cronbach’s alpha = 0.89 [12,13].”
MethodInfluential
Risk factors associated with functional decline in older hospital survivors with acute lower respiratory tract infections: a prospective cohort study
Weng, B., Jin, J., Huang, L., Tong, X., Jiao, W., Wang, Y., Fang, C., Wang, M., & Li, Y. (2024) · BMC Geriatrics · doi:10.1186/s12877-024-04838-0 · Cited by 12
“Sleep disorder was assessed using the Athens Insomnia Scale (AIS), with a cut-off score of 6 [19].”
Method
Estimation of cognitive impairment in chronic pain patients and characteristics of estimated mild cognitive impairment
Moriya, M., Hu, L., Sakatani, K., & Kitahara, M. (2024) · Frontiers in Neurology · doi:10.3389/fneur.2024.1344190 · Cited by 12
Long-Term Caregiving Impact and Self-Care Strategies in Family Caregivers of People with Neuropsychiatric Disorders: A Mixed-Method Study
Sánchez‐Martínez, V., Cauli, O., & Corchón, S. (2024) · Diseases · doi:10.3390/diseases12110292 · Cited by 15
Tryptophan for the sleeping disorder and mental symptom of new-type drug dependence
Wang, D., Li, W., Xiao, Y., He, W., Wei, W., Yang, L., Yu, J., Song, F., & Wang, Z. (2016) · Medicine · doi:10.1097/md.0000000000004135 · Cited by 12
Organizational justice and insomnia: a prospective cohort study examining insomnia onset and persistence
Hayashi, T., Odagiri, Y., Takamiya, T., Ohya, Y., & Inoue, S. (2016) · International Archives of Occupational and Environmental Health · doi:10.1007/s00420-016-1183-x · Cited by 12
“Insomnia was measured using the Athens Insomnia Scale (AIS) (Soldatos et al. 2000; Okajima et al. 2013).”
Method
Treatment Preferences for Internet-Based Cognitive Behavioral Therapy for Insomnia in Japan: Online Survey
Sato, D., Sutoh, C., Seki, Y., Nagai, E., & Shimizu, E. (2019) · JMIR Formative Research · doi:10.2196/12635 · Cited by 12
“The first part asked demographic questions including gender, age, living area, employment status, and presence and severity of insomnia using the Athens Insomnia Scale (AIS), a self-reported psychometric questionnaire consisting of eight items developed by Soldatos et al [19].”
Driving Behaviour in Depression: Findings from a Driving Simulator Study
Tsoutsi, V., Dikeos, D. G., Basta, M., & Papadakaki, M. (2019) · Safety · doi:10.3390/safety5040070 · Cited by 12
Relationship between central obesity and oxidative stress in premenopausal versus postmenopausal women
Sánchez-Rodrı́guez, M. A., Nicolás, A. R.-S., Zacarías-Flores, M., Correa‐Muñoz, E., & Mendoza-Núñez, V. M. (2020) · Nutrición Hospitalaria · doi:10.20960/nh.02552 · Cited by 12
Increase in Body Weight Following Residential Displacement: 5-year Follow-up After the 2011 Great East Japan Earthquake and Tsunami
Takahashi, S., Yonekura, Y., Tanno, K., Shimoda, H., Sakata, K., Ogawa, A., & Kobayashi, S. (2020) · Journal of Epidemiology · doi:10.2188/jea.je20190333 · Cited by 12
Social trust predicts sleep disorder at 6 years after the Great East Japan earthquake: data from a prospective cohort study
Sugawara, Y., Tomata, Y., Sekiguchi, T., Yabe, Y., Hagiwara, Y., & Tsuji, I. (2020) · BMC Psychology · doi:10.1186/s40359-020-00436-y · Cited by 12
“The questionnaires are composed of various items: residence status, medical history, physical health status, smoking habits, drinking habits, dietary habits, sleep status (based on the 8-item Athens Insomnia Scale [AIS]) [28], psychological distress (based on the 6-item Kessler Psychological Distress Scale [K6]) [29],…”
BackgroundMethodInfluential
Characteristics of Patients with Obstructive Sleep Apnea at High Risk for Cardiovascular Disease
Bouloukaki, I., Fanaridis, M., Stathakis, G., Ermidou, C., Kallergis, E. M., Moniaki, V., Mauroudi, E., & Schiza, S. E. (2021) · Medicina · doi:10.3390/medicina57111265 · Cited by 12
“The 8-item Athens Insomnia Scale is a self-assessment psychometric instrument based on the diagnostic criteria of the International Classification of Diseases 10th Revision (ICD-10), which has been developed as a tool to evaluate the severity of insomnia [13,14].”
Method
Functional Connectivity Density in the Sensorimotor Area is Associated with Sleep Latency in Patients with Primary Insomnia
Ji, B., Dai, M., Guo, Z., Li, J., Cao, Y., Zhang, Z., Zhang, Y., & Liu, X. (2022) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s338489 · Cited by 12
Psychiatric Sequelae Following Whiplash Injury: A Systematic Review
Al‐Khazali, H. M., Ashina, H., Iljazi, A., Al‐Sayegh, Z., Lipton, R. B., Ashina, M., Ashina, S., & Schytz, H. W. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.814079 · Cited by 12
Factors influencing caregiver burden in chronic pain patients: A retrospective study
Tsuji, H., Tetsunaga, T., Tetsunaga, T., Misawa, H., Oda, Y., Takao, S., Nishida, K., & Ozaki, T. (2022) · Medicine · doi:10.1097/md.0000000000030802 · Cited by 13
“The total score, ranging from 0 to 24, is the sum of all the scores, with higher scores indicating more severe insomnia.[19]”
Background
The Effect of Depressive and Insomnia Symptoms in Quality of Life among Community-Dwelling Older Adults
Tsaras, K., Tsiantoula, M., Papagiannis, D., Papathanasiou, I. V., Chatzi, M., Kelesi, Μ., Kaba, E., & Fradelos, Ε. C. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192013704 · Cited by 14
“Health-Related Quality of Life The 30-item Greek version of the World Health Organization Quality of Life (WHOQoL)-Bref [20] was used to assess the health-related QoL in older individuals.”
MethodInfluential
Psychological and sleep disturbances among first-line, second-line, and at home medical staff during the COVID-19 pandemic in Shanghai, China
Wang, P., Shen, X., Jiang, Y., Wu, L., Shen, J., Nie, X., Chen, W., & Liu, J. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.1006610 · Cited by 12
“The higher the AIS, the more severe the insomnia (13).”
Background
Caffeine Intake throughout Pregnancy, and Factors Associated with Non-Compliance with Recommendations: A Cohort Study
Román‐Gálvez, M. R., Martín‐Peláez, S., Hernández-Martínez, L., Ibáñez, N. C., Olmedo‐Requena, R., Martínez‐Galiano, J. M., Bueno‐Cavanillas, A., & Amezcua‐Prieto, C. (2022) · Nutrients · doi:10.3390/nu14245384 · Cited by 15
“In addition, at T1, T2, and T3 data about smoking and alcohol habits, insomnia (by AIS), categorized as no insomnia (<8) or insomnia (≥8) [21], physical activity”
Background
Chronic insomnia disorder as risk factor for stroke: a systematic review
Silva, L. A. S., do Amaral, M. M., Grassi, V., & Palmeira, A. L. R. (2022) · Arquivos de Neuro-Psiquiatria · doi:10.1055/s-0042-1755227 · Cited by 13
Relationship between objective cognitive functioning and work performance among Japanese workers
Shibaoka, M., Masuda, M., Iwasawa, S., Ikezawa, S., Eguchi, H., & Nakagome, K. (2023) · Journal of Occupational Health · doi:10.1002/1348-9585.12385 · Cited by 13
Association between physical activity, sedentary behavior patterns with bone health among Chinese older women
Ren, X., Hu, C., Wang, W., He, Q., Du, L., Li, T., Pan, Y., Chen, S., & Zhang, X. (2024) · Bone · doi:10.1016/j.bone.2024.117025 · Cited by 12
Sleep-improving effects of the aromatic compound heliotropin
Yamagishi, R., Yokomaku, A., Omoto, F., Misao, K., Takada, K., YOSHIMATSU, S., Abe, A., & Hayashi, M. (2010) · Sleep and Biological Rhythms · doi:10.1111/j.1479-8425.2010.00476.x · Cited by 12
Association of symptoms of insomnia and sleep parameters among kidney transplant recipients
Rónai, K. Z., Szentkirályi, A., Lázár, A. S., Lázár, Z. I., Papp, I., Gombos, F., Zoller, R., Czira, M. E., Lindner, A. V., Mucsi, I., et al. (2017) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2017.05.019 · Cited by 12
Association between sleep disturbance and new-onset subjective knee pain in Great East Japan Earthquake survivors: A prospective cohort study in the Miyagi prefecture.
Hagiwara, Y., Sekiguchi, T., Sugawara, Y., Yabe, Y., Koide, M., Itaya, N., Yoshida, S., Sogi, Y., Tsuchiya, M., Tsuji, I., et al. (2017) · Journal of Orthopaedic Science · doi:10.1016/j.jos.2017.10.011 · Cited by 9
Endothelial dysfunction, abnormal vascular structure and lower urinary tract symptoms in men and women
Matsui, S., Kajikawa, M., Maruhashi, T., Iwamoto, Y., Oda, N., Kishimoto, S., Hashimoto, H., Hidaka, T., Kihara, Y., Chayama, K., et al. (2018) · International Journal of Cardiology · doi:10.1016/j.ijcard.2018.02.041 · Cited by 12
SARC‐F Questionnaire: Rapid and Easy Tool for Identifying Physical Limitations in Hemodialysis Patients
Yamamoto, S., Matsuzawa, R., Harada, M., Watanabe, T., Shimoda, T., Suzuki, Y., Kamiya, K., Osada, S., Yoshida, A., & Matsunaga, A. (2019) · JCSM Clinical Reports · doi:10.17987/jcsm-cr.v4i1.74 · Cited by 12
A multicenter, randomized, double-blind, placebo-controlled trial evaluating the efficacy and safety of Taoren Honghua Jian granule in patients with stable coronary artery disease
Wang, Y., Zhang, Y., Du, Y., Yang, Y., Wei, J., Zhang, N., Mao, M., Du, W., & Liu, P. (2019) · Medicine · doi:10.1097/md.0000000000017753 · Cited by 11
“The higher score suggests the worse sleep quality.([19])”
Background
The relation of nocturnal exposure to aircraft noise and aircraft noise-induced insomnia with blood pressure
Rojek, M., Wojciechowska, W., Januszewicz, A., Czarnecka, D., Skalski, P., & Rajzer, M. W. (2020) · Polskie Archiwum Medycyny Wewnętrznej · doi:10.20452/pamw.15716 · Cited by 14
“Insomnia was evaluated using the Athens Insomnia Scale (AIS).[23] Sleep quality was measured by assessing eight factors, amongst which the first five factors are related to”
Method
The Joint Association of Daily Rest Periods and Sleep Duration with Worker Health and Productivity: A Cross-Sectional Web Survey of Japanese Daytime Workers
Ikeda, H., Kubo, T., Izawa, S., Nakamura‐Taira, N., Yoshikawa, T., & Akamatsu, R. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191711143 · Cited by 12
“The AIS, a self-administered questionnaire, which is based on the International Classification of Diseases 10th criteria, has been widely employed to evaluate sleep difficulty intensities [24].”
Method
Revisión de los diversos métodos de evaluación del trastorno de insomnio
Ruiz, C. (2007) · Digitum: Institutional Repository of the University of Murcia (University of Murcia) · Cited by 12
Exercise and Autism Symptoms: A Case Study
Burns, B. T., & Ault, R. L. (2009) · Psi Chi Journal of Psychological Research · doi:10.24839/1089-4136.jn14.2.43 · Cited by 12
Effect of Atogepant on Sleep Quality and Sleep-Related Adverse Events in Adult Patients with Migraine: A Prospective Observational 12-Week Study
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The Effect of Allergic Rhinitis on Quality of Life in Patients Suffering from the Disease: A Case Control Study
Komnos, I. D., Michali, M. C., ASIMAKOPOULOS, A. D., Basiari, L. V., & Kastanioudakis, I. G. (2019) · International Journal of Otolaryngology and Head & Neck Surgery · doi:10.4236/ijohns.2019.84014 · Cited by 15
“The AIS questionnaire examined characteristics of sleep quality within the last month by using 8 questions which were marked with numeric scores from zero (good results) to three (worst results) [22].”
Method
Physical activity improves sleep quality in women
Dąbrowska-Galas, M., & Dąbrowska, J. (2021) · Ginekologia Polska · doi:10.5603/gp.a2020.0172 · Cited by 11
“The AIS is a short, eight-point scale that measures the symptoms of insomnia [14].”
Background
Psychometric properties of Indonesian version of sleep condition indicator for screening poststroke insomnia
Hasan, F., Vidyanti, A. N., Tsai, P., Wu, D., Lee, H., Yuliana, L. T., Romadlon, D. S., Marta, O. F. D., & Chiu, H. (2023) · Sleep And Breathing · doi:10.1007/s11325-023-02797-1 · Cited by 11
“Several insomnia screening tools are widely used in various research fields and clinical settings [10], such as the Athens Insomnia Scale [11], Pittsburg Sleep Quality Index (PSQI) [12], and Insomnia Severity Index (ISI) [13].”
Method
Ozonated autohemotherapy combined with pulsed radiofrequency in the treatment of thoracic postherpetic neuralgia in older adults: a retrospective study
Li, X.-R., Cui, J., Ge, W.-P., Wang, Z., Chu, Y., & Zheng, G. (2023) · Medical Gas Research · doi:10.4103/2045-9912.372666 · Cited by 11
Anxiety, insomnia and family support in nurses, two years after the onset of the pandemic crisis
Sikaras, C., Tsironi, M., Zyga, S., & Παναγιώτου, Α. (2023) · AIMS Public Health · doi:10.3934/publichealth.2023019 · Cited by 11

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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