Defining insomnia: quantitative criteria for insomnia severity and frequency

Recent efforts have been made to develop quantitative frequency, duration, and severity criteria for insomnia. The current study was conducted to test a range of frequency and severity criteria sets for discriminating primary insomnia sufferers from normal sleepers. Seventy-two adults with primary i...

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Bibliographic Details
Published in:Sleep (New York, N.Y.) N.Y.), 2006-04, Vol.29 (4), p.479-485
Main Authors: Lineberger, Margaret D, Carney, Colleen E, Edinger, Jack D, Means, Melanie K
Format: Article
Language:English
Subjects:
Adult
Aged
Apnea - diagnosis
Apnea - epidemiology
Cross-Sectional Studies
Female
Humans
Incidence
Male
Middle Aged
ROC Curve
Sensitivity and Specificity
Severity of Illness Index
Sleep Initiation and Maintenance Disorders - diagnosis
Sleep Initiation and Maintenance Disorders - epidemiology
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Summary:Recent efforts have been made to develop quantitative frequency, duration, and severity criteria for insomnia. The current study was conducted to test a range of frequency and severity criteria sets for discriminating primary insomnia sufferers from normal sleepers. Seventy-two adults with primary insomnia and 88 age-matched normal sleepers. Participants completed 14 consecutive nights of sleep logs to monitor their home sleep patterns. Receiver-operator characteristic curve analyses were used to compare a range of severity and frequency criteria sets for discriminating the insomnia and normal-sleeper groups. In addition, sensitivity and specificity tests were conducted for a range of wake-time severity cutoffs based on 2-week mean sleep-log data. Receiver-operator characteristic curve analyses showed that no 1 combination of severity and frequency criteria maximized sensitivity and specificity. Rather, the optimal frequency cutoff decreased as the severity criterion increased. Analyses of mean sleep-log data showed that an average sleep-onset latency or middle-of-the-night wake time (ie, time awake between sleep onset and final morning awakening) cutoff of 20 minutes or longer over 2 weeks of sleep-log monitoring appeared to best maximize sensitivity (94.4%) and specificity (79.6%) for insomnia classification. The optimal quantitative insomnia criteria found herein differ from those previously proposed. Nonetheless, results suggest that quantitative criteria derived from sleep-log data may be useful for classification of primary insomnia.
ISSN:0161-8105
1550-9109
DOI:10.1093/sleep/29.4.479