Validering av spørreskjemaer for insomni i befolkningen: Helseundersøkelsen i Nord-Trøndelag (HUNT)

Forskere fra NTNU og St. Olavs hospital har i denne studien validert spørreskjemaene Karolinska Sleep Questionnaire (KSQ) og Insomnia Severity Index (ISI), sammenlignet med et semistrukturert ansikt til ansikt intervju for å diagnostisere insomni hos pasienter under og over 65 år. I tillegg ønsket forskerne å sammenligne prevalens ved bruk av spørreskjema kontra intervjubasert diagnostisering. Totalt 232 av 1200 inviterte (19,3 %) fra HUNT4 fylte ut spørreskjemaer, inkludert KSQ og ISI, kort tid før de deltok i et strukturert diagnostisk intervju om insomni basert på DSM-5 kriteriene. Validiteten av spørreskjema var høyere for personer under versus personer over 65 år. Resultatene fra studien bør vektlegges ved epidemiologiske populasjonsbaserte studier som bruker spørreskjemaer for å diagnostisere insomni.

Validation of insomnia questionnaires in the general population: The Nord-Trøndelag Health Study (HUNT)

Artikkelen er publisert i Journal of Sleep Research

James Filosa, Petter Moe Omland, Knut Langsrud, Knut Hagen, Morten Engstrøm, Ole Kristian Drange, Andreas Jarlalein Knutsen, Eiliv Brenner, Håvard Kallestad, Trond Sand

The primary aim was to validate questionnaire-based insomnia diagnoses from a modified Karolinska Sleep Questionnaire (KSQ) and the Insomnia Severity Index (ISI), by age category (< or >65 years), against a semi-structured face-to-face interview. Secondary aims were to split validity by diagnostic certainty of the interview and to compare prevalence estimates of questionnaire- and interview-based diagnoses. A total of 232 out of 1,200 invited (19.3%) from the fourth Nord-Trøndelag Health Study (HUNT4) completed questionnaires, including the KSQ and ISI, shortly before attending a face-to-face diagnostic interview for insomnia based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Both a tentative (DSM-5 criteria A-E) and a definite (criteria A-H) interview diagnosis was evaluated. Cohen's kappa statistic quantified questionnaire validity. In all, 33% (95% confidence interval 27-39%) of participants had definite insomnia: 40% of women and 21% of men. The ISI (cut-off 12) and several KSQ-based diagnoses showed very good validity (κ ≤0.74) against the tentative, versus good validity (κ ≤0.61) against the definite interview diagnosis. Short questionnaires, requiring a daytime symptom at least three times a week, may underestimate insomnia prevalence. Validity was consistently higher for persons aged below versus above 65 years (definite insomnia: κ ≤0.64 vs. κ ≤0.56). Our results have implications for epidemiological population-based studies utilising insomnia questionnaires.