Skip to main content
SpringerLink
Log in

Psychometric properties of Indonesian version of sleep condition indicator for screening poststroke insomnia

  • Psychiatrics • Original Article
  • Published:
Sleep and Breathing Aims and scope Submit manuscript

Abstract

Background

No study has examined the psychometric properties of the sleep condition indicator (SCI) for screening poststroke insomnia in the Indonesian population. We aimed to develop the Indonesian version of the sleep condition indicator (ISCI) and to examine its psychometric properties for screening adult patients in late sub-acute and chronic periods after stroke.

Methods

This was a cross-sectional study with two stages. In the first stage, the English version of the SCI was translated into the ISCI using standard procedures. The psychometric properties of the ISCI were tested in the second stage. Internal consistency and test–retest reliability of ISCI were used to evaluate reliability. A confirmatory factor analysis (CFA) was performed to test construct validity. To test concurrent and convergent validity, the Indonesian version of the insomnia severity index (ISI-INA), generalized anxiety disorder questionnaire (IGAD-7), and patient health questionnaire (IPHQ-9) were used. A receiver operating characteristic (ROC) analysis was conducted to calculate the optimal cutoff score of the ISCI on the basis of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria for insomnia.

Results

A total of 160 adults with a diagnosis of stroke for more than 3 months were included (median age of 58.5 years, 31% met the DSM-5 criteria for insomnia). The ISCI had a satisfactory Cronbach’s alpha of 0.89 and test–retest reliability of 0.78. The CFA revealed that the ISCI exhibited a satisfactory model fit and was associated with the ISI-INA, IGAD-7, and IPHQ-9 (r = −0.81, −0.32, and −0.52, respectively; all P < .001). The ROC test revealed that the optimal cutoff point of ≤23 yielded the highest sensitivity (94%) and specificity (97%).

Conclusion

The study results revealed that the 8-item ISCI is a reliable and valid screening tool for detecting insomnia symptoms according to the DSM-5 criteria in the chronic period after stroke.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

The data was available on reasonable request.

References

  1. Hasan F, Gordon C, Wu D, Huang H-C, Yuliana LT, Susatia B et al (2021) Dynamic prevalence of sleep disorders following stroke or transient ischemic attack: systematic review and meta-analysis. Stroke 52(2):655–63

    Article  CAS  PubMed  Google Scholar 

  2. Baylan S, Griffiths S, Grant N, Broomfield NM, Evans JJ, Gardani M (2020) Incidence and prevalence of post-stroke insomnia: a systematic review and meta-analysis. Sleep Med Rev 49:101222

    Article  PubMed  Google Scholar 

  3. American Psychiatric Association D, American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders: DSM-5 (vol. 5, no. 5). Washington, DC: American Psychiatric Association

  4. Iddagoda MT, Inderjeeth CA, Chan K, Raymond WD (2020) Post-stroke sleep disturbances and rehabilitation outcomes: a prospective cohort study. Intern Med J 50(2):208–13

    Article  PubMed  Google Scholar 

  5. Matas A, Amaral L, Patto AV (2022) Is post-ischemic stroke insomnia related to a negative functional and cognitive outcome? Sleep Med 94:1–7

    Article  PubMed  Google Scholar 

  6. Tang W-K, Grace Lau C, Mok V, Ungvari GS, Wong K-S (2015) Insomnia and health-related quality of life in stroke. Top Stroke Rehabil 22(3):201–7

    Article  PubMed  Google Scholar 

  7. Wang L, Tao Y, Chen Y, Wang H, Zhou H, Fu X (2016) Association of post stroke depression with social factors, insomnia, and neurological status in Chinese elderly population. Neurol Sci 37(8):1305–10

    Article  PubMed  Google Scholar 

  8. Zhao Y, Hu B, Liu Q, Wang Y, Zhao Y, Zhu X (2022) Social support and sleep quality in patients with stroke: The mediating roles of depression and anxiety symptoms. Int J Nurs Pract 28(3):e12939

    Article  PubMed  Google Scholar 

  9. Silva LC, Silva A, Rangel MFDA, Caetano LCG, Teixeira-Salmela LF, Scianni AA (2021) Depressive symptoms and functional status are associated with sleep quality after stroke. Top Stroke Rehabil 28(8):573–80

    Article  PubMed  Google Scholar 

  10. Talero-Gutiérrez C, Moreno C, González-Reyes R, Palacios L, de la Peña F, Muñoz-Delgado J (2008) Sleep evaluation scales and questionnaires: a review. Actas Esp Psiquiatr 36(1):50–9

    PubMed  Google Scholar 

  11. Soldatos CR, Dikeos DG, Paparrigopoulos TJ (2000) Athens Insomnia Scale: validation of an instrument based on ICD-10 criteria. J Psychosom Res 48(6):555–60

    Article  CAS  PubMed  Google Scholar 

  12. Buysse DJ, Ancoli-Israel S, Edinger JD, Lichstein KL, Morin CM (2006) Recommendations for a standard research assessment of insomnia. Sleep 29(9):1155–73

    Article  PubMed  Google Scholar 

  13. Bastien CH, Vallières A, Morin CM (2001) Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med 2(4):297–307

    Article  PubMed  Google Scholar 

  14. Chiu H-Y, Chang L-Y, Hsieh Y-J, Tsai P-S (2016) A meta-analysis of diagnostic accuracy of three screening tools for insomnia. J Psychosom Res 87:85–92

    Article  PubMed  Google Scholar 

  15. Espie CA, Kyle SD, Hames P, Gardani M, Fleming L, Cape J (2014) The Sleep Condition Indicator: a clinical screening tool to evaluate insomnia disorder. BMJ Open 4(3):e004183

    Article  PubMed  PubMed Central  Google Scholar 

  16. Espie CA, Farias Machado P, Carl JR, Kyle SD, Cape J, Siriwardena AN et al (2018) The Sleep Condition Indicator: reference values derived from a sample of 200 000 adults. J Sleep Res 27(3):e12643

    Article  PubMed  Google Scholar 

  17. Luik AI, Machado PF, Siriwardena N, Espie CA (2019) Screening for insomnia in primary care: using a two-item version of the Sleep Condition Indicator. Br J Gen Pract 69(679):79–80

    Article  PubMed  PubMed Central  Google Scholar 

  18. Espie CA, Kyle SD, Hames P, Cyhlarova E, Benzeval M (2012) The daytime Impactof DSM-5 insomnia disorder: comparative analysis of insomnia subtypes from the great British sleep survey. J Clin Psychiatry 73(12):4027

  19. Palagini L, Ragno G, Caccavale L, Gronchi A, Terzaghi M, Mauri M et al (2015) Italian validation of the Sleep Condition Indicator: A clinical screening tool to evaluate Insomnia Disorder according to DSM-5 criteria. Int J Psychophysiol 98(3):435–40

    Article  PubMed  Google Scholar 

  20. Bayard S, Lebrun C, Maudarbocus KH, Schellaert V, Joffre A, Ferrante E et al (2017) Validation of a French version of the Sleep Condition Indicator: a clinical screening tool for insomnia disorder according to DSM-5 criteria. J Sleep Res 26(6):702–8

    Article  PubMed  Google Scholar 

  21. Bayard S, Lebrun C, Arifi-Rossignol A, Geny C, Gély-Nargeot M-C, Luik AI (2021) Diagnostic Validity of the Sleep Condition Indicator to Screen for Diagnostic and Statistical Manual-5 Insomnia Disorder in Patients with Parkinson’s Disease. Eur Neurol 84(5):333–9

    Article  PubMed  Google Scholar 

  22. Wong ML, Lau KNT, Espie CA, Luik AI, Kyle SD, Lau EYY (2017) Psychometric properties of the Sleep Condition Indicator and Insomnia Severity Index in the evaluation of insomnia disorder. Sleep Med 33:76–81

    Article  PubMed  Google Scholar 

  23. Hellström A, Hagell P, Broström A, Ulander M, Luik AI, Espie CA et al (2019) A classical test theory evaluation of the Sleep Condition Indicator accounting for the ordinal nature of item response data. Plos one 14(3):e0213533

    Article  PubMed  PubMed Central  Google Scholar 

  24. Jones PS, Lee JW, Phillips LR, Zhang XE, Jaceldo KB (2001) An adaptation of Brislin’s translation model for cross-cultural research. Nurs Res 50(5):300–4

    Article  CAS  PubMed  Google Scholar 

  25. Anthoine E, Moret L, Regnault A, Sébille V, Hardouin J-B (2014) Sample size used to validate a scale: a review of publications on newly-developed patient reported outcomes measures. Health Qual Life Outcomes 12(1):1–10

    Article  Google Scholar 

  26. Charlson M, Pompei P, Ales KL, Mckenzie CR (1987) A new method of classyfing prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 40(5):373–83

    Article  CAS  PubMed  Google Scholar 

  27. Michaud AL, Zhou ES, Chang G, Recklitis CJ (2021) Validation of the Insomnia Severity Index (ISI) for identifying insomnia in young adult cancer survivors: comparison with a structured clinical diagnostic interview of the DSM-5 (SCID-5). Sleep Med 81:80–5

    Article  PubMed  PubMed Central  Google Scholar 

  28. Swanenghyun G (2015) Validitas dan reliabilitas alat ukur Insomnia Severity Index Versi Indonesia (ISI-INA) pada remaja jalanan di Yogyakarta. Dissertation, Universitas Gadjah Mada

  29. Kroenke K, Spitzer RL, Williams JB (2003) The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care 41:1284–92

    Article  PubMed  Google Scholar 

  30. Kroenke K, Spitzer RL, Williams JB (2001) The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 16(9):606–13

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Kroenke K, Spitzer RL (2002) The PHQ-9: a new depression diagnostic and severity measure. Psychiatric Ann 32(9):509–15

    Article  Google Scholar 

  32. Williams LS, Brizendine EJ, Plue L, Bakas T, Tu W, Hendrie H et al (2005) Performance of the PHQ-9 as a screening tool for depression after stroke. Stroke 36(3):635–8

    Article  PubMed  Google Scholar 

  33. Onie S, Kirana AC, Mustika NP, Adesla V, Ibrahim R (2020) Assessing the Predictive Validity and Reliability of the DASS-21, PHQ-9 and GAD-7 in an Indonesian Sample

    Book  Google Scholar 

  34. Kroenke K, Spitzer RL, Williams JB, Monahan PO, Löwe B (2007) Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med 146(5):317–25

    Article  PubMed  Google Scholar 

  35. Plummer F, Manea L, Trepel D, McMillan D (2016) Screening for anxiety disorders with the GAD-7 and GAD-2: a systematic review and diagnostic metaanalysis. Gen hosp Psychiatry 39:24–31

    Article  PubMed  Google Scholar 

  36. R Core Team R (2013) R: A language and environment for statistical computing. R foundation for statistical computing Vienna, Austria

    Google Scholar 

  37. Jm B, Altman D (1997) Statistics notes: Cron bach’s alpha. BmJ 314:572

    Article  Google Scholar 

  38. Weir JP (2005) Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res 19(1):231–40

    PubMed  Google Scholar 

  39. Fleiss J (1986) The design and analysis of clinical experiments. John Willey and Sons. Acta Physiol Scand, New York

    Google Scholar 

  40. Rosseel Y (2012) lavaan: An R package for structural equation modeling. J Stat Softw 48:1–36

    Article  Google Scholar 

  41. Brown TA (2015) Confirmatory factor analysis for applied research. Guilford publications, New York

    Google Scholar 

  42. Schumacker E, Lomax G (2016) A Beginner’s Guide to Structural Equation Modelling, 4th edn. Routledge, London

    Google Scholar 

  43. Hooper D, Coughlan J, Mullen M (2008) Structural equation modelling: guidelines for determining model fit. Electron J Bus Res Methods 6:53–60

    Google Scholar 

  44. Hu Lt, Bentler PM (1999) Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Modeling Multidiscip J 6(1):1–55

    Article  Google Scholar 

  45. Mandrekar JN (2010) Receiver operating characteristic curve in diagnostic test assessment. J Thorac Oncol 5(9):1315–6

    Article  PubMed  Google Scholar 

  46. Bewick V, Cheek L, Ball J (2004) Statistics review 13: receiver operating characteristic curves. Crit Care 8(6):1–5

    Article  Google Scholar 

  47. Yang B (2005) Factor analysis methods. Research in organizations: Foundations and methods of inquiry. pp 181–199

    Google Scholar 

  48. McArdle JJ (1996) Current directions in structural factor analysis. Curr Dir Psychol Sci 5(1):11–8

    Article  Google Scholar 

  49. Kääriäinen M, Kanste O, Elo S, Pölkki T, Miettunen J, Kyngäs H (2011) Testing and verifying nursing theory by confirmatory factor analysis. J Adv Nurs 67(5):1163–72

    Article  PubMed  Google Scholar 

  50. Wolf EJ, Harrington KM, Clark SL, Miller MW (2013) Sample size requirements for structural equation models: An evaluation of power, bias, and solution propriety. Educ Psychol Meas 73(6):913–34

    Article  Google Scholar 

  51. Barakat S, Abujbara M, Banimustafa R, Batieha A, Ajlouni K (2019) Sleep quality in patients with type 2 diabetes mellitus. J Clin Med Res 11(4):261

    Article  PubMed  PubMed Central  Google Scholar 

  52. Tzeng JI, Fu Y-W, Lin C-C (2012) Validity and reliability of the Taiwanese version of the Pittsburgh Sleep Quality Index in cancer patients. Int J Nurs Stud 49(1):102–8

    Article  PubMed  Google Scholar 

  53. Sohn SI, Kim DH, Lee MY, Cho YW (2012) The reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index. Sleep Breath 16(3):803–12

    Article  PubMed  Google Scholar 

  54. Glozier N, Moullaali TJ, Sivertsen B, Kim D, Mead G, Jan S et al (2017) The course and impact of poststroke insomnia in stroke survivors aged 18 to 65 years: results from the Psychosocial Outcomes In StrokE (POISE) Study. Cerebrovasc Dis Extra 7(1):9–20

    Article  PubMed  PubMed Central  Google Scholar 

  55. Kwakkel G, Buma F, Selzer M (2014) Understanding mechanisms underlying recovery after stroke. Textbook of Neural Repair and NeuroRehabilitation. pp 7–25

    Chapter  Google Scholar 

  56. Ohayon MM, Sagales T (2010) Prevalence of insomnia and sleep characteristics in the general population of Spain. Sleep Med 11(10):1010–8

    Article  PubMed  Google Scholar 

  57. Khaled SM, Petcu C, Al-Thani MA, Al-Hamadi AMH, Daher-Nashif S, Zolezzi M et al (2021) Prevalence and associated factors of DSM-5 insomnia disorder in the general population of Qatar. BMC Psychiatry 21(1):1–10

    Article  Google Scholar 

  58. Ohayon MM (2002) Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev 6(2):97–111

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

Firstly, we would like to thank to Professor Colin A. Espie PhD, DSc (Med) Professor of Sleep Medicine, University of Oxford, for permission to translate and validate the SCI. Secondly, we would like to express our gratitude to all of the study participants for their invaluable efforts, which we appreciate.

Funding

This research was supported by grants from the Ministry of Science and Technology, Taiwan (MOST 110-2628-B-038-017).

Author information

Authors and Affiliations

  1. School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan

    Faizul Hasan, Pei-Shan Tsai, Lia Taurussia Yuliana, Debby Syahru Romadlon & Hsiao-Yean Chiu

  2. Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

    Amelia Nur Vidyanti

  3. Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Pei-Shan Tsai, Hsin-Chien Lee & Hsiao-Yean Chiu

  4. Department of Neurology, Taipei Medical University Shuang Ho Hospital, New Taipei City, Taiwan

    Dean Wu

  5. Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Dean Wu

  6. Sleep Center, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, 23561, Taiwan

    Dean Wu

  7. Taipei Neuroscience Institute, Taipei Medical University, New Taipei City, 23561, Taiwan

    Dean Wu

  8. Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan

    Dean Wu

  9. Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan

    Hsin-Chien Lee

  10. Nursing Department, Faculty of Health Science, University of Muhammadiyah, Malang, Indonesia

    Ollyvia Freeska Dwi Marta

  11. Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan

    Hsiao-Yean Chiu

Authors
  1. Faizul Hasan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amelia Nur Vidyanti
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pei-Shan Tsai
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Dean Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hsin-Chien Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lia Taurussia Yuliana
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Debby Syahru Romadlon
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ollyvia Freeska Dwi Marta
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hsiao-Yean Chiu
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conceptualization: HYC and FH; methodology: HYC and FH; investigation: ANF, HYC and FH; software: FH and HYC; formal analysis: HYC and FH; data curation: HYC, FH, and LTY; validation: HYC, FH, and LTY; resources: HYC, FH, DSR, and OFDM; writing- original draft: HYC and FH; writing—review and editing: HYC, FH, ANF, PST, HSL, and DW; supervision: HYC, FH, ANF, PST, HSL, and DW; funding acquisition: HYC.

Corresponding author

Correspondence to Hsiao-Yean Chiu.

Ethics declarations

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Taipei Medical University Jointed Institutional Review Board (N202106016) and Medical and Health Research Ethic Committee Dr. Sardjito General Hospital (KE/FK/0810/EC/2021).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflicts of interest

The authors declare no potential conflicts of interest regarding the authorship and publication of this article.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hasan, F., Vidyanti, A.N., Tsai, PS. et al. Psychometric properties of Indonesian version of sleep condition indicator for screening poststroke insomnia. Sleep Breath 27, 2013–2020 (2023). https://doi.org/10.1007/s11325-023-02797-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11325-023-02797-1

Keywords

Search

Navigation