The Minimal Insomnia Symptom Scale (MISS): A Brief Measure of Sleeping Difficulties

Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden.
Upsala journal of medical sciences (Impact Factor: 1.98). 02/2008; 113(2):131-42.
Source: PubMed


To evaluate basic psychometric properties and obtain normative values for a novel 3-item scale, the Minimal Insomnia Symptom Scale (MISS), a sleep questionnaire was sent out to a randomly selected sample of the general population, aged 20-64 years. Responses were obtained from 1075 subjects corresponding to a response rate of 78%. Results showed that MISS possessed satisfactory reliability and validity. Women scored significantly higher than men while there was no age relationship. A receiver operating characteristic curve analysis revealed that MISS was able to distinguish subjects with a clinical insomnia according to ICD-10 research criteria. The main advantage of MISS over other insomnia instruments is its brevity and ease of use. Evidence was provided for the utility of MISS in epidemiological settings. MISS also showed promise as a convenient ultra-short screening measure of insomnia in health care settings.

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    • "This study focuses on a brief seven-item scale developed for higher-education students that may be easily transposed to other populations, in order to parsimoniously measure the continuum ranging from good to poor sleepers by concentrating on the main night symptoms of insomnia and poor sleep quality. Although several useful instruments have been published over the last years with focus on insomnia or sleep quality (Broman et al., 2008; Espie et al., 2014; Hyeryeon et al., 2006; Kessler et al., 2010; Okun et al., 2009; Pallesen et al., 2008; Soldatos et al., 2000); on the date, we started collecting data on a large sample in the academic year of 2001/2002, very few brief tools were then available (Moul et al., 2004; Shahid et al., 2012). Moreover, at the present time, full psychometric characterization is sporadic or limited in regard to more specific populations such as higher-education students. "
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    ABSTRACT: Sleep effort is generally defined as the attempt to force and induce sleep in a voluntary manner. This study aimed to document the psychometric properties of a brief measure of sleep effort-the Glasgow Sleep Effort Scale-in its European (Portuguese) version using a large sample (N = 2,995). The results supported the good internal consistency of the overall scale scores (α = .79). Potential construct validity was evaluated with various methods, including criterion validity. There was also a convergent validity indicator. Principal components analysis revealed a 1-dimensional structure that accounted for 45% of the total variance. This preliminary study suggests that this Portuguese version of the Glasgow Sleep Effort Scale is a measure of sleep behavior suitable for research and clinical purposes. However, more studies are needed, particularly with clinical groups. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
    No preview · Article · Jun 2015 · Psychological Assessment
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    • "This yields a total score ranging from 0 to 12 (12 = more insomnia). Previous studies have suggested cut-offs of ≥6 among adults [1] and ≥7 among the elderly [2] "
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    ABSTRACT: Background: The psychometric properties of the three-item Minimal Insomnia Symptom Scale (MISS) were evaluated using the classical test theory. Different cut-offs for identifying insomnia were suggested in two age groups (≥6 and ≥7 among adult and elderly people, respectively). The aim of the present study was to test the measurement properties of the MISS using the Rasch measurement model, with special emphasis on differential item functioning by gender and age. Methods: Cross-sectional MISS data from adult (age 20-64 years, n = 1075) and elderly (age 65+, n = 548) populations were analysed using the Rasch measurement model. Results: Data generally met Rasch model requirements and the scale could separate between two distinct groups of people. Differential item functioning was found by age but not gender. The difference between the adult and elderly samples was lower for the originally recommended ≥6 points cut-off (0.09 logits) than for the ≥7 points cut-off (0.23 logits), but greater at the lower and higher ends of the scale. Conclusions: This study provides general support for the measurement properties of the MISS. Caution should be exercised in comparing raw MISS scores between age groups, but applying a ≥6 cut-off appears to allow for valid comparisons between adults and the elderly regarding the presence of insomnia. Nevertheless, additional studies are needed to determine the clinically optimal cut-score for identification of insomnia.
    Full-text · Article · Jan 2015 · Sleep Medicine
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    • "Information on sleep function and vitality was self-reported and not based on direct measurements; however, these questions have been used and validated in other studies with reliable findings. Thus, non-restorative sleep was explored in the Minimal Insomnia Symptom Scale (MISS) [34], and our question on vitality was included in a validation of the SF-36 questionnaire [35]. The question on self-experienced lack of sleep in this study is a general perception on the sleep quality covering both sleep duration and sleep quality as compared to instruments that evaluate more specific domains of sleep quality like the Pittsburg Slep Quality Index [36]. "
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    ABSTRACT: The increased incidence of impaired glucose tolerance (IGT), are serious public health issues, and several studies link sleeping disorders with increased risk of developing type 2 diabetes, impaired glucose tolerance and insulin resistance (IR). This study explore how self-reported lack of sleep and low vitality, are associated with IGT in a representative Swedish population. A cross-sectional survey conducted in two municipalities in South-western Sweden. Participants aged 30--75 were randomly selected from the population in strata by sex and age. Altogether, 2,816 participants were surveyed with a participation rates at 76%. Participants with normal glucose tolerance (n=2,314), and those with IGT (n=213) were retained for analyses. The participants answered a questionnaire before the oral glucose tolerance test (OGTT). Associations for questions concerning sleeping disorders, vitality and IGT were analysed using logistic regression and were expressed as odds ratios (OR) with 95% CI. In men a statistically significant age-adjusted association was found between self-reported lack of sleep and IGT: OR 2.4 (95% CI: 1.1-5.4). It did not weaken after further adjustment for body mass index (BMI), smoking, education, and leisure time physical activity 2.3 (1.0-5.5, p=0.044). No such associations were found in females. Corresponding age-adjusted associations between low vitality and IGT in both men 2.8 (1.3-5.8), and women 2.0 (1.2-3.4) were successively lost with increasing adjustment. Insufficient sleep seems independently associated with IGT in men, while low vitality was not independently associated with IGT neither in men nor women, when multiple confounders are considered. IGT should be considered in patients presenting these symptoms, and underlying mechanisms further explored.
    Full-text · Article · Jul 2013 · BMC Public Health
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