Okun Michele L, Buysse Daniel J, Hall Martica H
School of Medicine, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA.
University of Colorado, Colorado Springs, CO.
J Clin Sleep Med. 2015 Jun 15;11(6):645-54. doi: 10.5664/jcsm.4776.
Although a substantial number of pregnant women report symptoms of insomnia, few studies have used a validated instrument to determine the prevalence in early gestation. Identification of insomnia in pregnancy is vital given the strong connection between insomnia and the incidence of depression, cardiovascular disease, or immune dysregulation. The goal of this paper is to provide additional psychometric evaluation and validation of the Insomnia Symptom Questionnaire (ISQ) and to establish prevalence rates of insomnia among a cohort of pregnant women during early gestation.
The ISQ was evaluated in 143 pregnant women at 12 weeks gestation. The internal consistency and criterion validity of the dichotomized ISQ were compared to traditional measures of sleep from sleep diaries, actigraphy, and the Pittsburgh Sleep Quality Index using indices of sensitivity, specificity, positive and negative predictive value (PPV, NPV), and likelihood ratio (LR) tests.
The ISQ identified 12.6% of the sample as meeting a case definition of insomnia, consistent with established diagnostic criteria. Good reliability was established with Cronbach α = 0.86. The ISQ had high specificity (most > 85%), but sensitivity, PPV, NPV, and LRs varied according to which sleep measure was used as the validating criterion.
Insomnia is a health problem for many pregnant women at all stages in pregnancy. These data support the validity and reliability of the ISQ to identify insomnia in pregnant women. The ISQ is a short and cost-effective tool that can be quickly employed in large observational studies or in clinical practice where perinatal women are seen.
A commentary on this article appears in this issue on page 593.
尽管大量孕妇报告有失眠症状，但很少有研究使用经过验证的工具来确定妊娠早期的失眠患病率。鉴于失眠与抑郁症、心血管疾病或免疫失调的发生率之间存在密切联系，识别孕期失眠至关重要。本文的目的是对失眠症状问卷（ISQ）进行额外的心理测量评估和验证，并确定一组孕妇在妊娠早期的失眠患病率。
对143名妊娠12周的孕妇进行了ISQ评估。使用敏感性、特异性、阳性和阴性预测值（PPV、NPV）以及似然比（LR）检验指标，将二分法ISQ的内部一致性和效标效度与睡眠日记、活动记录仪和匹兹堡睡眠质量指数等传统睡眠测量方法进行比较。
ISQ将12.6%的样本确定为符合失眠病例定义，与既定诊断标准一致。Cronbach α = 0.86，表明具有良好的信度。ISQ具有较高的特异性（多数>85%），但敏感性、PPV、NPV和LR根据用作验证标准的睡眠测量方法而有所不同。
失眠是许多孕妇在孕期各个阶段面临的健康问题。这些数据支持ISQ在识别孕妇失眠方面的有效性和可靠性。ISQ是一种简短且经济高效的工具，可快速应用于大型观察性研究或围产期妇女就诊的临床实践中。
关于本文的一篇评论发表在本期第593页。
