Ethics code: IR.ZUMS.REC.1396.35

XML Print


1- Student Research Committee, Department of Clinical Psychology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
2- Department of Psychology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
3- Student Research Committee, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
4- Department of Clinical Psychology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran , o.saed@zums.ac.ir
Abstract:   (246 Views)
Background & Objective: Insomnia, a widespread sleep disorder, impacts 15-35% of the general population and a concerning 30% of medical sciences students. This study aims to assesses the psychometric properties, factor structure and measurement invariance of the Insomnia Severity Index (ISI) in Iranian medical university students.
Material & Methods: This cross-sectional study included 370 medical university students (54.9% females). After providing a detailed introduction regarding the purpose of the study and receiving participants' consent online, they were requested to fill out the Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI). Confirmatory factor analysis and hierarchical regression analysis were used to examine the factor structure and predict insomnia severity.
Results: The results of descriptive statistics showed that the prevalence of clinical insomnia was 22.6% in male and 27.9% in female students, and 62.2% of male and 67.5% of female students had poor sleep quality. CFA showed that the one-factor model with all items was the most suitable structure (x2= 13.82, df= 9, GFI= .990, CFI= .994, TLI= .986, RMSEA= .038). The study's findings indicate that the ISI exhibits measurement invariance across genders, ensuring its unbiased application for both male and female populations. Furthermore, this scale demonstrated acceptable reliability and validity. Finally, the results of hierarchical regression analysis indicated that the poor sleep quality was a significant predictor of insomnia severity (β= .389).
Conclusion: The Persian version of ISI showed strong validity and reliability. These findings indicate that insomnia severity could be measured adequately in Iranian samples using the ISI.
  |   |   Full-Text (HTML)  (59 Views)  
Article Type : Orginal Research | Subject: Medical Education
Received: 2024/06/15 | Accepted: 2025/02/2

References
1. Ohayon MM. Epidemiology of insomnia: what we know and what we still need to learn. Sleep Medicine Reviews. 2002;6(2):97-111. [DOI]
2. Ohayon MM, Guilleminault C. Epidemiology of sleep disorders. Sleep: a comprehensive handbook. 2006;73. [DOI]
3. Ibrahim JM, Abouelezz NF. Relationship between insomnia and computer use among students at Ain Shams University, Cairo, Egypt. Egyptian Journal of Community Medicine. 2011;29(2). [DOI]
4. Yassin A, Al Mistarehi AH, Beni Yonis O, Aleshawi AJ, Momany SM, Khassawneh BY. Prevalence of sleep disorders among medical students and their association with poor academic performance: a cross-sectional study. Annals of Medicine and Surgery. 2020;58:124-9. [DOI]
5. Sateia MJ. International classification of sleep disorders-third edition. Chest. 2014;146(5):1387-94. [DOI]
6. Roane BM, Taylor DJ. Adolescent insomnia as a risk factor for early adult depression and substance abuse. Sleep. 2008;31(10):1351-6. [DOI]
7. Curcio G, Ferrara M, De Gennaro L. Sleep loss, learning capacity and academic performance. Sleep Medicine Reviews. 2006;10(5):323-37. [DOI]
8. Vedaa Ø, Erevik EK, Hysing M, Hayley AC, Sivertsen B. Insomnia, sleep duration and academic performance: a national survey of Norwegian college and university students. Sleep Medicine: X. 2019;1:100005. [DOI]
9. Kamdar BB, Kaplan KA, Kezirian EJ, Dement WC. The impact of extended sleep on daytime alertness, vigilance, and mood. Sleep Medicine. 2004;5(5):441-8. [DOI]
10. Azad MC, Fraser K, Rumana N, et al. Sleep disturbances among medical students: a global perspective. Journal of Clinical Sleep Medicine. 2015;11(1):69-74. [DOI]
11. Castronovo V, Galbiati A, Marelli S, et al. Validation study of the Italian version of the insomnia severity index (ISI). Neurological Sciences. 2016;37:1517-24. [DOI]
12. Ruiz C, Guilera G, Gómez-Benito J. Development of a scale to assess the diurnal impact of insomnia. Psychiatry Research. 2011;190(2):335-41 [DOI]
13. Yazdi Z, Sadeghniiat-Haghighi K, Zohal MA, Elmizadeh K. Validity and reliability of the Iranian version of the insomnia severity index. Malaysian Journal of Medical Sciences. 2012;19(4):31-6. [DOI]
14. Omachi TA. Measures of sleep in rheumatologic diseases: Epworth sleepiness scale (ESS), functional outcome of sleep questionnaire (FOSQ), insomnia severity index (ISI), and Pittsburgh sleep quality index (PSQI). Arthritis Care & Research. 2011;63(S11):S287-S96. [DOI]
15. Bastien CH, Vallières A, Morin CM. Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Medicine. 2001;2(4):297-307 [DOI]
16. Chahoud M, Chahine R, Salameh P, Sauleau EA. Reliability, factor analysis and internal consistency calculation of the insomnia severity index (ISI) in French and in English among Lebanese adolescents. eNeurologicalSci. 2017;7:9-14. [DOI]
17. Fernandez-Mendoza J, Rodriguez-Muñoz A, Vela-Bueno A, et al. The Spanish version of the insomnia severity index: a confirmatory factor analysis. Sleep Medicine. 2012;13(2):207-10. [DOI]
18. Lin RM, Xie SS, Yan WJ, Yan YW. Factor structure and psychometric properties of the insomnia severity index in Mainland China. Social Behavior and Personality: an international journal. 2018;46(2):209-18. [DOI]
19. Farrahi Moghaddam J, Nakhaee N, Sheibani V, Garrusi B, Amirkafi A. Reliability and validity of the Persian version of the Pittsburgh sleep quality index (PSQI-P). Sleep and Breathing. 2012;16(1):79-82. [DOI]
20. Chehri A, Khazaie H, Eskandari S, et al. Validation of the Farsi version of the revised Adolescent Sleep Hygiene Scale (ASHSr): a cross-sectional study. BMC Psychiatry. 2017;17(1):408. [DOI]
21. Anthoine E, Moret L, Regnault A, Sébille V, Hardouin JB. Sample size used to validate a scale: a review of publications on newly-developed patient reported outcomes measures. Health and Quality of Life Outcomes. 2014;12(1):2. [DOI]
22. Manzar MD, Jahrami HA, Bahammam AS. Structural validity of the insomnia severity index: a systematic review and meta-analysis. Sleep Medicine Reviews. 2021;60:101531. [DOI]
23. Mollayeva T, Thurairajah P, Burton K, Mollayeva S, Shapiro CM, Colantonio A. The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: a systematic review and meta-analysis. Sleep Medicine Reviews. 2016;25:52-73. [DOI]
24. Manzar MD, BaHammam AS, Hameed UA, et al. Dimensionality of the Pittsburgh sleep quality index: a systematic review. Health and Quality of Life Outcomes. 2018;16:1-22. [DOI]
25. Shadzi MR, Rahmanian M, Heydari A, Salehi A. Structural validity of the Pittsburgh sleep quality index among medical students in Iran. Scientific Reports. 2024;14(1):1538. [DOI]
26. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25(24):3186-91 [DOI]
27. Brislin RW. Back-translation for cross-cultural research. Journal of Cross-Cultural Psychology. 1970;1(3):185-216. [DOI]
28. West SG, Taylor AB, Wu W. Model fit and model selection in structural equation modeling. Handbook of structural equation modeling. 2012;1:209-31. [DOI]
29. Schmitt N, Kuljanin G. Measurement invariance: review of practice and implications. Human Resource Management Review. 2008;18(4):210-22. [DOI]
30. Zeng LN, Zong QQ, Yang Y, et al. Gender difference in the prevalence of insomnia: a meta-analysis of observational studies. Frontiers in Psychiatry. 2020;11:577429. [DOI]
31. Lallukka T, Sares-Jäske L, Kronholm E, et al. Sociodemographic and socioeconomic differences in sleep duration and insomnia-related symptoms in Finnish adults. BMC Public Health. 2012;12:1-22. [DOI]
32. Asher M, Aderka IM. Gender differences in social anxiety disorder. Journal of Clinical Psychology. 2018;74(10):1730-41. [DOI]
33. Lund HG, Reider BD, Whiting AB, Prichard JR. Sleep patterns and predictors of disturbed sleep in a large population of college students. Journal of Adolescent Health. 2010;46(2):124-32. [DOI]
34. Arber S, Bote M, Meadows R. Gender and socio-economic patterning of self-reported sleep problems in Britain. Social Science & Medicine. 2009;68(2):281-9. [DOI]
35. Fatima Y, Najman JM, Al Mamun A. Exploring gender difference in sleep quality of young adults: findings from a large population study. Clinical Medicine and Research. 2016;14(3-4):138-44. [DOI]
36. Kaufmann CN, Orff HJ, Moore RC, Delano-Wood L, Depp CA, Schiehser DM. Psychometric Characteristics of the Insomnia Severity Index in Veterans With History of Traumatic Brain Injury. Behavioral Sleep Medicine. 2019;17(1):12-8. [DOI]
37. Dragioti E, Wiklund T, Alföldi P, Gerdle B. The Swedish version of the Insomnia Severity Index: Factor structure analysis and psychometric properties in chronic pain patients. Scandinavian Journal of Pain. 2015;9(1):22-7. [DOI]
38. Otte JL, Bakoyannis G, Rand KL, et al. Confirmatory factor analysis of the insomnia severity index (ISI) and invariance across race: a pooled analysis of MsFLASH data. Menopause. 2019;26(8):850-5. [DOI]
39. Putnick DL, Bornstein MH. Measurement invariance conventions and reporting: the state of the art and future directions for psychological research. Developmental Review. 2016;41:71-90 [DOI]
40. Backhaus J, Junghanns K, Broocks A, Riemann D, Hohagen F. Test–retest reliability and validity of the Pittsburgh sleep quality index in primary insomnia. Journal of Psychosomatic Research. 2002;53(3):737-40. [DOI]
41. Irish LA, Kline CE, Gunn HE, Buysse DJ, Hall MH. The role of sleep hygiene in promoting public health: a review of empirical evidence. Sleep Medicine Reviews. 2015;22:23-36 []

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.