0430 Beyond symptoms: Using the Cost of Insomnia Checklist to Characterize the Subjective Burden of Insomnia

Abstract

Abstract Introduction Traditional symptom focused assessments do not characterize the subjective impact of insomnia on patient's function and quality of life (QOL). The authors developed the Cost of Insomnia Checklist (CIC) to evaluate the effects of insomnia in the life domains most meaningful to patients. In bringing attention and awareness to these areas, such a tool may increase patient motivation to look for, initiate, and or persist in treatment. It may also help overcome habituation effects that lead patients to minimize the seriousness of insomnia. Methods The CIC has 68 items across seven categories (financial; health; family; cognition; mental and emotional; work; social and recreational). We developed CIC items based on clinical interviews with chronic insomnia patients in a behavioral sleep medicine clinic. Ninety-five patients completed the CIC during their clinical evaluation for chronic insomnia. Results Participants were 53% female, 81% white, 57% employed, 56% married, and 23% living alone with a mean age of 50.48 (+/- 16.03) and mean BMI of 24.91 (+/-5.29). Patients endorsed an average of 21.9 (SD 33.9; Median=21) items with a range of 4 to 52 items. The most often endorsed items (>70%) focused on not feeling rested, worry about sleep, daytime sleepiness and fatigue, and memory and attention problems. 97% of respondents endorsed one or more additional items. The most frequently endorsed additional items were “can't maintain energy level” (69.5%), “too tired to exercise” (57.9%), “discomfort of sleeplessness” (56.8%), “irritable/unkind to others” (55.8%), “can't think of the words I want to use” (54.7%), “unmotivated/uninterested” (54.7%), “daytime discomfort after a bad night” (53.7%), “stressed without good reason” (52.6%), “worry about daytime function” (51.6%), “news/doctors tell me Insomnia is bad for me” (50.5%). Conclusion The CIC evaluates the effect of insomnia in many life domains and may help patients recognize the impact of insomnia on daytime function and QOL. Future studies will measure how the CIC correlates with treatment participation, adherence, and outcomes. Future studies will also support revision of the CIC to keep only items not measured by other instruments. Support (If Any) None