Development of the Lebanese insomnia scale (LIS-18): a new scale to assess insomnia in adult patients

Souheil Hallit,Aline Hajj,Diana Malaeb,Hala Sacre,Gloria Al Karaki,Rabih Hallit,Pascale Salameh,Chadia Haddad,Nelly Kheir

doi:10.1186/s12888-019-2406-y

Abstract

ObjectiveTo define the development and validation of the Lebanese Insomnia Scale (LIS-18) to be used for the evaluation of insomnia in Lebanese adult patients.MethodsA first cross-sectional study, conducted between August 2017 and April 2018, enrolled 789 participants (sample 1). A second sample was recruited in May 2018 to confirm the results obtained from the first sample.ResultsFive factors derived from the LIS-18 scale items with an Eigenvalue over 1, explaining a total of 59.64% of the variance (Cronbach’s alpha = 0.821). The first ROC curve, comparing participants with diagnosed insomnia to healthy individuals, showed that the optimal score was seen at a cutoff of 58.00, with a good sensitivity and specificity at this cutoff (93.3 and 88.4%, respectively). A second ROC curve, comparing participants taking drug medication for insomnia vs. those not taking drug, showed that the optimal score was seen at a cutoff of 52.50, with a good sensitivity and specificity at this cutoff (89.5 and 80.0%, respectively). A third ROC curve, comparing participants diagnosed by a physician or taking drug medication for insomnia and healthy control without insomnia drug, showed that the optimal score was seen at 51.50, with good sensitivity and specificity at this cutoff as well (90.0 and 78.10%, respectively). The positive predicted value (PPV) of the LIS-18 score in sample 2 was 93.3%, whereas the negative predicted value (NPV) was 88.4%.ConclusionThe results demonstrate that the LIS-18 can be used in clinical practice and research to measure insomnia.

Highlights

Insomnia seems to be one of the most common sleep complaints among people [1]
Arabic versions of some scales were validated in Lebanon [17], none of these instruments was generated in a neighboring country i.e. Middle-East, Arab countries and developing countries and all the cited tools reflect the insomnia perception in the developed countries
Concurrent validity The results showed that a higher Lebanese Insomnia Scale (LIS)-18 score was significantly correlated with a higher Athens Insomnia Scale (AIS) score (r = 0.678; p < 0.001), higher Insomnia Severity Index (ISI) (=0.577; p < 0.001), higher Pittsburgh sleep quality index (PSQI) (r = 0.574; p < 0.001) and a lower MOSS sleep scale score (r = − 0.671; p < 0.001)

Summary

Introduction

Insomnia seems to be one of the most common sleep complaints among people [1]. It affects one’s life negatively especially when it comes to daily functioning, work absenteeism and quality of life [2, 3]. Insomnia can Numerous standardized and validated tools had been established for measuring insomnia intensity, including but not limited to the Athens Insomnia Scale (AIS) [13], the Regensburg Insomnia Scale (RIS) [14], the Insomnia Severity Index (ISI) [15], reflecting the increasing need for assessment instruments in insomnia research. Since sleep is considered a behavior to a certain extent, its pattern is expected molded by culture [18]. Since these tools cover different aspects of insomnia, we had to use them all to come-up with a final scale covering all of these aspects. It was deemed necessary to develop and validate a Lebanese Insomnia Scale (LIS-18) explicitly intended for the Lebanese adult population, taking into account multicultural adaptation procedures and the abovementioned reasons

Methods

Results

Discussion

Conclusion