Abstract
Background. Sleep disorders are common in perinatal women and may underlie or trigger anxiety and depression. We aimed to translate and validate and evaluate the psychometric properties of the Italian version of the Insomnia Symptom Questionnaire (ISQ), in a sample of women during late pregnancy and 6-months postpartum according to the DSM-5 criteria. Methods. The ISQ was administered to 292 women prenatally along with other measures of sleep quality, depression, and anxiety, to examine its construct and convergent validity. Women were readministered the ISQ six months postdelivery to assess test–retest reliability. Women were divided into DSM-5 No-Insomnia (N = 253) and Insomnia (N = 39) groups. Results. The insomnia group had received more psychopharmacotherapy, had more psychiatric family history, increased rates of medically assisted reproduction, of past perinatal psychiatric disorders, and scored higher on almost all TEMPS-A dimensions, on the EPDS, HCL-32, PSQI, and on ISQ prenatally and postnatally. ISQ scores correlated with all scales, indicating adequate convergent and discriminant validity; furthermore, it showed antenatal–postnatal test–retest reliability, 97.5% diagnostic accuracy, 79.5% sensitivity, 94.9% specificity, 70.5% positive predictive power, and 92.8% negative predictive power. Conclusions. The ISQ is useful, valid, and reliable for assessing perinatal insomnia in Italian women. The Italian version showed equivalent properties to the original version.
Highlights
The DSM-5 [1] defined insomnia as dissatisfaction with sleep quantity or quality, associated with one or more of the following symptoms: difficulty initiating sleep, difficulty maintaining sleep, frequent awakenings, or problems returning to sleep after awakenings.Sleep difficulties occur despite adequate opportunity for sleep, at least 3 nights per week, for at least 3 months
Our study investigated the psychometric properties of the Italian Version of the Insomnia Symptom Questionnaire (ISQ) in pregnant women with and without DSM-5 insomnia disorder, investigating the validity, reliability, and convergent and discriminant validity of the tool during late pregnancy and 6-months postpartum according to the DSM-5 criteria
Even though polysomnography is the most objective method for the assessment of most sleep disorders, the ICSD-3 and DSM-5 do not recommend it for the diagnosis of insomnia disorder due to its low feasibility
Summary
The DSM-5 [1] defined insomnia as dissatisfaction with sleep quantity or quality, associated with one or more of the following symptoms: difficulty initiating sleep, difficulty maintaining sleep, frequent awakenings, or problems returning to sleep after awakenings.Sleep difficulties occur despite adequate opportunity for sleep, at least 3 nights per week, for at least 3 months. Sleep disorders are common in perinatal women and may underlie or trigger anxiety and depression. We aimed to translate and validate and evaluate the psychometric properties of the Italian version of the Insomnia Symptom Questionnaire (ISQ), in a sample of women during late pregnancy and 6-months postpartum according to the DSM-5 criteria. The ISQ was administered to 292 women prenatally along with other measures of sleep quality, depression, and anxiety, to examine its construct and convergent validity. The insomnia group had received more psychopharmacotherapy, had more psychiatric family history, increased rates of medically assisted reproduction, of past perinatal psychiatric disorders, and scored higher on almost all TEMPSA dimensions, on the EPDS, HCL-32, PSQI, and on ISQ prenatally and postnatally.
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