A Validation Study of the Chinese Version of the Athens Insomnia Scale

中文版雅典失眠量表信效度研究

10.29478/TJP.200903.0005

江惠綾(Huey-Ling Chiang)；陳錫中(Hsi-Chung Chen)；白其卉(Chyi-Huey Bai)；車先蕙(Hsien-Huei Che)；李明濱(Ming-Been Lee)；賴仕涵(Shih-Han Lai,)；周碧瑟(Pesus Chou)

失眠 ； 篩檢 ； 問卷 ； 睡眠障礙 ； insomnia ； mass screening ； questionnaires ； sleep disorders

台灣精神醫學

23卷1期（2009 / 03 / 01）

43 - 52

英文

前言：本研究目的為建立中文版雅典失眠量表Chinese version of the Athens Insomnia Scale(CAIS)之信效度，並提供篩檢失眠症之最佳切分點。研究方法：本研究共取283位樣本，其中65人為醫學中心精神科門診病人，另外218人無精神科疾病。使用中文版Insomnia Self-assessment Inventory(ISAI)作為外部效度評估工具。失眠症的診斷乃依據ICD-10之診斷準則。結果：CAIS-8（原問卷第1-8題）及CAIS-5（原問卷第1-5題），內部一致性信度係數高達0.82-0.84，再測可信度為0.84-0.86，與ISAI的相關係數是0.72-0.76。CAIS-8的因素分析結果呈現2個因素，分別為1-5題（夜間症狀）及6-8題（日間症狀）。CAIS-8用於失眠症之篩檢，最適合的切分點是8分，CAIS-5則為5分。結論：無論是CAIS-8或CAIS-5皆有良好之信效度，適合選用為快速篩檢失眠症的問卷。

Objectives: To establish the validity of the Chinese version of the Athens Insomnia Scale (CAIS) and the diagnostic cutoff scores for insomnia. Methods: Two hundred and eighty-three subjects, consisting of 65 psychiatric outpatients and 218 non-clinical samples, completed the CAIS. The ICD-10 ”nonorganic insomnia” was the diagnostic standard of insomnia, and the Insomnia Self-assessment Inventory (ISAI) was used as the external validator. Both the 8-item scale (CAIS-8) and the brief version containing the first 5 items (CAIS-5) were analyzed. Results: In both versions, the Cronbach's α of internal consistency reached 0.82-0.84. Correlation coefficients of test-retest reliability were 0.84-0.86. The correlation coefficients between the CAIS and ISAI were 0.72-0.76. The CAIS-8 demonstrated two components in factor analysis: items 1 to 5 (nighttime symptoms) and items 6 to 8 (daytime symptoms). The suggested cutoff points for insomnia among this ethnic Chinese population are 8 for the CAIS-8 (AUC=0.89, p＜0.01) and 5 for the CAIS-5 (AUC=0.90, p＜0.01), respectively. Conclusion: The CAIS-8 and CAIS-5 are fair tools in screening and making insomnia diagnoses in clinical practice, and have satisfactory reliability and validity.

1. Aargun MY,Kara H,Solmaz M(1997).Sleep disturbances and suicidal behavior in patients with major depression.J Clin Psychiatry,58,249-251.
2. Akerstedt T,Fredlund P,Gillberg M,Jansson B(2002).A prospective study of fatal occupational accidents: relationship to sleeping difficulties and occupational factors.J Sleep Res,11,69-71.
3. Breslau N,Roth T,Rosenthal L,Andreski P(1996).Sleep disturbance and psychiatric disorders: a longitudinal epidemiological study of young adults.Biol Psychiatry,39,411-418.
4. Chen HC,Wu CH,Lee YJ,Liao SC,Lee MB(2005).Validity of the five-item Brief Symptom Rating Scale among subjects admitted for general health screening.J Formos Med Assoc,104,824-829.
5. Chen YY,Kawachi I,Subramanian SV,Acevedo-Garcia D,Lee YJ(2005).Can social factors explain sex differences in insomnia? Findings from a national survey in Taiwan.J Epidemiol Community Health,59,488-494.
6. Chevalier H,Los F,Boichut D(1999).Evaluation of severe insomnia in the general population: results of a European multinational survey.J Psychopharmacol,13(1),21-24.
7. Chuang HH,Chiu NY,Hu SH(2004).Diagnostic categories in first-visit psychiatric outpatients with in-somnia.Changhua J Med,9,254-260.
8. Directorate General of Budget AaS, Executive Yuan.(2001).Directorate General of Budget, Accounting and Statistics.Executive Yuan.
9. Hornyak M,Feige B,Riemann D,Voderholzer U(2006).Periodic leg movements in sleep and periodic limb movement disorder: prevalence, clinical significance and treatment.Sleep Med Rev,10,169-177.
10. Larsson L-G,Lindberg A,Franklin KA,Lundback B(2003).Gender differences in symptoms related to sleep apnea in a general population and in relation to referral to sleep clinic.Chest,124,204-11.
11. Morin CM,LeBlanc M,Daley M,Gregoire JP,Merette C(2006).Epidemiology of insomnia: prevalence, self-help treatments, consultations, and determinants of help-seeking behaviors.Sleep Med,7,123-130.
12. Nilsson PM,Nilsson JA,Hedblad B,Berglund G(2001).Sleep disturbance in association with elevated pulse rate for prediction of mortality: consequences of mental strain.J Intern Med,250,521-529.
13. Nilsson PM,Roost M,Engstrom G,Hedblad B,Berglund G(2004).Incidence of diabetes in middle-aged men is related to sleep disturbances.Diabetes Care,27,2464-2469.
14. Nomura K,Yamaoka K,Nakao M,Yano E(2005).Impact of insomnia on individual health dissatisfaction in Japan, South Korea, and Taiwan.Sleep,28,1328-1332.
15. Pearson NJ,Johnson LL,Nahin RL(2006).Insomnia, trouble sleeping, and complementary and alternative medicine: Analysis of the 2002 national health interview survey data.Arch Intern Med,166,175-182.
16. Sheehan DV,Lecrubier Y,Sheehan KH(1998).The Mini-International Neuropsychiatric Interview (M.LN.L): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10.J Clin Psychiatry,59(20),22-33.
17. Soldatos CR,Dikeos DG,Paparrigopoulos TJ(2000).Athens Insomnia Scale: validation of an instrument based on ICD-10 criteria.J Psychosom Res,48,555-560.
18. Soldatos CR,Dikeos DG,Paparrigopoulos TJ(2003).The diagnostic validity of the Athens Insomnia Scale.J Psychosom Res,55,263-267.
19. Spiegel K,Leproult R,Van Canter E(1999).Impact of sleep debt on metabolic and endocrine function.Lancet,354,1435-1439.
20. Spiegel K,Sheridan JF,Van Cauter E(2002).Effect of sleep deprivation on response to immunization.JAMA,288,1471-1472.
21. Stoller MK(1994).Economic effects of insomnia.Clin Ther,16,873-897.
22. Su TP,Huang SR,Chou P(2004).Prevalence and risk factors of insomnia in community-dwelling Chinese elderly: a Taiwanese urban area survey.Aust N Z J Psychiatry,38,706-713.
23. Teran-Santos J,Jimenez-Gomez A,CorderoGuevara J(1999).The association between sleep apnea and the risk of traffic accidents.N Engl J Med,340,847-851.
24. Weissman MM,Greenwald S,Nino-Murcia G, Dement WC(1997).The morbidity of insomnia uncomplicated by psychiatric disorders.Gen Hasp Psychiatry,19,245-250.

1. 邊立中,鍾錦鈿,陳淑如,陳昱廷,林依宣,林步鴻,李昕緯,江亭穎(2022)。學童網路成癮與睡眠品質、學習注意力及執行功能之相關性。新臺北護理期刊，24(2)，9-21。
2. 楊南屏,陳錫中,林寬佳,周碧瑟,古博文(2020)。「健康人權教育網」在離島的應用與展望。醫學與健康期刊，9(3)，17-28。
3. 楊雅婷,陳奕樺(2013)。課室專注力量表之建構。教育研究與發展期刊，9(4)，1-28。
4. 鍾錦鈿,陳淑如,陳昱廷,柳美如,林依宣,林步鴻,李昕緯,江亭穎(2023)。認知行為介入對學童網路成癮之改善成效。新臺北護理期刊，25(1)，10-22。
5. (2014)。探討高中生身體活動對睡眠品質、正、負向情緒、課室專注力與學業成就之影響：以臺北市高中一年級學生為例。臺東大學教育學報，25(1)，1-38。