Moreover, the limited time available for most primary care encounters may prevent providers from completing full-length sleep questionnaires. 15 However, many primary care providers are unfamiliar with how to deliver and score sleep questionnaires. 12 Early screening and treatment of sleep problems might prevent or ameliorate negative outcomes.įull-length, multi-item sleep questionnaires, including the Pittsburgh Sleep Quality Index 13 and Insomnia Severity Index, 14 are considered feasible, reliable assessment tools. 7 Chronic insomnia has been linked to increased risk for incident mental health disorders 8, 9, 10, – 11 and suicidal ideation and attempts. 3, 4 Sleep problems contribute to impaired performance, 5 reduced quality of life, 6 and increased healthcare utilization. 1, 2 Insomnia symptoms, including trouble falling or staying asleep, waking up earlier than desired, and excessive daytime fatigue and impairment as a result of restless or disturbed nighttime sleep, are particularly common. Sleep problems are a common complaint among United States military veterans. Early detection and treatment of sleep problems might prevent or ameliorate several negative outcomes, including incident mental health disorders. Our initial findings suggest that existing items in the SCL may serve as a first step in screening for sleep problems. Using an item response of 1, all three items demonstrated moderate sensitivity (0.70–0.78) and acceptable rates of false positives and false negatives (0.23–0.48 and 0.11–0.42, respectively) in predicting both outcomes, poor sleep and probable insomnia. Main MeasuresĪn in-person health and sleep questionnaire, including the Pittsburgh Sleep Quality Index (PSQI) and the Symptom Checklist (SCL). military veterans with one or more overseas deployments and with no current DSM Axis I mental health disorder ( N = 1118). Item performance was evaluated using sensitivity, specificity, and predictive value calculations, along with receiver operating characteristic (ROC) curves. Designĭata were drawn from the cross-sectional Post-Deployment Mental Health Study, hosted by the Mid-Atlantic VA Mental Illness Research, Education, and Clinical Center. The objective of this study was to examine the utility of three single items (i.e., trouble falling asleep, awakening in the early morning, and sleep that is restless or disturbed) embedded into the Symptom Checklist-90-Revised (SCL) for identifying two outcomes of interest, poor sleep and probable insomnia. Items assessing insomnia and poor sleep are often embedded into commonly used psychological assessments, and may serve as a viable first step in screening. To date, no brief sleep screeners have been developed or validated. However, sleep problems remain overlooked in primary care settings. Left untreated, chronic sleep problems increase the risk for a range of negative outcomes, including incident mental health disorders. As many as two-thirds of post-9/11 military veterans complain of sleep problems, including insomnia-like symptoms.
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