title: Agreement among subjective, objective, and collateral measures of insomnia in postwithdrawal recovering alcoholics.
abstract: The level of agreement among objective, subjective, and collateral assessments of insomnia was examined in 56 recovering alcoholics. Participants underwent a multimodal sleep assessment protocol consisting of sleep logs, actigraph recordings, questionnaires, and collateral reports of insomnia severity. All sleep measures confirmed moderate to severe insomnia in the study sample. Over 1 week of simultaneous sleep log and actigraph recording, the average disagreement between methods ranged from 16 min for sleep onset latency to 1 hr for wake time after sleep onset. Interrater agreement for the severity of insomnia symptoms using the Sleep Impairment Index was poor for subject-clinician, subject-collateral, and collateral-clinician rating pairs (intraclass correlation coefficients < .35). In general, recovering alcoholics' self-reported sleep reflected a greater severity of insomnia symptoms than did the actigraph and collateral measures. Given that such high levels of disagreement can occur in individual participants, researchers are advised to use a combination of sleep measures to assess insomnia in this population.
authors.affiliation: Addiction Centre, Foothills Medical Centre, Calgary, Alberta, Canada. scurrie@ucalgary.ca
authors.forename: Shawn R
authors.initials: SR
authors.lastname: Currie
authors.forename: Sonya
authors.initials: S
authors.lastname: Malhotra
authors.forename: Stewart
authors.initials: S
authors.lastname: Clark
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000534:rehabilitation*; D003289:Convalescence; D039721:Diagnostic and Statistical Manual of Mental Disorders; D000431:Ethanol / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology* / Q000628:therapy*; D013375:Substance Withdrawal Syndrome / Q000453:epidemiology* / Q000209:etiology*; D011795:Surveys and Questionnaires
chemical_list: D000431:Ethanol