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Open Access Highly Accessed Research article

Measurement properties of the Minimal Insomnia Symptom Scale (MISS) in an elderly population in Sweden

Amanda Hellström12*, Peter Hagell2, Cecilia Fagerström1 and Ania Willman1

Author Affiliations

1 School of Health Science, Blekinge Institute of Technology, SE-371 79 Karlskrona, Sweden

2 Department of Health Sciences, Lund University, Lund, Sweden

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BMC Geriatrics 2010, 10:84  doi:10.1186/1471-2318-10-84

Published: 5 November 2010

Abstract

Background

Insomnia is common among elderly people and associated with poor health. The Minimal Insomnia Symptom Scale (MISS) is a three item screening instrument that has been found to be psychometrically sound and capable of identifying insomnia in the general population (20-64 years). However, its measurement properties have not been studied in an elderly population. Our aim was to test the measurement properties of the MISS among people aged 65 + in Sweden, by replicating the original study in an elderly sample.

Methods

Data from a cross-sectional survey of 548 elderly individuals were analysed in terms of assumptions of summation of items, floor/ceiling effects, reliability and optimal cut-off score by means of ROC-curve analysis and compared with self-reported insomnia criteria.

Results

Corrected item-total correlations ranged between 0.64-0.70, floor/ceiling effects were 6.6/0.6% and reliability was 0.81. ROC analysis identified the optimal cut-off score as ≥7 (sensitivity, 0.93; specificity, 0.84; positive/negative predictive values, 0.256/0.995). Using this cut-off score, the prevalence of insomnia in the study sample was 21.7% and most frequent among women and the oldest old.

Conclusions

Data support the measurement properties of the MISS as a possible insomnia screening instrument for elderly persons. This study make evident that the MISS is useful for identifying elderly people with insomnia-like sleep problems. Further studies are needed to assess its usefulness in identifying clinically defined insomnia.