BMC Med. 2025 Oct 8;23(1):542. doi: 10.1186/s12916-025-04285-7.
ABSTRACT
BACKGROUND: A robust insomnia screening and measuring tool is essential for accurately assessing and diagnosing insomnia in research and clinical settings. The Sleep Condition Indicator (SCI) is an initial screening tool designed to assess insomnia complaints according to the DSM-5 criteria. This study aims to systematically evaluate item content, psychometric performance, diagnostic performance, and overall application of the SCI through a methodological quality assessment of original validation studies. These findings offer valuable information for optimizing insomnia diagnosis, assessment, and monitoring.
METHODS: A comprehensive search was conducted for finding studies published from 2012 to 2024, in PubMed, EMBASE, CINAHL, and MEDLINE electronic databases, and citation searching in PubMed, SCOPUS, Web of Science, and Google Scholar. Full-text articles focusing on the translation, validation, and application of the SCI were included. The psychometric studies were assessed regarding their measurement properties and methodological quality, using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. The diagnostic studies were assessed using the Standard for Reporting of Diagnostic Accuracy (STARD) guidelines. Finally, studies in which the SCI was used for assessment or screening purposes provided general information on the application of the scale.
RESULTS: We identified 285 studies with over 720,000 participants that used the SCI, and 13 language versions of the SCI were employed across at least 31 regions. The most commonly assessed measurement properties of the SCI within 19 studies were structural validity, internal consistency, criterion validity, and reliability, with findings supporting a stable two-factor structure and credible overall psychometric properties. The SCI demonstrated adequate sensitivity and specificity in 14 studies evaluating its diagnostic performance, and a cut-off value of 16 was recommended for screening insomnia. Finally, the studies showed that the SCI is widely used across clinical and non-clinical settings and provides valuable information for assessing insomnia risks.
CONCLUSIONS: The SCI includes items that align with the most current diagnostic criteria for insomnia disorder from the DSM-5. This tool demonstrates excellent psychometric performance and strong diagnostic performance. Overall, the SCI provides useful information for screening, diagnosing, and monitoring insomnia, making it a valuable tool in both research and clinical settings.
PMID:41063190 | DOI:10.1186/s12916-025-04285-7
