Usefulness of the Minimal Insomnia Symptom Scale (MISS) in elderly persons

Document type: Conference Papers
Peer reviewed: Yes
Author(s): Amanda Hellström, Peter Hagell, Cecilia Fagerström, Ania Willman
Title: Usefulness of the Minimal Insomnia Symptom Scale (MISS) in elderly persons
Conference name: 20th Nordic Congress of Gerontology
Year: 2010
Publisher: Nordisk Gerontologisk Forening
City: Reykjavik
Organization: Blekinge Institute of Technology
Department: School of Health Science (Sektionen för hälsa)
School of Health Science S-371 79 Karlskrona
+46 455 38 50 00
Authors e-mail:
Language: English
Abstract: Sleep is found to be a fundamental part in experiencing health. Sleep is needed for memory consolidation, metabolic balance, immune functioning and alertness at day time and experiencing quality of life. Insomnia has also been found to be associated with cardiac disorders. Elderly people are especially vulnerable for poor sleep, why prevention of sleep disturbances should be of regard when caring for older persons. MISS is a 3 item questionnaire, with a total-score of 0-12 that could be used to find insomnia in elderly persons.
Aim: To test of the measurement properties of the Minimal Insomnia Symptom Scale in an elderly sample ≥65 years in Sweden.
Study sample
Persons participating in the Swedish National Study on Ageing and Care – Blekinge were invited.
● 548 participated (response-rate 61.4%)
● Mean age 77.8 (SD 8.63) years
● Female 57.5%

Reliability was found to be 0.81. ROC analysis where MISS was compared with self-reported insomnia criteria (i.e. day-time sleepiness, not feeling refreshed by sleep, experiencing sleep difficulties) identified optimal cut-off score as ≥7, and sensitivity 93%, specificity 84%. Area under curve = 0.93.
Data support the measurement properties of MISS as an insomnia screening instrument among elderly persons and its brevity makes it appealing. Through insomnia-screening, older persons at risk of health problems can be found and offered treatment and thereby health and quality of life can be restored.
Subject: Nursing & Caring Sciences\General
Note: Contact Amanda Hellström for more information.