. 2023 Nov 21;8(6):102047. doi: 10.1016/j.esmoop.2023.102047

Table 1.

Examples of the most frequently used psychometric and nonpsychometric validated tools to assess insomnia disorders in patients with cancer

Measures	Description
Scales
ISI²⁸	The ISI is a self-report seven-item scale investigating sleep over the past 14 days (difficulties falling asleep, difficulties maintaining sleep, early morning awakenings, satisfaction or dissatisfaction with the current sleep pattern, how noticeable the effect on well-being is to others, how distressing the current sleep problem is and to what extent it interferes with daily functioning) Each item is scored on a four-point scale (score range 0-28) A score ≥8 indicates subthreshold insomnia and a score ≥15 indicates clinical insomnia
SCI³⁰	The SCI is an eight-item scale, comprising two quantitative items on sleep continuity (item 1: getting to sleep; item 2: remaining asleep), two qualitative items on sleep satisfaction or dissatisfaction (item 4: SQ; item 7: troubled or not), two quantitative items on severity (item 3: nights per week; item 8: duration of problem) and two qualitative items on attributed daytime consequences of poor sleep [item 5: effects on mood, energy or relationships (personal functioning); item 6: effects on concentration, productivity or ability to stay awake (daytime performance)] Each item is scored on a five-point scale (0-4), with lower scores in the 0-2 range reflecting putative DSM-5 threshold criteria for insomnia disorder Possible total score ranges from 0 to 32, with higher values indicative of better sleep. A score ≤16 is considered a ‘probable insomnia disorder’ To facilitate interpretation for clinicians and patients, total scores can be converted to a 0-10 scale by dividing the total by 3.2, where 10 represents the best possible sleep
PSQI³¹	The self-administered PSQI measures sleep disturbance and usual sleep habits during the prior month through 19 items on a 0-3 Likert scale in seven clinically derived domains of sleep difficulties (SQ, sleep latency, sleep duration, habitual SE, sleep disturbances, use of sleeping medications and daytime dysfunction) A higher global SQ score (sum of the seven domains, score range 0-21) indicates poorer SQ A score of >5 has a diagnostic sensitivity of 89.6% and specificity of 86.5% to distinguish ‘poor’ sleepers from ‘good’ sleepers (healthy individuals)
Single items
US NCI PRO-CTCAE²³	In the last 7 days, what was the severity of your insomnia (including difficulty falling asleep, staying asleep or waking up early) at its worst? [Score range 0 (none) to 4 (very severe)] In the last 7 days, how much did insomnia (including difficulty falling asleep, staying asleep or waking up early) interfere with your usual or daily activities? [Score range 0 (not at all) to 4 (very much)]
NCCN distress management in oncology²¹ and NCCN survivorship in oncology²² guidelines	Are you having problems falling asleep, staying asleep, waking up too early or with poor SQ? Are you experiencing excessive sleepiness (sleepiness or falling asleep in inappropriate situations or sleeping more during a 24-hour period than in the past)? Have you been told that you snore frequently or stop breathing during sleep?
Sleep diary
CSD³⁵	The CSD asks patients to record (e.g. every morning for 7-10 days) the following aspects of their sleep: 1. What time did you get into bed? Write the time that you got into bed. This may not be the time that you began ‘trying’ to fall asleep 2. What time did you try to go to sleep? Record the time that you began ‘trying’ to fall asleep 3. How long did it take you to fall asleep? Beginning at the time you wrote in question 2, how long did it take you to fall asleep? 4. How many times did you wake up, not counting your final awakening? How many times did you wake up between the time you first fell asleep and your final awakening? 5. In total, how long did these awakenings last? What was the total time you were awake between the time you first fell asleep and your final awakening. For example, if you woke three times for 20 minutes, 35 minutes and 15 minutes, add them all up (20 + 35 + 15 = 70 minutes or 1 hour and 10 minutes) 6. What time was your final awakening? Record the last time you woke up in the morning 7. What time did you get out of bed for the day? What time did you get out of bed with no further attempt at sleeping? This may be different from your final awakening time (e.g. you may have woken up at 6:35 am but did not get out of bed to start your day until 7:20 am) 8. How would you rate the quality of your sleep? ‘Sleep quality’ is your sense of whether your sleep was good or poor 9. Comments: if you have anything that you would like to say that is relevant to your sleep feel free to write it here Data from sleep diaries are used to calculate sleep outcomes such as SOL, WASO, TIB, TST and SE, which is the time in bed spent sleeping (%)

CSD, Consensus Sleep Diary; DSM-5, Diagnostic and Statistical Manual of Mental Disorders fifth edition; ISI, Insomnia Severity Index; NCCN, National Comprehensive Cancer Network; NCI, National Cancer Institute; PRO-CTCAE, Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events; PSQI, Pittsburgh Sleep Quality Index; SCI, Sleep Condition Indicator; SE, sleep efficiency; SOL, sleep onset latency; SQ, sleep quality; TIB, time in bed; TST, total sleep time; US, United States; WASO, wakefulness after sleep onset.