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Measurement properties of the Minimal Insomnia Symptom Scale (MISS) among cardiac arrest survivors – A Rasch evaluation study

Hellström, Patrik ; Israelsson, Johan ; Blennow Nordström, Erik LU orcid ; Hjelm, Carina ; Broström, Anders ; Hagell, Peter and Årestedt, Kristofer (2025) In Resuscitation Plus 22.
Abstract
Introduction
Cardiac arrest (CA) survivors often face significant health challenges, including insomnia, which can adversely affect their health-related quality of life. The Minimal Insomnia Symptom Scale (MISS) is a brief, self-reported instrument designed to screen for insomnia. This study aimed to identify the measurement properties of the MISS in CA survivors and to explore a relevant cut-off score.
Methods
Data were collected from two studies: a health survey of CA survivors and a sub-study of a randomized controlled trial (RCT) on targeted temperature management (TTM2). A total of 269 CA survivors participated, with 212 from the survey and 57 from the RCT, the data was collected 6–7 months after CA. The MISS was evaluated... (More)
Introduction
Cardiac arrest (CA) survivors often face significant health challenges, including insomnia, which can adversely affect their health-related quality of life. The Minimal Insomnia Symptom Scale (MISS) is a brief, self-reported instrument designed to screen for insomnia. This study aimed to identify the measurement properties of the MISS in CA survivors and to explore a relevant cut-off score.
Methods
Data were collected from two studies: a health survey of CA survivors and a sub-study of a randomized controlled trial (RCT) on targeted temperature management (TTM2). A total of 269 CA survivors participated, with 212 from the survey and 57 from the RCT, the data was collected 6–7 months after CA. The MISS was evaluated using the polytomous Rasch model, focusing on model fit, local independence, response category functioning, targeting, reliability, and differential item functioning (DIF).
Results
In total, 212 participants were males and 57 females, with a mean age of 66 years. Overall, 51% had survived in-hospital CA and 49% out-of-hospital CA. The MISS exhibited acceptable model fit and targeting, with no disordered thresholds or DIF for age, sex, or place of arrest. The reliability was acceptable. The suggested optimal cut-off score for identifying insomnia was ≥6 points.
Conclusions
The findings indicate that MISS is a valid and reliable screening instrument for insomnia in CA survivors. These results support the use of MISS for screening insomnia in CA survivors. (Less)
Abstract (Swedish)
Introduction
Cardiac arrest (CA) survivors often face significant health challenges, including insomnia, which can adversely affect their health-related quality of life. The Minimal Insomnia Symptom Scale (MISS) is a brief, self-reported instrument designed to screen for insomnia. This study aimed to identify the measurement properties of the MISS in CA survivors and to explore a relevant cut-off score.
Methods
Data were collected from two studies: a health survey of CA survivors and a sub-study of a randomized controlled trial (RCT) on targeted temperature management (TTM2). A total of 269 CA survivors participated, with 212 from the survey and 57 from the RCT, the data was collected 6–7 months after CA. The MISS was evaluated... (More)
Introduction
Cardiac arrest (CA) survivors often face significant health challenges, including insomnia, which can adversely affect their health-related quality of life. The Minimal Insomnia Symptom Scale (MISS) is a brief, self-reported instrument designed to screen for insomnia. This study aimed to identify the measurement properties of the MISS in CA survivors and to explore a relevant cut-off score.
Methods
Data were collected from two studies: a health survey of CA survivors and a sub-study of a randomized controlled trial (RCT) on targeted temperature management (TTM2). A total of 269 CA survivors participated, with 212 from the survey and 57 from the RCT, the data was collected 6–7 months after CA. The MISS was evaluated using the polytomous Rasch model, focusing on model fit, local independence, response category functioning, targeting, reliability, and differential item functioning (DIF).
Results
In total, 212 participants were males and 57 females, with a mean age of 66 years. Overall, 51% had survived in-hospital CA and 49% out-of-hospital CA. The MISS exhibited acceptable model fit and targeting, with no disordered thresholds or DIF for age, sex, or place of arrest. The reliability was acceptable. The suggested optimal cut-off score for identifying insomnia was ≥6 points.
Conclusions
The findings indicate that MISS is a valid and reliable screening instrument for insomnia in CA survivors. These results support the use of MISS for screening insomnia in CA survivors. (Less)
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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Heart arrest, Insomnia, Psychometrics, Rasch model, Sleep, Validation study, Heart arrest, Insomnia, Psychometrics, Rasch model, Sleep, Validation study
in
Resuscitation Plus
volume
22
article number
100876
publisher
Elsevier
external identifiers
  • scopus:85216768108
  • pmid:39990956
ISSN
2666-5204
DOI
10.1016/j.resplu.2025.100876
language
English
LU publication?
yes
additional info
We would like to thank Elisabeth Ericsson, Emilie Bertilsson, Gisela Lilja, Gunilla Edholm, Katarina Bång, Katarina Heimburg, Lillemor Håkansson, Maria Pettersson, Monica Jonsson, and Magnus Segerström for their help with the data collection. A special thanks to the participating survivors.
id
cf4984b4-5c5d-43ed-a229-e6fc7460d9c3
date added to LUP
2025-02-07 20:06:59
date last changed
2025-05-10 03:00:05
@article{cf4984b4-5c5d-43ed-a229-e6fc7460d9c3,
  abstract     = {{Introduction<br/>Cardiac arrest (CA) survivors often face significant health challenges, including insomnia, which can adversely affect their health-related quality of life. The Minimal Insomnia Symptom Scale (MISS) is a brief, self-reported instrument designed to screen for insomnia. This study aimed to identify the measurement properties of the MISS in CA survivors and to explore a relevant cut-off score.<br/>Methods<br/>Data were collected from two studies: a health survey of CA survivors and a sub-study of a randomized controlled trial (RCT) on targeted temperature management (TTM2). A total of 269 CA survivors participated, with 212 from the survey and 57 from the RCT, the data was collected 6–7 months after CA. The MISS was evaluated using the polytomous Rasch model, focusing on model fit, local independence, response category functioning, targeting, reliability, and differential item functioning (DIF).<br/>Results<br/>In total, 212 participants were males and 57 females, with a mean age of 66 years. Overall, 51% had survived in-hospital CA and 49% out-of-hospital CA. The MISS exhibited acceptable model fit and targeting, with no disordered thresholds or DIF for age, sex, or place of arrest. The reliability was acceptable. The suggested optimal cut-off score for identifying insomnia was ≥6 points.<br/>Conclusions<br/>The findings indicate that MISS is a valid and reliable screening instrument for insomnia in CA survivors. These results support the use of MISS for screening insomnia in CA survivors.}},
  author       = {{Hellström, Patrik and Israelsson, Johan and Blennow Nordström, Erik and Hjelm, Carina and Broström, Anders and Hagell, Peter and Årestedt, Kristofer}},
  issn         = {{2666-5204}},
  keywords     = {{Heart arrest; Insomnia; Psychometrics; Rasch model; Sleep; Validation study; Heart arrest; Insomnia; Psychometrics; Rasch model; Sleep; Validation study}},
  language     = {{eng}},
  month        = {{02}},
  publisher    = {{Elsevier}},
  series       = {{Resuscitation Plus}},
  title        = {{Measurement properties of the Minimal Insomnia Symptom Scale (MISS) among cardiac arrest survivors – A Rasch evaluation study}},
  url          = {{http://dx.doi.org/10.1016/j.resplu.2025.100876}},
  doi          = {{10.1016/j.resplu.2025.100876}},
  volume       = {{22}},
  year         = {{2025}},
}