Outcome Measure
Regensburg Insomnia Scale
What it measures?
- Psychological symptoms of insomnia assessing cognitive, emotional and behavioural aspects. The RIS measures four factors of sleep including: sleep depth, sleep quantity, fearfully focussing on insomnia, and hypnotics and daytime functioning over the past 4 weeks. THE RIS can also be used to measure the effectiveness of sleep interventions.
Who is it for?
The RIS has been developed and validated for use in adult populations (Crönlein et al., 2013).
Instrument Quality
- The RIS is a commonly used measure for insomnia with demonstrated validity and sensitivity to change (Crönlein et al., 2013). One study reported high validity amongst an Arabic version of the RIS in Lebanese populations (Halli et al., 2019), however, there continues to be a lack of independent research evaluating the psychometric properties of the RIS in diverse populations.
Structure
- 10 items - sleep depth (3), sleep quantity (3), fearfully focussing on insomnia (2), hypnotics and daytime functioning (2)
- 5-point Likert scale
- Respondents indicate how frequently (0 = "Never"; 4 = "Always") they have experienced psychophysiological symptoms of insomnia over the past 4 weeks on 8 questions (e.g. I wake up too early), and indicate their quantity of sleep (0 = “7 hours and more”; 4 = “0-1 hours”) and time required to fall asleep (0 = “1-20 minutes”; 4 = “91 minutes and more”).
Scoring instructions
- Total scores are calculated by summing the response values of all items.
- Overall total scores range from 0 - 40.
- Sleep depth scores range from 0 - 12.
- Sleep quantity scores range from 0 -12.
- Fearfully focussing on insomnia scores range from 0 - 8.
- Hypnotics and daytime functioning scores range from 0 - 8.
- Overall scores above the cutoff (13+) indicate elevated symptoms consistent with psychophysiological insomnia and should be investigated further.
- Average scores within the four factors can be calculated by dividing the total score of items from each factor by the number of items in each factor. This can be used to compare relative strengths and weaknesses in the individual’s sleep.
| Subscale | Item number |
|---|---|
Full-scale (RIS) |
1,2,3,4,5,6,7,8,9,10 |
Score Interpretation
What higher scores mean?
- Greater severity of cognitive, behavioural, and emotional difficulties associated with psychophysiological insomnia.
How to assess symptom severity & change?
| Description | Score Range | |
|---|---|---|
| Normal | 0 | |
| Clinically significant | 13 | |
| Insomnia | >=13 | Provisional Diagnosis |
| Maximum | 40 |
Instrument developers
- Crönlein, T., Langguth, B., Popp, R., Lukesch, H., Pieh, C., Hajak, G., & Geisler, P. (2013). Regensburg Insomnia Scale (RIS): a new short rating scale for the assessment of psychological symptoms and sleep in insomnia; study design: development and validation of a new short self-rating scale in a sample of 218 patients suffering from insomnia and 94 healthy controls. Health and quality of life outcomes, 11(1), 1-8.
Refrences
* Crönlein, T., Langguth, B., Popp, R., Lukesch, H., Pieh, C., Hajak, G., & Geisler, P. (2013). Regensburg Insomnia Scale (RIS): a new short rating scale for the assessment of psychological symptoms and sleep in insomnia; study design: development and validation of a new short self-rating scale in a sample of 218 patients suffering from insomnia and 94 healthy controls. Health and quality of life outcomes, 11(1), 1-8. * Hallit, S., Haddad, C., Hallit, R., Al Karaki, G., Malaeb, D., Sacre, H., ... & Salameh, P. (2019). Validation of selected sleeping disorders related scales in Arabic among the Lebanese population. Sleep and Biological Rhythms, 17, 183-189.
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Severity ranges
Crönlein et al. (2013) proposed that scores from 0-12 were considered normal, and scores above the cutoff (13+) indicated the presence of psychophysiological insomnia symptoms requiring further investigation.
Provisional diagnosis
Crönlein et al. (2013) proposed that scores from 0-12 were considered normal, and scores above the cutoff (13+) indicated the presence of psychophysiological insomnia symptoms requiring further investigation.
Reliable change and clinically significant improvement
Wampold et al (2001) conducted a meta analysis of psychotherapy outcome studies and noted that the average improvement was reflected in an effect size (ES) of .80. Because a change of 1 SD corresponds to an ES of 1.0, and .80 is considered to be a large ES, Wise (2004) concludes that a change of 1 SD is a defensible indicator of clinically significant change.
Reliability