Study of the Effect of Spa Therapy on Insomnia

This instrument assesses the severity and consequences of insomnia through 5 questions. Each item is rated on a five-point Likert scale ranging from 0 to 4. Higher total scores indicate greater insomnia severity (0-7: no insomnia; 8-14: subthreshold insomnia; 15-21: moderate insomnia; 22-28: severe insomnia).

Total nighttime sleep duration during a typical night, self-reported by the participant and expressed in hours.

Number of awakenings occurring during a typical night of sleep, self-reported by the participant and expressed as the number of awakenings per night.

Overall sleep satisfaction assessed using a visual numeric scale ranging from 0 (very poor sleep quality) to 10 (excellent sleep quality), expressed as a score from 0 to 10.

Pain will be assessed using a Visual Numeric Rating Scale (NRS). This self-assessment tool is simple, reproducible, and sensitive to changes in pain intensity. It provides a quantitative yet subjective measure of pain.

The numeric rating scale ranges from 0 to 10, where 0 corresponds to no pain and 10 to the worst imaginable pain. Participants select the number that best represents their current level of pain. The chosen number reflects the intensity of pain experienced.

The Hospital Anxiety and Depression Scale (HADS) is a screening tool used to assess levels of anxiety and depression in patients. It consists of 14 items divided into two subscales: 7 items for anxiety (HADS-A) and 7 items for depression (HADS-D). Each item is scored from 0 to 3, resulting in a total score ranging from 0 to 21 for each subscale.

The Pichot Fatigue Scale is a self-assessment tool used to measure physical and mental fatigue in individuals. It is commonly used in the follow-up of patients with chronic conditions, psychiatric disorders such as depression, or chronic fatigue syndromes.

The scale consists of 8 items, each rated from 0 to 4 according to the intensity of the symptom experienced. It is a simple, quick instrument (less than 5 minutes to complete) and provides a reliable measure to quantify fatigue and monitor its evolution over time.

The Epworth Sleepiness Scale assesses a patient's likelihood of falling asleep in eight everyday situations. It measures daytime sleepiness. A total score greater than 10 is considered indicative of excessive daytime sleepiness.

The EQ-5D-5L is a self-administered questionnaire assessing health-related quality of life across five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension includes five severity levels ranging from no problems to extreme problems/unable to perform. Responses define a five-digit health state that can be converted into a utility index score ranging from values below 0 to 1.00, with higher scores indicating better health status.

Perceived health is assessed using the EQ Visual Analogue Scale (EQ-VAS), ranging from 0 (worst imaginable health state) to 100 (best imaginable health state), with higher scores indicating better perceived health.

The Clinical Global Impression - Improvement scale assesses overall change in a patient's clinical condition following an intervention compared with baseline. Scores range from 1 (very much improved) to 7 (very much worse), with lower scores indicating greater improvement.

The Perceived Stress Scale (PSS-10), developed by Cohen, Kamarck, and Mermelstein in 1983, is a psychometric instrument used to measure the level of stress perceived by an individual over the past month.

It consists of 10 items derived from the original 14-item version (PSS-14). The scale assesses subjective stress perception by evaluating the frequency of stress-related thoughts and feelings. Responses are rated on a scale from 0 (never) to 4 (very often).

The International Restless Legs Syndrome Rating Scale IRLS assesses the severity of restless legs syndrome by evaluating symptom intensity frequency and impact on daily functioning and quality of life. The score ranges from 0 to 40 with higher scores indicating greater symptom severity.

The Ricci and Gagnon Physical Activity Questionnaire assesses an individual's level of physical activity using questions on the frequency intensity and duration of daily activities. The total score ranges from 0 to 45 with higher scores indicating higher levels of physical activity. Scores lower than 18 indicate inactivity scores between 18 and 35 indicate an active lifestyle and scores above 35 indicate a very active lifestyle.