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Measuring Subjective Sleep Quality: A Review

Author

Listed:
  • Marco Fabbri

    (Department of Psychology, University of Campania Luigi Vanvitelli, 8100 Caserta, Italy)

  • Alessia Beracci

    (Department of Psychology, University of Campania Luigi Vanvitelli, 8100 Caserta, Italy)

  • Monica Martoni

    (Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy)

  • Debora Meneo

    (Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy)

  • Lorenzo Tonetti

    (Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy)

  • Vincenzo Natale

    (Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy)

Abstract

Sleep quality is an important clinical construct since it is increasingly common for people to complain about poor sleep quality and its impact on daytime functioning. Moreover, poor sleep quality can be an important symptom of many sleep and medical disorders. However, objective measures of sleep quality, such as polysomnography, are not readily available to most clinicians in their daily routine, and are expensive, time-consuming, and impractical for epidemiological and research studies., Several self-report questionnaires have, however, been developed. The present review aims to address their psychometric properties, construct validity, and factorial structure while presenting, comparing, and discussing the measurement properties of these sleep quality questionnaires. A systematic literature search, from 2008 to 2020, was performed using the electronic databases PubMed and Scopus, with predefined search terms. In total, 49 articles were analyzed from the 5734 articles found. The psychometric properties and factor structure of the following are reported: Pittsburgh Sleep Quality Index (PSQI), Athens Insomnia Scale (AIS), Insomnia Severity Index (ISI), Mini-Sleep Questionnaire (MSQ), Jenkins Sleep Scale (JSS), Leeds Sleep Evaluation Questionnaire (LSEQ), SLEEP-50 Questionnaire, and Epworth Sleepiness Scale (ESS). As the most frequently used subjective measurement of sleep quality, the PSQI reported good internal reliability and validity; however, different factorial structures were found in a variety of samples, casting doubt on the usefulness of total score in detecting poor and good sleepers. The sleep disorder scales (AIS, ISI, MSQ, JSS, LSEQ and SLEEP-50) reported good psychometric properties; nevertheless, AIS and ISI reported a variety of factorial models whereas LSEQ and SLEEP-50 appeared to be less useful for epidemiological and research settings due to the length of the questionnaires and their scoring. The MSQ and JSS seemed to be inexpensive and easy to administer, complete, and score, but further validation studies are needed. Finally, the ESS had good internal consistency and construct validity, while the main challenges were in its factorial structure, known-group difference and estimation of reliable cut-offs. Overall, the self-report questionnaires assessing sleep quality from different perspectives have good psychometric properties, with high internal consistency and test-retest reliability, as well as convergent/divergent validity with sleep, psychological, and socio-demographic variables. However, a clear definition of the factor model underlying the tools is recommended and reliable cut-off values should be indicated in order for clinicians to discriminate poor and good sleepers.

Suggested Citation

  • Marco Fabbri & Alessia Beracci & Monica Martoni & Debora Meneo & Lorenzo Tonetti & Vincenzo Natale, 2021. "Measuring Subjective Sleep Quality: A Review," IJERPH, MDPI, vol. 18(3), pages 1-50, January.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:3:p:1082-:d:487179
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    References listed on IDEAS

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    1. Raudah Mohd Yunus & Syeda Wasfeea Wazid & Noran N Hairi & Wan Yuen Choo & Farizah M Hairi & Rajini Sooryanarayana & Sharifah N Ahmad & Inayah A Razak & Devi Peramalah & Suriyati A Aziz & Zaiton L Moha, 2017. "Association between elder abuse and poor sleep: A cross-sectional study among rural older Malaysians," PLOS ONE, Public Library of Science, vol. 12(7), pages 1-14, July.
    2. Carolina Climent-Sanz & Anna Marco-Mitjavila & Roland Pastells-Peiró & Fran Valenzuela-Pascual & Joan Blanco-Blanco & Montserrat Gea-Sánchez, 2020. "Patient Reported Outcome Measures of Sleep Quality in Fibromyalgia: A COSMIN Systematic Review," IJERPH, MDPI, vol. 17(9), pages 1-26, April.
    3. Lee Cronbach, 1951. "Coefficient alpha and the internal structure of tests," Psychometrika, Springer;The Psychometric Society, vol. 16(3), pages 297-334, September.
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    1. Caitlin R. Semsarian & Gabrielle Rigney & Peter A. Cistulli & Yu Sun Bin, 2021. "Impact of an Online Sleep and Circadian Education Program on University Students’ Sleep Knowledge, Attitudes, and Behaviours," IJERPH, MDPI, vol. 18(19), pages 1-14, September.
    2. Kaja Kastelic & Nejc Šarabon & Michael D. Burnard & Željko Pedišić, 2022. "Validity and Reliability of the Daily Activity Behaviours Questionnaire (DABQ) for Assessment of Time Spent in Sleep, Sedentary Behaviour, and Physical Activity," IJERPH, MDPI, vol. 19(9), pages 1-11, April.
    3. Marco Fabbri & Alessia Beracci & Monica Martoni, 2022. "Insomnia, Time Perspective, and Personality Traits: A Cross-Sectional Study in a Non-Clinical Population," IJERPH, MDPI, vol. 19(17), pages 1-15, September.
    4. Mohamed Abdelhack & Peter Zhukovsky & Milos Milic & Shreyas Harita & Michael Wainberg & Shreejoy J. Tripathy & John D. Griffiths & Sean L. Hill & Daniel Felsky, 2023. "Opposing brain signatures of sleep in task-based and resting-state conditions," Nature Communications, Nature, vol. 14(1), pages 1-14, December.
    5. Anna Tetych & Grażyna Olchowik & Jan Warchoł, 2022. "Investigations Concerning the Influence of Sleep Disorders on Postural Stability in Young Men," IJERPH, MDPI, vol. 19(14), pages 1-13, July.
    6. Silvia Vivarelli & Sebastiano Italia & Michele Teodoro & Manuela Pollicino & Carmen Vitello & Annalisa De Vita & Angela Alibrandi & Chiara Costa & Concettina Fenga, 2023. "Salivary Biomarkers Analysis and Neurobehavioral Assessment in Nurses Working Rotation Shifts: A Pilot Study," IJERPH, MDPI, vol. 20(7), pages 1-21, April.
    7. Marco Mirolli & Luca Simione & Monica Martoni & Marco Fabbri, 2021. "Accept Anxiety to Improve Sleep: The Impact of the COVID-19 Lockdown on the Relationships between Mindfulness, Distress, and Sleep Quality," IJERPH, MDPI, vol. 18(24), pages 1-11, December.
    8. Park, Kiwoong & Kim, Jinho, 2023. "Longitudinal association between perceived discrimination and sleep problems among young adults in the United States: Tests of moderation by race/ethnicity and educational attainment," Social Science & Medicine, Elsevier, vol. 321(C).
    9. Cailan Lindsay Feingold & Abbas Smiley, 2022. "Healthy Sleep Every Day Keeps the Doctor Away," IJERPH, MDPI, vol. 19(17), pages 1-35, August.

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