Abstract
BackgroundSleep Hygiene Index (SHI) was designed to assess sleep hygiene. Although the SHI has shown adequate psychometric properties in a nonclinical sample, it has not been validated in a sample with chronic pain. Also, its factor structure, measurement error, and incremental validity over and above other factors affecting sleep quality have not been investigated in a nonclinical sample. Thus, this present study aimed to extend prior psychometric investigation of the SHI. Specifically, we evaluated the factor structure, measurement error, and incremental validity as well as the reliabilities and concurrent validity of the SHI in a sample with chronic pain.MethodsA total of 161 patients seeking treatment in a tertiary pain center located in Seoul, Korea participated. To explore the factor structure of the SHI, we performed an exploratory factor analysis using principal component with varimax. Cronbach’s alphas and intraclass correlation coefficients were computed to investigate internal consistency and 2-week test-retest stability of the SHI, respectively. Measurement error was estimated using standard error of measurement and minimum detectable change (MDC) of the SHI. For concurrent validity, Pearson correlations were calculated to examine the relations between the SHI and outcome measures including background variables. Also for incremental validity, a hierarchical multiple regression was performed in relation to sleep quality.ResultsResults indicated that two-factor solution is most appropriate; sleep disturbing behavior and environment (B/E) and irregular sleep-wake schedule. Results also showed that the internal consistencies and test–retest stability estimates of the SHI were deemed acceptable. At the 95% confidence level, the MDCs were 5.75 for ‘sleep disturbing B/E,’ 3.65 for ‘irregular sleep-wake schedule,’ and 7.49 points for total. The SHI was significantly correlated with age, depression, pain-related anxiety, and sleep quality. Also, sleep quality was significantly predicted by the irregular sleep-wake schedule subscale of the SHI, over and above background variables, pain intensity, depression, pain-related anxiety.ConclusionsThe SHI has the reliability, measurement error, and concurrent and incremental validity support for assessing sleep hygiene in a sample with chronic pain.
Highlights
Sleep Hygiene Index (SHI) was designed to assess sleep hygiene
The role of sleep hygiene on sleep quality has not been established in patients with chronic pain (PCP), sleep hygiene is one of the first things to check when they complain about poor sleep quality [15]
Results showed that the internal consistencies and test–retest stability estimates of the SHI subscale and total scores were deemed acceptable and relatively high compared to the prior study [18]
Summary
Sleep Hygiene Index (SHI) was designed to assess sleep hygiene. the SHI has shown adequate psychometric properties in a nonclinical sample, it has not been validated in a sample with chronic pain. Its factor structure, measurement error, and incremental validity over and above other factors affecting sleep quality have not been investigated in a nonclinical sample This present study aimed to extend prior psychometric investigation of the SHI. Findings from earlier studies have indicated that poor sleep quality is linked to a wide range of deleterious outcomes, Poor sleep quality in PCP has been reported to correlate with pain [10] and emotional distress [10,11]. Other than these factors, poor sleep quality in PCP may be associated with behavioral and environmental factors such as poor sleep habits (referred to as sleep hygiene) [12]. The role of sleep hygiene on sleep quality has not been established in PCP, sleep hygiene is one of the first things to check when they complain about poor sleep quality [15]
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