Sleep Hygiene Program Research Articles

Sleep Characteristics in Dance Students Related to Psychological Inflexibility.

Introduction: Dance, as a performance activity, is associated with various problems. Among these challenges, sleep disturbances are notably prevalent. Aims: This study aimed to explore the potential relationship between sleep characteristics-specifically chronotype and subjective sleep quality- and psychological inflexibility in dance students. Methods: This research adopted a cross-sectional design using non-probabilistic sampling. The data were collected in paper format by visiting public conservatories and private academies, and online. One hundred fourteen dance students, with a mean age of 23.87 years, participated in the study. Assessment tools included the Acceptance and Action Questionnaire-II, Pittsburgh Sleep Quality Index, and the Composite Scale of Morningness. Results: The results revealed that 80.7% of all students reported poor sleep quality, compared to 19.3% who reported good sleep quality. Differences emerged in both subjective sleep quality (F(2, 113) = 4.825, P = .010) and chronotype (F(2, 113) = 6.172, P = .003) when students were grouped according to low, medium, or high levels of psychological inflexibility. Those with low inflexibility, as opposed to those with high inflexibility, report better sleep quality, with no differences observed between medium and high inflexibility groups. Students with high-medium levels of psychological inflexibility showed a higher risk (OR = 6.373 times higher) of experiencing poor sleep quality compared to those with low psychological inflexibility. In terms of chronotype, the low inflexibility group is inclined to be more of a morning type than the medium and high inflexibility groups, with no differences between the latter 2 groups. Students categorized as having low inflexibility tend to have a longer history of dancing under the guidance of a teacher and dedicate more hours and days per week to rehearsal. Conclusion: Conservatories can become "healthy spaces." In this regard, sleep hygiene programs and Acceptance and Commitment Therapy interventions can provide guidance to professionals working with dancers in professional companies and conservatories.

The effect of sleep hygiene and physiotherapy on bruxism, sleep, and oral habits in children with sleep bruxism during the COVID-19 pandemic.

Sleep bruxism has been associated with temporomandibular dysfunction, pain, fatigue, and poor sleep quality. The aim of this study was to determine the gender and age distribution of sleep and oral habits of children with sleep bruxism and to examine the effect of a sleep hygiene and physiotherapy program. In this cross-sectional study, 82 children aged 6-13 years with sleep bruxism were initially screened between March 2020 and June 2021, from which 37 of them voluntarily attended an 8-week sleep hygiene and physiotherapy program. Evaluations were made using a Visual Analogue Scale (VAS), the Children's Sleep Habits Questionnaire (CSHQ), and the Oral Habits Questionnaire (OHQ) at the beginning and at the end of the 8-week program. Statistically significant differences were determined between the 6-9 years and 10-13-year age groups in respect of the sleep habits subcategories of resistance to bedtime (p= 0.001), sleep anxiety (p= 0.043), parasomnia (p= 0.040), and sleep respiratory disorder (p= 0.041). Following the 8-week treatment program, a significant reduction was obtained in the VAS value (p< 0.05), CSHQ subcategories of resistance to bedtime (p= 0.001), sleep duration (p= 0.008), parasomnia (p= 0.000), and in the OHQ score (p= 0.000). There was no relationship between sleep bruxism and gender, but a relationship was found with age. The rate of bruxism was seen to decrease with an increase in age. It was determined that oral, sleep habits, and bruxism are closely related, and the rates at which bruxism is seen are affected by the oral habits. Sleep hygiene and physiotherapy have been effective in children with sleep bruxism.

Stress and Sleep Difficulties in a Sample of Medical Students, Ain-Shams University

Introduction: Background Becoming a medical doctor is a highly complex process. High incidence of stress disorders among medical students was reported. Psychological stress is a triggering factor for insomnia and has a bidirectional association with poor sleep quality. the relationship between stress and sleep difficulties among medical students should be assessed and evaluated as it may affect Academic achievement, and cause difficulty in concentration, tiredness, headache, bad appetite, disturbed bowel habits and tiredness and weakness during daytime, To raise the awareness about the importance of good sleep quality for health and academic achievement Objective To measure stress among medical students, determine pattern of sleep difficulties and to find relationship between stress and sleep quality among medical students. Subjects and Methods: A cross sectional study, Questionnaire based, convenience sample. The sample consisted of 300 undergraduate medical students at Faculty of Medicine, Ain-Shams University, Egypt from January 2019 to March 2020. All students fulfilling the inclusion criteria were offered to participate in the study by using GHQ, PSQI, MSSQ &amp; SCID I Results 300 medical students were recruited in this study; their mean age were 21.4 ± 2.3 year ranging from 17-30 years. 40 % (n = 120) of them were males &amp; 60% (n = 180) were females. 98% (n = 294) of the study sample were single and 4.7% of students (n = 14) were smoker. 50.7% (n = 152) had one or more hobbies. Females reported higher Mean ± SD than males in all MSSQ domains except Drive &amp; desire related stressors. There was statistically significant difference regarding female gender was reported. Conclusion There is high prevalence of stress and poor sleep quality in medical school students. Strong association between sleep quality and stress was found. Medical students need to be educated about sleep hygiene and stress management programs to emphasize on study skills, time management, healthy lifestyles, and effective coping strategies. Conflicts of Interest None of the authors have any conflicts of interest to disclose. Abbreviations PSQI: Pittsburgh Sleep Quality Index; GHQ: General health Questionnaire; MSSQ: medical students stress scale

Evaluation of the effectiveness of sleep hygiene education and FITBIT devices on quality of sleep and psychological worry: a pilot quasi-experimental study among first-year college students.

College students report disturbed sleep patterns that can negatively impact their wellbeing and academic performance. This study examined the effect of a 4-week sleep hygiene program that included sleep education and actigraph sleep trackers (FITBITs) on improving sleep quality and reducing psychological worry without control group. A pilot quasi-experimental design, participants were randomly selected medical and health sciences from a university students in the United-Arab-Emirates. Students were asked to wear FITBITs and log their daily sleep data and completed the Pittsburgh Sleep Quality Index (PSQI) and Penn State Worry Questionnaire (PSWQ). Extensive sleep hygiene education was delivered via lectures, a WhatsApp group, and the Blackboard platform. In total, 50 students completed pre-and post-assessments and returned FITBIT data. There was a significant difference in the prevalence of good sleep postintervention compared with pre-intervention (46% vs. 28%; p = 0.0126). The mean PSQI score was significantly lower post-intervention compared with pre-intervention (6.17 ± 3.16 vs. 7.12.87; p = 0.04, Cohen's d 0.33). After the intervention, subjective sleep quality, sleep latency, and daytime dysfunction were significantly improved compared with pre-intervention (p < 0.05). In addition, FITBIT data showed total sleep time and the number of restless episodes per night were significantly improved postintervention compared with pre-intervention (p = 0.013). The mean PSWQ score significantly decreased from pre-intervention to p = 0.049, Cohen' d = 0.25. The correlation between PSQI and PSWQ scores was significant post-intervention (β = 0.40, p = 0.02). Our results may inform university educational policy and curricular reform to incorporate sleep hygiene awareness programs to empower students and improve their sleep habits.

Sleep quality index among the elderly population in selected areas of Delhi: a community-based cross-sectional study

Background: Studies have shown that effects of low sleep quality can include cognitive decline, sleepiness during the day, and decreased quality of life. Problems with sleep have also been associated with an increased risk of hospitalization and increased mortality. Therefore, the present study was envisaged to assess the sleep quality index and the factors associated with it among the elderly. Methods: This cross-sectional study was conducted in rural and urban setting of Delhi. We selected 115 participants in each area using systematic random sampling. We used a semi structured questionnaire and validated sleep quality index to collect the data. Results: In the present study, only 41 (17.8%) out of 230 individuals were having normal sleep quality and 189 out of 230 individuals were having poor sleep quality. 105 (55.5%) in the rural area (Fatehpur Beri), and 84 (44.5%) in the urban area (Aliganj) were having poor sleep quality respectively. In the rural area, taking sleeping pills and depression were significantly associated with higher scores of sleep quality index. Conclusions: Poor sleep quality was found in 82.2% of elderly participants which was associated with a rural locality, depression, and not taking sleep pills. There is a need to start a sleep hygiene program for the elderly population, particularly in rural area.

Exploration of a Sleep Hygiene, Mindfulness, and Sensory Pillow Program to Address Sleep Quality and Stress Among Higher Education Students

Abstract Date Presented 04/02/2022 Sleep disturbances may negatively influence an individual’s mental and psychosocial functioning, with higher education students of particular concern while managing daily stress. This exploratory study examined technology-aided interventions for sleep routine establishment, sleep hygiene, a mindfulness app, and a sensory pillow. Findings suggest improvements in sleep quality and sleep hygiene knowledge, no change in perceived stress, and various changes in objective sleep tracking data. Primary Author and Speaker: Sara Benham Additional Authors and Speakers: Karlie Brogan, Lauren Brown, Caitlin Gladwell, Christine Neu Contributing Authors: Nabila Enam

The Impact of Implementing Sleep Hygiene Program for Patients with Type Two Diabetes Mellitus and Uncontrolled Glucose Level

The Impact of Implementing Sleep Hygiene Program for Patients with Type Two Diabetes Mellitus and Uncontrolled Glucose Level

The Effectiveness of a Combined Healthy Eating, Physical Activity, and Sleep Hygiene Lifestyle Intervention on Health and Fitness of Overweight Airline Pilots: A Controlled Trial.

(1) Background: The aim of this study was to evaluate the effectiveness of a three-component nutrition, sleep, and physical activity (PA) program on cardiorespiratory fitness, body composition, and health behaviors in overweight airline pilots. (2) Methods: A parallel group study was conducted amongst 125 airline pilots. The intervention group participated in a 16-week personalized healthy eating, sleep hygiene, and PA program. Outcome measures of objective health (maximal oxygen consumption (VO2max), body mass, skinfolds, girths, blood pressure, resting heart rate, push-ups, plank hold) and self-reported health (weekly PA, sleep quality and duration, fruit and vegetable intake, and self-rated health) were collected at baseline and post-intervention. The wait-list control completed the same assessments. (3) Results: Significant group main effects in favor of the intervention group were found for all outcome measures (p < 0.001) except for weekly walking (p = 0.163). All objective health measures significantly improved in the intervention group when compared to the control group (p < 0.001, d = 0.41–1.04). Self-report measures (moderate-to-vigorous PA, sleep quality and duration, fruit and vegetable intake, and self-rated health) significantly increased in the intervention group when compared to the control group (p < 0.001, d = 1.00–2.69). (4) Conclusion: Our findings demonstrate that a personalized 16-week healthy eating, PA, and sleep hygiene intervention can elicit significant short-term improvements in physical and mental health outcomes among overweight airline pilots. Further research is required to examine whether the observed effects are maintained longitudinally.

Relationship among chrononutrition, sleep, and glycemic control in women with gestational diabetes mellitus: a randomized controlled trial

BACKGROUNDGestational diabetes mellitus is associated with an increased risk of maternal, fetal, and neonatal morbidities. Chronobiological disorders have recently been identified as risk factors for those morbidities. The disorders include chrononutritional disorders related to meal frequency and content according to the sleep-wake cycle, sleep disorders related to sleep quality, and chrono-obesity disorders, such as abnormal weight gain because of sleep deprivation and time of eating. OBJECTIVEThis study aimed to assess whether a chrononutritional and sleep hygiene intervention can improve maternal glycemic control and reduce the proportion of large-for-gestational-age newborns among women with gestational diabetes mellitus. STUDY DESIGNThis randomized controlled trial included 103 women with gestational diabetes mellitus who were carrying a singleton fetus and assigned to either the intervention group (n=33) or the control group (n=70). The intervention group was assigned to a chrononutrition and sleep hygiene program, in addition to the usual care for gestational diabetes mellitus, from the time of diabetes mellitus diagnosis to birth, whereas the control group received the usual gestational diabetes mellitus care. RESULTSThe chrononutritional and sleep hygiene intervention significantly reduced the proportion of women with suboptimal glycemic control (<80% of the plasma glucose values at target), after adjustment for maternal age, prepregnancy body mass index, gravidity, history of gestational diabetes mellitus, and large for gestational age (relative risk, 0.28; 95% confidence interval, 0.18–0.81). The effect of the intervention on balancing maternal glycemic control was mainly because of the decreased carbohydrate intake in the evening interval of the day (relative risk, 0.8; 95% confidence interval, 0.64–0.99). However, the intervention had no effect on the proportion of large-for-gestational-age newborns. CONCLUSIONThe chrononutritional and sleep hygiene intervention can improve maternal glycemic control.

Sleep habits, quality and chronotype of Paralympic athletes

This study aimed to understand the sleeping habits of Israeli Paralympic Athletes as a pre-intervention stage to implement sleep hygiene programs. The Pittsburgh Sleep Quality Index questionnaire was used to assess sleep quality. The Epworth Sleepiness Scale was used to determine sleepiness throughout the day. Chronotype was detected using the Horne and Östberg Questionnaire. Para-athletes who were expected to represent Israel at the Tokyo 2020 games were approached via email. The surveys were collected online between April and August, 2018. Para-athletes (n = 52, male = 32, female = 20, mean age = 31.2y, SD = 11.9, from 13 different sport disciplines) completed the online surveys. One-way ANOVA test was used to compare sleep ef&#64257;ciency between the sleepy and non-sleepy groups. MANOVA test was performed to evaluate differences between sleep efficiency, daytime dysfunction and latency between the good and poor sleep quality groups. Non-parametric tests were conducted to analyze the association between the results of the three questionnaires and each sample characteristics. Under a third (31%, n=16) of the athletes slept between 6.5 to 7 hours per night, and a further 29% (n=15) slept less than 6 hours. From the MANOVA analysis, athletes with poor sleep quality had statistically signi&#64257;cantly lower sleep ef&#64257;ciency (p = .028, F(1,50) = 5.11, medium effect size:  = .093), greater daytime dysfunction (p &lt; .001, F(1,50) = 14.19, large effect size:  = .221), and greater sleep latency (p &lt; .001, F(1,50) = 15.08, large effect size:  = .232), than athletes with good sleep quality. Of the athletes, 33% reported having &#8216;moderate to excessive daytime sleepiness&#8217;, 46% did not train at times that match their chronotype. The results of this study may aid in planning effective intervention methods to improve athletes&#8217; sleep quality.

Effect of Sleeping Instruction on Reducing Insomnia among Elderly

Background: Insomnia disorder is a public health concern and is often considered a normal aging phenomenon. Aim of the study: evaluating the effect of sleeping instruction on reducing insomnia among the elderly. Design: A quasi-experimental design. Settings: conducted at sleep disturbance outpatient clinic in Aswan university hospital g a structured interview questionnaire & Athens insomnia scale Results: The designed sleep hygiene program had statistically significant improvement in elderly knowledge and practices. Indeed, there was no statistically significant correlation between elderly’ sleep hygiene and Athens insomnia scale as sleep latency, sleep duration, sleep efficiency, sleep disturbances, and day time dysfunction at the pre and post-intervention phases at P < 0.05.Conclusion: The designed sleep hygiene program don in this study had statistically significant improvement in elderly knowledge and practices and reducing insomnia. Recommendations: Design an awareness Program regarding insomnia among the elderly to enhance sleep by emphasizing the importance of sleep hygiene practice.

Sleep analysis in emergency nurses' department.

Shift work increases the risk of suffering physiological and psychological alterations, due to the sleep disorders that it usually produces in the staff with this type of workday. Analyze the influence of shift work on sleep quality in the nursing staff of the emergency department of the University Hospital of Leon. A total of 70 emergency department nurses aged between 24-56 years were divided into two groups (rotating shift and fixed morning or afternoon shift). The Pittsburgh sleep quality index was used for this purpose. In order to establish differences between the two groups, a bivariate analysis was performed using the χ² test. The results showed that both groups had "rather poor" subjective sleep quality, with scores of 8.5 for fixed shift versus. 6.3 for a rotating shift. The group of nurses' rotating shifts slept an average of 5.39 hours compared to 7.47 hours for a fixed shift. Significant differences were found in sleep latency, sleep disturbances, and the use of sleep medication, with more negative results for the rotating shift. Rotating shift produces a poor quality of sleep compared to a fixed morning or afternoon shift, and it would be interesting for the center itself to establish sleep improvement and sleep hygiene programs.

367 A sleep hygiene and relaxation training program after the Great East Japan Earthquake: What aspects of sleep could be improved?

Abstract Introduction After a natural disaster, the incidence of sleep difficulties tends to increase. Specifically, the prevalence of suspected insomnia was reported to have increased among disaster victims after the Great East Japan Earthquake of March 11, 2011. In a previous study, we have reported that education on sleep hygiene and relaxation training was effective in improving nighttime sleep in students of universities in Sendai city after the earthquake of March 2011. According to analyses of subscale scores of the Pittsburgh Sleep Quality Index (PSQI), the present study aimed to determine what aspects of sleep difficulties were successfully improved. Methods University undergraduates and graduates who reported having sleep difficulties were asked to respond to a questionnaire including the PSQI thrice, before attending a 90-min lecture on sleep hygiene and relaxation training, and a month and three months after attending the program. All participants who reported the total PSQI score of the cutoff point (6) or more were divided into two groups based on their PSQI scores before the program, that attending the course and that not attending it, that is, the “waiting list” group. Results The “attending” group exhibited a decrease in the total PSQI score in the first month after attending the program, and the score in this group reduced further three months later; Nine of twenty (45.0%) attending participants reported the score of less than 6 after a month, while only three of seventeen (17.6%) wait-list participants did. The PSQI subscale scores reported by the nine successful attending participants indicated a significant decrease in the subscale scores on subjective sleep quality, sleep latency, sleep duration, and sleep disturbance from before the program to one month later. Conclusion These results suggest that the short course on sleep hygiene and relaxation training intended for university students was effective, and about a half of the attended participants reported the PSQI score of less than the PSQI cutoff score one month later. This substantial effect would be mainly based on the improvement of their subjective sleep quality, latency, duration, and disturbance. Support (if any) This study was supported by a research grant from the Japanese Psychological Association, Tokyo, Japan.

Adolescent Sleep Problems and Susceptibility to Peer Influence

Susceptibility to peer influence among adolescents is associated with a variety of negative interpersonal and psychosocial outcomes. Although proper sleep is crucial for adolescent development and well-being, no study to date has examined the influence of sleep problems on susceptibility to peer influence. We assess this relationship using two waves of data ( n = 907; 50% male, 18% non-White) from the Study of Early Child Care and Youth Development (SECCYD). Results of a series of multivariate regression models demonstrate that sleep problems are positively associated with susceptibility to peer influence, net of pertinent demographic characteristics, theoretical controls, and prior susceptibility to peer influence. These findings suggest that efforts to improve sleep quality and quantity among adolescents, including educational sleep hygiene programs and later school start times, may serve to curtail susceptibility to peer influence and improve various aspects of wellbeing.

Fatigue and sleepiness in night workers: preliminary results of an educational program

Abstract Background Night work has negative effects on sleep, sleepiness and fatigue with repercussions in performance, safety and health. Therefore, implementing sleep hygiene educational intervention seems of tremendous importance to industries. The questions underlying this study were: 1) To what extent do shift workers experience risk levels of fatigue and sleepiness?; 2) May a sleep hygiene program be associated with improvements on fatigue and sleepiness? Methods The study was conducted in industry and employed a pre pos-test design using the Epworth's Sleepiness Scale and Chalder's Fatigue Scale. From 471 night workers assessed 45 participants at risk for fatigue and sleepiness (93.3% males), mean age of 31 years (SD = 7.3), were selected for the intervention, composed of four sessions along five months, delivered by the occupational medical doctor. The first three sessions, in small groups, focused in sleep literacy and sleep hygiene; the last one, individual, focused in clinical issues (personalized intervention plan). Results Results suggested that 9.6% (N = 45) of the night workers were at high risk (higher levels of fatigue and sleepiness). After intervention, paired T tests revealed significant decreases (p&amp;lt;.001) on mean values for fatigue from T0 (M = 6.67; SD = 2.23) to T1 (M = 4.78; SD = 3.02), and for sleepiness from T0 (M = 15.49; SD = 4.39) to T1 (M = 11.8; SD = 5.95). Along the intervention, participants pointed out family-related routines as an obstacle to daytime sleeping period. Conclusions Results support the importance of this educational program focused on sleep hygiene, in reducing sleepiness and fatigue. The program is now part of the occupational health procedures of the company but qualitative results also suggest the importance of including the family in the program, as an innovative procedure. In summary, education of night workers and their families is needed regarding sleep habits in order to promote safety and health in workplace. Key messages The sleep hygiene program implemented in permanent night workers allowed to reduce fatigue and sleepiness. Fatigue and sleepiness management improvements might contribute to reduce the risk of accidents in the workplace and increase the workers’ health condition.

Implementation of a Sleep Hygiene Program in 4 - 6 Year Old Portuguese Children: the “It is Time to Sleep” Project First Results

Abstract Introduction Sleep, as one of the most determining and present factors in our life, is fundamental for humans, and especially during childhood: it is indispensable for good cognitive, physical and emotional development. Objectives Designed in the scope of the Portuguese National School Health Program, the objectives of this project were to promote adequate sleep routines, raise awareness of children’s sleep deprivation and to the consequences of an abusive contact with technologies. At the end of this activity, children should be able to recognize the importance of these dimensions. Methodology The formative activity, performed by 2 school nurses, was applied to 104 children (from 3 different schools from a northern city of Portugal), with 4 (41.3 %), 5 (44.2 %) and 6 years old (14.4 %), and lasted 45 minutes. The project comprises 4 stages: the first one relates to nurses and project theme presentation; the second one is the implementation of a theatre where major issues of the project are presented, namely the importance of sleep and nap, sleep hygiene rules, consequences of sleep deprivation and the influence of technologies on sleep; the third one is the discussion of the main ideas using the song "Sleep Hour"; at the end, a questionnaire was applied to assess children knowledge about sleep hygiene habits divided into six questions with two images each, in which one corresponds to a healthy practice and the other does not. Results The percentage of correct answers ranged between 96.6 to 98.3 %, suggesting that the formative activity had a positive impact on children’s knowledge about healthy sleep hygiene habits. The 2 questions on which the rate of incorrect answers was higher relate to the fact that sleeping with parents is better than sleeping alone (6.3 %) and that watching TV before going to sleep is a better option than reading a story (4.4 %). Conclusion This intervention has given children important knowledge about healthy sleep hygiene habits, resulting in its understanding through an approach tailored to their age.

Expression of anger in university students according to perceived quality of sleep.

Objective We analyzed the expression of anger according to the perceived quality of sleep in university students.Methods A total sample of 1252 students participated in the study, with an average age of 23.58 years. Using an ex-post facto design and an incidental sampling procedure, the Pittsburgh Sleep Quality Index and the State-Trait Anger Expression Inventory-2 were applied.Results Students with poor sleep quality (PSQI scores> 5) scored higher on the subscales of STAXI-2, showing higher risk of obtaining superior values in Trait Anxiety [OR=1.90] and in the Index of Expression of Anger [OR=1.56], but not in Internal Control of Anger.Conclusions There appears to be a marked relationship between quality of sleep and anger, and it is suggested that sleep hygiene programs can help to reduce the negative consequences of poor sleep quality in terms of health and academic performance in students.

Level of physical activity and sleep characteristics in university students.

ABSTRACTIntroduction: The aim of the present study was to identify the subjective quality of sleep, the chronotype, the frequency of nightmares and the propensity for nightmares in university students depending on whether they are sufficiently physically active (SPA) or insufficiently physically active (IPA).Methods: The study involved 855 students (55.67% women) of which 38.01% are IPA. Evaluations were conducted using the Brief Physical Activity Assessment Tool, the Pittsburgh Sleep Quality Index, the Nightmare Frequency Scale, the Nightmare Proneness Scale and The Composite Scale of Morningness.Results: IPA students showed a greater probability of presenting [OR=2.02] poor sleep quality (> 5 PSQI points) compared with SPA students (p<.001). The IPA participants showing a greater probability [OR=3.70] of having an evening chrontoype (p<.001), report a higher frequency of nightmares (p<.001) and a greater propensity for nightmares (p<.001) compared with the SPA participants. In terms of propensity for nightmares an interaction was found between gender and level of PA (F (3,843)=11.360, p=.001).Conclusion: The possibility of implementing strategies to increase the level of PA among university students should be explored, as well as offering sleep hygiene programs that are effective when used in brief sessions.

Evaluating the Experience and Effectiveness of an Occupational Therapy–Based Sleep Hygiene Program for U.S. Army Service Members: A Mixed Methods Study

Abstract Date Presented 4/20/2018 This study evaluated the effectiveness and perceptions of an occupational therapy–based sleep hygiene program to promote sleep behavior, sleep quality, and occupational performance in service members. The findings suggest that use of an occupational therapy approach to treat sleep difficulties in service members is beneficial. Primary Author and Speaker: Yvette Woods Additional Authors and Speakers: Robin Tennekoon Contributing Authors: Stephen L. Turner

Validating the Persian Adolescent Sleep Hygiene Scale-Revised (ASHSr) using comprehensive psychometric testing methods

BackgroundThis study translated the Adolescent Sleep Hygiene Scale-revised (ASHSr) into Persian and aimed to validate its psychometric properties using classical test theory and Rasch analyses. MethodsAdolescents aged 14–18 (n = 389; 199 males) and their parents in Iran participated in the study. Each adolescent wore a wrist actigraphy device during sleep time and completed the ASHSr, the Depression Anxiety Stress Scale (DASS), the General Health Questionnaire (GHQ), the Pediatric Daytime Sleepiness Scale (PDSS), and the Pittsburgh Sleep Quality Index (PSQI). A parent of each adolescent completed the Sleep Disturbance Scale for Children (SDSC). ResultsThe construct validity of the ASHSr was supported by both classical test theory (factor loadings from confirmatory factor analysis [CFA] = 0.64 to 0.88; corrected item-total correlations = 0.70 to 0.92; test-retest reliability = 0.72 to 0.90) and Rasch analyses (infit mean square = 0.73 to 1.30; outfit mean square = 0.74 to 1.32). ASHSr had significantly negative associations with DASS subscales (β = −0.15 to −0.42, ps < 0.001) and GHQ (β = −0.663, p < 0.001). Known-group validity was demonstrated by the significant differences between poor and good sleep hygiene based on ASHSr in the actigraphy measure and scores of PDSS, PSQI, and SDSC. The multigroup CFA and differential item functioning in Rasch analyses suggested that all the participants interpreted the ASHSr similarly, regardless of their gender or living in a private room. ConclusionsThe Persian ASHSr demonstrated good reliability and validity in assessing sleep hygiene among Iranian adolescents. Healthcare providers may use it to assess the effectiveness of sleep hygiene programs.