Validity of two retrospective questionnaire versions of the Consensus Sleep Diary: the whole week and split week Self-Assessment of Sleep Surveys.

OBJECTIVE/BACKGROUND: Prospective, daily sleep diaries are the gold standard for assessing subjective sleep but are not always feasible for cross-sectional or epidemiological studies. The current study examined psychometric properties of two retrospective questionnaire versions of the Consensus Sleep Diary. PARTICIPANTS/METHODS: College students (N = 131, mean age = 19.39 ± 1.65; 73% female) completed seven days of prospective sleep diaries then were randomly assigned to complete either the Self-Assessment of Sleep Survey (SASS), which assessed past week sleep (n = 70), or the SASS-Split (SASS-Y), which assessed weekday/weekend sleep separately (n = 61). Participants also completed psychosocial/sleep questionnaires including the Pittsburgh Sleep Quality Index (PSQI). Sleep parameters derived from SASS, SASS-Y, PSQI, and sleep diaries were assessed via Bland Altman plots, limits of agreement, mean differences, and correlations. RESULTS: SASS-Y demonstrated stronger correlations with prospective sleep diaries and slightly less biased estimates (r = 0.51 to 0.85, α = -0.43 to 1.70) compared to SASS (r = 0.29 to 0.84, α = -1.63 to 2.33) for terminal wakefulness (TWAK), sleep onset latency (SOL), sleep efficiency (SE), and quality (QUAL). SASS resulted in slightly less bias for total sleep time (TST) and wake after sleep onset (WASO) (α = -0.65 and 0.93, respectively) compared to SASS-Y (α = 14.90 and 1.05, respectively). SASS and SASS-Y demonstrated greater convergence with sleep diary than PSQI. CONCLUSIONS: Results demonstrated good psychometric properties for the SASS and SASS-Y. When prospective sleep diaries are not feasible, the SASS and SASS-Y are acceptable substitutes to retrospectively estimate sleep parameters. Retrospective estimation of sleep parameters separately for weekdays/weekends may offer advantages compared to whole week estimation.

Psychometric Evaluation of the PSQI in U.S. College Students.

STUDY OBJECTIVES: Examine the psychometric properties of the PSQI in two U.S. college samples. METHODS: Study I assessed convergent and divergent validity in 866 undergraduates who completed a sleep diary, PSQI, and other sleep and psychosocial measures. Study II assessed PSQI insomnia diagnostic accuracy in a separate sample of 147 healthy undergraduates with and without insomnia. RESULTS: The PSQI global score had only moderate convergent validity with sleep diary sleep efficiency (prospective global measure of sleep continuity; r = 0.53), the Insomnia Severity Index (r = 0.63), and fatigue (r = 0.44). The PSQI global score demonstrated good divergent validity with measures of excessive daytime sleepiness (r = 0.18), circadian preference (r = -0.08), alcohol (r = 0.08) and marijuana (r = 0.05) abuse scales, and poor divergent validity with depression (r = 0.48), anxiety (r = 0.40), and perceived stress (r = 0.33). Examination of other analogous PSQI and sleep diary components showed low to moderate convergent validity: sleep latency (r = 0.70), wake after sleep onset (r = 0.37), sleep duration (r = 0.51), and sleep efficiency (r = -0.32). Diagnostic accuracy of the PSQI to detect insomnia was very high (area under the curve = 0.999). Sensitivity and specificity were maximized at a cutoff of 6. CONCLUSIONS: The PSQI demonstrated moderate convergent validity compared to measures of insomnia and fatigue and good divergent validity with measures of daytime sleepiness, circadian phase preference, and alcohol and marijuana use. The PSQI demonstrated considerable overlap with depression, anxiety, and perceived stress. Therefore, caution should be used with interpretation.

Circadian phase preference in college students: relationships with psychological functioning and academics.

The current study offers a comprehensive assessment of psychosocial functioning and academic performance in relation to circadian phase preference in a US sample of undergraduate college students (N = 838), aged 17-26 (M = 19.78, SD = 1.89). Women had greater morning preference than men, and seniors had greater morning preference than freshmen. Circadian phase preference, fatigue, perceived stress, depression, anxiety, and substance use were assessed cross-sectionally and grade point average (GPA) was assessed prospectively. Evening phase preference was related to higher levels of fatigue, alcohol and caffeine use, and worse academic performance than morning or intermediate phase preferences.