Kate Wilkinson

State-Trait Anxiety Inventory (STAI)

The STAI is a 40-item questionnaire designed to measure two aspects of anxiety: the temporary and episodic form of anxiety that fluctuates across situations and circumstances, and the stable personality traits that predispose individuals to anxiety in general [1]. Though the scale has been widely used in research, it is also a valuable clinical tool. The STAI’s two subscales make it ideal for sleep specialists hoping to identify both current recurring anxiety problems in order to address their influence on sleep quality.

Nonrestorative sleep: Symptom or unique diagnostic entity?

Nonrestorative sleep (NRS) refers to the subjective experience of sleep as insufficiently refreshing, often despite the appearance of normal sleep according to traditionally assessed objective parameters. This has led researchers to pursue alternative physiological markers of nonrestorative or unrefreshing sleep, though much of this research remains controversial and inconclusive. This review summarizes the recent findings on NRS in the literature and discusses some of the issues inherent in current efforts to define and measure NRS. We offer a summary of recommended clinical approaches to NRS and discuss a new potential paradigm for the assessment of NRS-an approach modelled on current diagnosis of insomnia.

Pittsburgh Sleep Quality Index (PSQI)

As psychiatric disorders are often associated with sleep disturbances, the PSQI was designed to evaluate overall sleep quality in these clinical populations. Each of the questionnaire’s 19 self-reported items belongs to one of seven subcategories: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. Five additional questions rated by the respondent’s roommate or bed partner are included for clinical purposes and are not scored.

Child Behavior Checklist (CBCL), 6–18

Completed from the perspective of the child’s parent or guardian, the questionnaire evaluates a variety of behavioral problems and competencies in young children. Parents respond to 99 Likert-type items by selecting the option that best represents their child’s behavior over the past 6 months (0 = “Not true (as far as you know),” 1 = “Somewhat or sometimes true,” and 2 = “Very true or often true”).

Karolinska Sleepiness Scale (KSS)

This scale [1] measures the subjective level of sleepiness at a particular time during the day. On this scale subjects indicate which level best reflects the psycho-physical sate experienced in the last 10 min. The KSS is a measure of situational sleepiness. It is sensitive to fluctuations.

Visual Analogue Scale to Evaluate Fatigue Severity (VAS-F)

The scale consists of 18 items relating to the subjective experience of fatigue. Each item asks respondents to place an “X,” representing how they currently feel, along a visual analogue line that extends between two extremes (e.g., from “not at all tired” to “extremely tired”). In contrast to discrete, Likert-type scales, the VAS-F places fewer restrictions on the range of responses available to individuals. However, the benefits of a visual analogue scale may be offset by the frequent reluctance of individuals to use the highest and lowest extremes.

Development and validation of the Nonrestorative Sleep Scale (NRSS).

STUDY OBJECTIVES Nonrestorative sleep (NRS) is defined as the subjective feeling that sleep has been insufficiently refreshing, often despite the appearance of physiologically normal sleep. While NRS has been shown to be associated with a variety of cognitive, affective, and medical complaints, there is currently no valid, reliable instrument available in the public domain for its assessment. The purpose of this study was to develop and validate the nonrestorative sleep scale (NRSS). PARTICIPANTS The scale was administered to a sample of 226 (age: 46.7 ± 14.9 years; gender: 48% female) consecutive sleep clinic patients and to 30 control participants (age: 36.9 ± 12.5; gender: 53% female). RESULTS Data screening led to a final instrument of 12 items, and factor analysis resulted in 4 factors accounting for 73.2% of total variance. The scale demonstrated excellent internal reliability (α = 0.88) and good test-retest reliability (r = 0.72). Preliminary evaluations of construct validity found that certain subscales correlated reasonably well with previously validated sleep, alertness, and affective scales. Comparisons between global NRSS scores and objective polysomnographic variables revealed a few very small but significant correlations. CONCLUSIONS Based on these findings, the NRSS was confirmed to be a valid and reliable tool for the assessment of nonrestorative sleep.

School Sleep Habits Survey

The School Sleep Habits Survey is an eight-page, 63-item questionnaire designed to assess the sleep/wake habits and typical daytime functioning of high school students. As a thorough method for data collection, the survey allows researchers and clinicians alike to gather valuable demographic and behavioral information, including: sleep schedule regularity, school performance, daytime sleepiness, behavior problems, depressive mood, and bed times, rise times, and total sleep times for both weeknights and weekends [1].

Pediatric Sleep Questionnaire (PSQ)

Designed to screen for sleep problems in children. A shorter version is shown (following) which specifically relates to sleep-disordered breathing (SDB) in children. The scale consists of 22 parent-reported items examining snoring and breathing problems, daytime sleepiness, inattention, hyperactivity, and other signs and symptoms of apnea including obesity and nocturnal enuresis.

Epworth Sleepiness Scale (ESS)

Designed to evaluate overall daytime sleepiness, the questionnaire asks respondents to rate how likely they are to fall asleep in eight different situations. Each circumstance represents a moment of relative inactivity, from lying down for a nap in the afternoon to sitting in a car stopped in traffic. The scale may be indicated for use in research as well as for clinicians requiring an efficient screening devise for daytime sleepiness.