A new single-item sleep quality scale: results of psychometric evaluation in patients with chronic primary insomnia and depression
Open accessAbstract
Study objectives A single-item sleep quality scale (SQS) was developed as a simple and practical sleep quality assessment and psychometrically evaluated.Methods SQS measurement characteristics were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and morning questionnaire-insomnia (MQI) according to prespecified analysis plans in separate clinical studies of patients with insomnia and depression. Patients with insomnia (n = 70) received 4 weeks' usual care with an FDA-approved hypnotic agent; patients with depression (n = 651) received 8 weeks' active or experimental therapy.Results Concurrent criterion validity (correlation with measures of a similar construct) was demonstrated by strong (inverse) correlations between the SQS and MQI (week 1 Pearson correlation -.76) and PSQI (week 8 Goodman-Kruskal correlation -.92) sleep quality items in populations with insomnia and depression, respectively. In patients with depression, stronger correlations between the SQS and PSQI core sleep quality components versus other items supported convergent/divergent construct validity (similarity/dissimilarity to related/unrelated measures). Known-groups validity was evidenced by decreasing mean SQS scores across those who sleep normally, those borderline to having sleep problems, and those with problems sleeping. Test-retest reliability (intraclass correlation coefficient) was .62 during a 4-week period of sleep stability in patients with insomnia and .74 in stable patients with depression (1 week). Effect sizes (standardized response means) for change from baseline were 1.32 (week 1) and .67 (week 8) in populations with insomnia and depression, respectively. Mean SQS changes from baseline to week 8 convergently decreased across groups of patients with depression categorized by level of PSQI sleep quality improvement.Conclusions The SQS possesses favorable measurement characteristics relative to lengthier or more frequently administered sleep questionnaires in patients with insomnia and depression.Clinical trial registration Registry: ClincalTrials.gov, Title: Treatment of Patients With Major Depressive Disorder With MK0869, Identifier: NCT00034983, URL: https://clinicaltrials.gov/ct2/show/NCT00034983.
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The SQS has excellent concurrent and convergent validity with other lengthier sleep scales and is effective in determining clinically meaningful changes in sleep quality.
“The SQS has been shown to have excellent concurrent and convergent validity with other lengthier sleep scales and has been demonstrated to be effective in determining clinically meaningful changes in sleep quality (Snyder et al., 2018).”
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“The SQS has been shown to have excellent concurrent and convergent validity with other lengthier sleep scales and has been demonstrated to be effective in determining clinically meaningful changes in sleep quality (Snyder et al., 2018).”
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- Authors
- Snyder, E., Cai, B., DeMuro, C., Morrison, M. F., & Ball, W.
- Affiliations
- Merck & Co., Inc., Rahway, NJ, USA (United States) (US)
- Corresponding author
- Snyder, Ellen
- Venue
- Journal of Clinical Sleep Medicine
- Published
- 2018-11-15
- Volume
- 14
- Issue
- 11
- Pages
- 1849-1857
- ISSN
- 1550-9389 (ISSN-L)
- 1550-9397
- PMC
- PMC6223557
- OpenAlex
- W2900723373
- Cited by
- 473
- References
- 15
- Citations by year
- 2026: 103 · 2025: 114 · 2024: 75 · 2023: 57 · 2022: 66 · 2021: 36 · 2020: 17 · 2019: 4
- FWCI
- 18.66
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Sleep Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Keywords
- sleep quality assessment, chronic primary insomnia, depression, psychometric validation, criterion validity, construct validity, known-groups validity, test-retest reliability, Pittsburgh Sleep Quality Index, hypnotics, major depressive disorder
- MeSH terms
- Aprepitant, Adult, Aged, Major Depressive Disorder, Depressive Disorder, Major, Dose-Response Relationship, Drug, Double-Blind Method, Female, Humans, Hypnotics and Sedatives, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Psychometrics, Surveys and Questionnaires, Reproducibility of Results, Comorbidity, Paroxetine
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