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There are no established questionnaires that evaluate habitual sleep practices in the context of beliefs and attitudes about sleep. This study describes an effort to develop and evaluate a questionnaire that assesses habitual sleep; behaviors associated with sleep and potential sleep problems; sleep hygiene; social and environmental determinants of...
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Context 1
... to items characterizing the general sense of importance of sleep are reported in Table 3. Overall, most respondents indicated that their parents stressed the importance of sleep, and this was reflected in responses to an item asking whether sleep was important for children, to which > 90% of respondents indicated that they "strongly agree." ...
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Citations
... The Sleep Practices and Attitudes Questionnaire (SPAQ) was included in the survey to investigate behaviour and attitudes about sleep. The SPAQ has been used previously to assess habitual sleep, behaviours associated with sleep and sleep problems, sleep hygiene, social and environmental factors of sleep and beliefs and attitudes about sleep 22) . Participants were asked to self-rate the degree to which they either agree or disagree with the statement "I have control over when and how much I sleep" (strongly agree, agree, unsure, disagree and strongly disagree). ...
Paramedics commonly experience both poor sleep and mental health symptoms. Clarifying whether sleep or mental health symptoms are a challenge prior to commencement of employment is important, as early prevention and intervention initiatives during training could support these workers. Paramedicine students (n=53) were included, with sleep disorder screening (obstructive sleep apnea, insomnia and restless legs syndrome), and mental health outcomes (depressive symptoms: Patient Health Questionnaire-9, and anxiety symptoms: General Anxiety Disorder-7). Data were analysed using robust regression models, adjusted for age, sex, and shift work status. Meeting criteria for a sleep disorder (n=21) was associated with higher scores for anxiety (8.2 [95% CI: 5.9–10.5] v 4.6, [3.4–5.8]) and depressive symptoms (11.1 [8.6–13.6] v 4.4 [3.1–5.7)] compared to those who did not meet the criteria for a sleep disorder (n=32). Depressive symptoms were lower in those with perceived control over sleep (5.2 [3.2–7.2] v 9.8 [7.7–11.8]). There was no interaction between sleep disorder risk and perceived control over sleep on mental health symptoms. Investigation and management of factors contributing to low perceived control over sleep, together with early screening and management of sleep disorders, are likely to be important priorities to support paramedic student wellbeing prior to commencing shift work.
... Third, the external validation did not include the association of sleep beliefs with sleep attitudes, as evaluated by the Sleep Practices and Attitudes Questionnaire (54) or sleep disbeliefs as evaluated by the DBAS scale (50,51). Although consumptions are strongly related to sleep (55)(56)(57), and despite their presence in 4 of the 20 items of the SBS, they were not evaluated. ...
Background
The Sleep Beliefs Scale (SBS) is a well-known tool to design and monitor personalized sleep health promotion at an individual and population level. The lack of an established French version limits the development of effective interventions targeting these populations. Thus, the aim of this study was to validate the French version of the SBS in a representative sample of the general population.
Methods
Quota sampling was used to recruit 1,004 participants (18–65 years, mean age: 43 years, 54% of female) who underwent an online survey to complete the SBS, and to assess sleep schedules, sleep quality and disorders, and mental health. Cronbach’s α coefficient, confirmatory factor analysis, item-internal consistency (IIC), and item discriminant validity (IDV) of the SBS were computed to assess internal validity while bivariate associations with sleep schedules, sleep quality and disorders, and mental health were used to assess external convergent and discriminant validity.
Results
The mean score on the SBS was 12.3 ± 4.9. Item 19 (“Quiet & Dark”) showed the highest rate of correct answers (n = 801, 79.8%), while item 20 (“Recovering sleep”) showed the lowest rate of correct answers (n = 246, 24.5%). Overall, the SBS showed satisfactory internal consistency (α = 0.87) and confirmed the three-factor structure proposed by the original study. All items were found consistent (IIC > 0.4) and discriminant (IIC > IDV) except for item 20 (“recovering lost sleep by sleeping for a long time”). Females, older participants, and subjects with short time-in-bed, poor sleep quality, insomnia, and circadian rhythm disorder had higher SBS scores while participants with depressive symptoms had lower SBS scores.
Conclusion
We successfully translated and validated the French version of the SBS in a representative sample, making it a reliable instrument for researchers and clinicians to assess and target sleep beliefs. Correct answers vary from 25 to 80% which underlines the importance of continuing sleep health promotion campaigns by targeting poorly understood behaviors. Our findings also shed light on the fickleness of beliefs that are prone to vary within individuals across time, in step with societal changes. Several associated factors were identified, thus contributing to our understanding of sleep beliefs and offering insights for personalized approaches to enhance sleep health and overall well-being.
... This questionnaire reported some preliminary support for structural validity and internal consistency [15]. Additionally, there are different questionnaires on explanatory variables of sleep such as the Sleep Practices and Attitudes Questionnaire, or the Dysfunctional Beliefs and Attitudes about Sleep Scale (specific for insomnia), and the Sleep Beliefs Scale [48][49][50]. Most of these questionnaires investigate explanatory variables, which often lacks the link with a behavior change theory [48][49][50]. ...
... Additionally, there are different questionnaires on explanatory variables of sleep such as the Sleep Practices and Attitudes Questionnaire, or the Dysfunctional Beliefs and Attitudes about Sleep Scale (specific for insomnia), and the Sleep Beliefs Scale [48][49][50]. Most of these questionnaires investigate explanatory variables, which often lacks the link with a behavior change theory [48][49][50]. Moreover, none of these questionnaires addressed multiple behaviors such as 24-h movement behaviors, whereas this newly developed questionnaire does. ...
A questionnaire on explanatory variables for each behavior of the 24-h movement behaviors (i.e., physical activity, sedentary behavior, sleep) was developed based on three levels of the socio-ecological model, i.e., the intrapersonal level, interpersonal level and the physical environmental level. Within these levels, different constructs were questioned, i.e., autonomous motivation, attitude, facilitators, internal behavioral control, self-efficacy, barriers, subjective norm, social modeling, social support, home environment, neighborhood, and work environment. The questionnaire was tested for test–retest reliability (i.e., intraclass correlation (ICC)) for each item and internal consistency for each construct (i.e., Cronbach’s Alpha Coefficient) among a group of 35 healthy adults with a mean age of 42.9 (±16.1) years. The total questionnaire contained 266 items, consisting of 14 items on general information, 70 items on physical activity, 102 items on sedentary behavior, 45 items on sleep and 35 items on the physical environment. Seventy-one percent of the explanatory items showed moderate to excellent reliability (ICC between 0.50 and 0.90) and a majority of constructs had a good homogeneity among items (Cronbach’s Alpha Coefficient ≥ 0.70). This newly developed and comprehensive questionnaire might be used as a tool to understand adults’ 24-h movement behaviors.
... Specifically, questions were aimed to assess: (1) ongoing sleep-wake patterns and sleep quality, (2) cultural ideas and practices sorrounding sleep, (3) characteristics and cultural settings in which adolescents slept, and (4) access to electricity and/or electronic devices. Interviews were based on Grandner et al. 70 and included items from the Pittsburgh Sleep Quality Index (PSQI) 69,70 . Ethnographic observations were made in and outside the schools to explore social roles further, peer relationships, attitudes towards sleep and daily lives of adolescents. ...
... Specifically, questions were aimed to assess: (1) ongoing sleep-wake patterns and sleep quality, (2) cultural ideas and practices sorrounding sleep, (3) characteristics and cultural settings in which adolescents slept, and (4) access to electricity and/or electronic devices. Interviews were based on Grandner et al. 70 and included items from the Pittsburgh Sleep Quality Index (PSQI) 69,70 . Ethnographic observations were made in and outside the schools to explore social roles further, peer relationships, attitudes towards sleep and daily lives of adolescents. ...
Comparing the nature of adolescent sleep across urban and more isolated, rural settings through an ecological, cross-cultural perspective represents one way to inform sleep nuances and broaden our understanding of human development, wellbeing and evolution. Here we tested the Social Jetlag Hypothesis, according to which contemporary, urban lifestyles and technological advances are associated with sleep insufficiency in adolescents. We documented the adolescent sleep duration (11–16 years old; X̅ = 13.7 ± 1.21; n = 145) in two small agricultural, indigenous and one densely urban context in Mexico to investigate whether adolescents in socio-ecologically distinct locations experience sleep deprivation. Sleep data was assembled with actigraphy, sleep diaries and standardized questionnaires. We employed multilevel models to analyze how distinct biological and socio-cultural factors (i.e., pubertal maturation, chronotype, napping, gender, working/schooling, access to screen-based devices, exposure to light, and social sleep practices) shape adolescent sleep duration. Results suggest that the prevalence of adolescent short sleep quotas is similar in rural, more traditional environments compared to highly urbanized societies, and highlight the influence of social activities on the expression of human sleep. This study challenges current assumptions about natural sleep and how adolescents slept before contemporary technological changes occurred.
... Based on Grandner's questionnaire (Grandner et al., 2014), we administer an 83-item questionnaire to assess individuals' attitudes and values toward sleep. After the questionnaire survey, we cluster the participants according to their values toward sleep and conduct messaging and sleep time measurement experiments on the participants selected from each cluster. ...
To improve sleep habits, we will create messages to raise awareness of sleep and examine the effects of messaging on sleep habits. Japanese people, especially children, and workers, sleep less than their counterparts, both men and women, in other countries. As a result, some people "sleep in on weekends," getting a lot of sleep on weekends to secure more sleep. Then, the rhythm becomes disturbed, and it becomes challenging to re-synchronize with the schedule. Therefore, it is necessary to improve sleeping habits to secure a certain amount of sleep. This study will utilize a messaging approach, gain/loss-framing messages. Then, we will investigate which message is more effective for sleep habits according to each participant's values about sleep. This experiment first administered a questionnaire to 130 college students and adults to assess their attitudes and values toward sleep. We conducted an exploratory factor analysis of 83 items of the questionnaire. As a result, factor scores were calculated for each respondent, and a total of six clusters were determined by cluster analysis. For the experiment, a total of 10 participants (college students in their 20s), five each with high factor scores, were selected from the "sleep-oriented" and "sleep-unoriented" types. The selected participants wore wristwatch-type terminals and went to bed after checking the messages sent to them. Participants received each of seven different kinds of gain/loss-framing messages per week. In questionnaires on 14 different messages, participants responded to the acceptability of the messages and changes in their attitudes toward sleep, such as going to bed early, getting up early, and reviewing their daily rhythms. A two-way ANOVA was conducted at the 5% significance level on the change in sleep awareness after confirmation of the sent message and on the evaluation of the acceptability of the sent message. We identified significant differences in sleep awareness in the main effects between clusters and in the interaction between clusters and message type. Sleep-oriented types tended to report more change in sleep awareness with loss-framing messages. In comparison, sleep-unoriented types tended to report more change in sleep awareness with gain-framing messages. Mean sleep time (minutes) during each period was calculated for each participant, and a two-way ANOVA was performed with message content and clusters as factors at a 5% significance level. We didn't find significant differences between clusters, message types, or interactions. However, sleep-oriented types tended to sleep longer than sleep-unoriented types. Furthermore, in both clusters, sleep duration tended to be longer in weeks when they received loss-framing messages than in weeks when they received gain-framing messages. The interventions in this study produced changes in sleep attitudes, but these changes differed across clusters. On the other hand, all clusters showed a trend toward longer sleep duration for loss-framing messages. In other words, changes in sleep attitudes may not be directly reflected in behavior, and we need to investigate this in the future.
... This 7-item measure includes questions on difficulty falling asleep and staying asleep, satisfaction with current sleep, and the extent to which sleep problems interfere with daily functioning.The ISI ranges from 0 to 28, with greater scores indicating worse insomnia severity. To assess sleep attitudes, we administered the sleep and health section of the Sleep Practices and Attitudes Questionnaire (SPAQ;Grandner, Jackson, Gooneratne, & Patel, 2014), in which participants responded on a 5-point scale from "Strongly disagree" to "Strongly agree" whether insufficient sleep led to detriments in daytime sleepiness, work/school performance and other areas. The 14 questions in this section are framed in the context of "If I don't get enough sleep, it can cause me to …", with rated items ...
Informal learning settings such as museums provide unique opportunities for educating a local community about sleep. However, in such settings, information must be capable of immediately inciting interest. We developed a series of sleep "icebreakers" (brief, informal facts) to determine whether they elicited interest in sleep and encouraged behavioural change. There were 859 participants across three cross-sectional samples: (a) members of the local museum; (b) Mechanical Turk workers who responded to a "sleep" study advertisement; and (c) Mechanical Turk workers who responded to a "various topics" study advertisement that did not mention sleep. All three samples demonstrated high interest in sleep topics, though delayed recall of the icebreakers was strongest in participants who expected to learn about the sleep topics. Icebreaker interest ratings were independent of age, gender and race/ethnicity, suggesting that sleep is a topic of universal interest. Importantly, regardless of demographics and sample, the more the icebreakers interested the participants, the more likely participants were to indicate willingness to donate to a sleep exhibit, change their sleep behaviours, and post to social media. Thus, sleep icebreakers can rapidly elicit people's interest, and future outreach efforts should couple icebreakers with opportunities for subsequent personalized learning.
... This 7-item measure includes questions on difficulty falling asleep and staying asleep, satisfaction with current sleep, and the extent to which sleep problems interfere with daily functioning.The ISI ranges from 0 to 28, with greater scores indicating worse insomnia severity. To assess sleep attitudes, we administered the sleep and health section of the Sleep Practices and Attitudes Questionnaire (SPAQ;Grandner, Jackson, Gooneratne, & Patel, 2014), in which participants responded on a 5-point scale from "Strongly disagree" to "Strongly agree" whether insufficient sleep led to detriments in daytime sleepiness, work/school performance and other areas. The 14 questions in this section are framed in the context of "If I don't get enough sleep, it can cause me to …", with rated items ...
Introduction
Insufficient sleep is widespread in the general population, but education and outreach can combat this problem. Informal learning settings, like museums, provide unique opportunities for educating a local community. However, in such settings, engagement with the content relies on the topic’s ability to immediately incite interest. Therefore, we developed and tested a series of sleep “icebreakers” (brief, informal facts) to determine their effectiveness in eliciting interest in sleep science and encouraging behavioral change.
Methods
Five hundred and twenty-one participants were recruited via the local museum (n=103) and Amazon Mechanical Turk (n=418). Participants viewed eight sleep icebreakers (randomly-selected from a bank of 16 icebreakers) and rated whether they knew it already, if they found it interesting, and if it made them want to learn more. Participants also completed questionnaires on demographics, sleep health/attitudes, and future intended sleep behaviors.
Results
Both the museum member and general population samples showed substantial interest in sleep science, regardless of age, gender, race/ethnicity, socioeconomic status, neighborhood disadvantage, prior sleep knowledge, and prior sleep health/attitudes. The most effective icebreakers related to REM sleep behavior disorder, sleep in Alzheimer’s disease, unihemispheric sleep, dreaming, and sleep state misperception. Importantly, the more the icebreakers interested participants, the more likely they were to formulate a specific plan to change their sleep behaviors (OR: 1.55, p = .001), express willingness to post to social media platforms (OR: 1.46, p < .01), and indicate willingness to donate to an exhibit on sleep (OR: 2.51, p < .001), even after controlling for psychosocial, sleep health/attitudes, and demographic measures.
Conclusion
If you could only tell someone one thing about sleep, there are a lot of good options. This interest in sleep science was enjoyed by individuals regardless of psychosocial, educational, and demographic backgrounds, and the icebreakers encouraged half of participants to form an intention to change their sleep behaviors. Coupling icebreakers with opportunities for personalized learning, and providing structure to formulate specific plans to change sleep behaviors, are promising directions for sleep health outreach efforts.
Support (If Any)
National Science Foundation (1920730 and 1943323)
... It is important that future studies use validated domainspecific subjective sleep measures, for example the Self-Assessment of Sleep Surveys (SASS) [105]. Further, future studies should consider the use of comprehensive subjective sleep measures covering nocturnal and daytime sleep, such as the Sleep Practices and Attitudes Questionnaire (SPAQ) [106], or a combination of PSQI and Napping Behaviour Questionnaire, based on the findings from validation studies in general and/or clinical population [107,108]. ...
University students have low levels of physical activity and report disturbances to sleep, which are independently associated with poor health outcomes. Some research suggests that there is a bi-directional relationship between sleep and physical activity in adults. However, the relationship between sleep and physical activity in university students has not yet been evaluated. Therefore, the aim of this systematic review and meta-analysis was to qualitatively synthesise and quantitatively evaluate the evidence for the association between sleep and physical activity in university students. Twenty-nine eligible studies were included, with a total of 141,035 participants (43% men and 57% women). Only four studies used device-based measures of sleep and/or physical activity, with the remainder including self-report measures. Qualitative synthesis found that the majority of studies did not find any association between sleep and physical activity in university students. However, random-effects meta-analysis showed that moderate-to-high intensity physical activity was associated with lower PSQI scores (e.g., better sleep quality) [r = -0.18, 95% CI (-0.37, 0.03), p = 0.100]. Further, a weak negative association between moderate-to-vigorous physical activity level and sleep duration was also found [r = -0.02, 95% CI (-0.16, 0.12), p = 0.760]. As the findings of this review are predominantly derived from cross-sectional investigations, with limited use of device-based measurement tools, further research is needed to investigate the relationship between sleep and physical activity in university students. Future studies should employ longitudinal designs, with self-report and device-based measures, and consider the intensity and time of physical activity as well as records of napping behaviour.
... The Sleep and Practices and Attitudes Questionnaire (SPAQ) (13) was also administered. Specifically, items from the social norms subscale identifying the level of agreement participants had about insufficient sleep leading to detrimental health and behavior were administered. ...
... Participants self-rated the degree to which they agreed with statements indicating that "not getting enough sleep" could cause any of the following: sleepiness, drowsy driving, weight gain, heart disease, high cholesterol, hypertension, moodiness, lower energy, decreased sex drive, missed days at work, decreased performance, memory concentration problems, diabetes, and/or tiredness on a 1-5 scale with lower scores disagreeing and higher scores agreeing with the statement. The SPAQ has previously demonstrated validity in the context of other health behaviors and sleep behaviors (13). ...
Objectives:
The objective of the present study is to identify which underlying beliefs about the impact of sleep on health may motivate change in sleep behavior.
Design:
A cross-sectional study conducted between 2012 and 2014.
Setting:
Data were from the Sleep and Healthy Activity, Diet, Environment, and Socialization (SHADES) study conducted in Philadelphia, PA, and its surrounding regions.
Participants:
Participants consisted of N = 1007 community-dwelling adults age 22-60.
Measurements:
Respondents indicated behaviors they could improve on to facilitate sleep and their corresponding readiness to change. They were also asked items from the Sleep Practices and Attitudes Questionnaire (SPAQ) regarding the degree to which they agree with whether "not getting enough sleep" can impact a variety of health factors.
Results:
In adjusted analyses, stage of change was associated with degree of agreement that insufficient sleep can cause sleepiness (odds ratio [OR] = 1.17, P = .035), weight gain (OR = 1.20, P < .0005), heart disease (OR = 1.21, P = .001), cholesterol (OR = 1.13, P = .047), hypertension (OR = 1.16, P = .014), moodiness (OR = 1.42, P < .0005), decreased energy (OR = 1.30, P = .002), absenteeism (OR = 1.13, P = .007), decreased performance (OR = 1.20, P = .003), concentration/memory problems (OR = 1.23, P = .004), diabetes (OR = 1.14, P = .042), and feeling tired (OR = 1.39, P < .0005). When sleep duration was added to the model, significant associations remained for all except cholesterol. When accounting for insomnia, significant associations were maintained for only weight, moodiness, performance, diabetes, and tiredness.
Conclusions:
Degree of belief that insufficient sleep can cause outcomes such as moodiness, occupational problems, and health problems may impact whether an individual is contemplating/attempting to change their sleep-related behaviors. Targeting these key messages about the associations between sleep health with moodiness and weight gain in informational material may enhance education/outreach efforts aimed at adults.
... The longest of these instruments is the Sleep Practices and Attitudes Questionnaire (SPAQ), which contains 151 questions divided into 16 different domains. 75 74,28 The majority of the instruments use Likert-type scales as response options to generate scores. The time needed to complete an instrument was not reported in the majority of the studies reviewed. ...
... 46 With the exception of SHAPS, all of these instruments had low internal consistency (α < 0.7) and only the SHI and the SHAPS were evaluated for their reproducibility. 75,[61][62][63] Discussion This study identified 31 sleep instruments and described in detail their psychometric properties as described in 107 validation and cultural adaptation studies. In the validation studies included in this review, only the ISI, FOSQ and MISS were evaluated for all four psychometric properties such as responsiveness, interpretability, reliability and validity. ...
Introduction: Self-reported sleep instruments remain the most practical methods for the assessment of insomnia in clinical practice. This systematic review aims to identify, describe and summarize the psychometric properties of questionnaires available for the assessment of insomnia in the adult population. In addition, the review also aimed to identify sleep instruments available in the Arabic language. Methods: A systematic literature search was conducted using the following electronic databases: PubMed, EMBASE, ProQuest Central, SCOPUS, and Google Scholar. The quality assessment of the instruments was conducted using two established international criteria. Results: One hundred and seven articles were selected for inclusion, from which 31 instruments were identified and categorized based on the constructs they assess as: (1) screening for insomnia (n=14); (2) measuring the consequences of insomnia (n=8); (3) assessing the cognitive aspects of insomnia (n= 5); and (4) assessing sleep hygiene (n= 4). The review of the psychometric properties showed that the Insomnia Severity Index and the Functional Outcomes of Sleep Questionnaire were the most extensively evaluated instrument. Criterion validity and reliability measures were the most commonly reported properties. Only four of the identified instruments were available in Arabic. Discussion: Overall, the findings of this study indicate ample availability of sleep instruments. However, psychometric testing for several of the available sleep instruments remains incomplete, particularly responsiveness and interpretability. Our findings suggest that future studies should focus on reporting more psychometric measures to ensure the trustworthiness of these instruments.
