Isaksson Sebastian, Henriksson Vera, Salim Osame, Bäccman Charlotte, Norell Annika
School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Sweden; Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Sweden.
Sleep Med. 2025 Sep;133:106595. doi: 10.1016/j.sleep.2025.106595. Epub 2025 May 19.
Previous reports have highlighted the abundance of cognitive constructs in insomnia research as a growing issue. Several questionnaires that measure sleep-related cognitions have been developed and there are indications of conceptual overlap between different cognitive constructs and the questions used to operationalize them.
This study examines the convergent validity of three established questionnaires measuring cognitive processes in insomnia: the Anxiety and Preoccupation about Sleep Questionnaire (APSQ), the Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS-10), and the Pre-Sleep Arousal Scale (PSAS-C). Another objective was to explore how a briefer scale can be structured as well as to investigate this scale's ability to predict incident and persistent insomnia compared to the established scales.
2333 participants from the general population completed surveys on insomnia symptoms and cognitive processes at baseline and 18 months later. Confirmatory factor analysis was used to investigate the scales' conceptual overlap as well as distinctive factors. An exploratory factor analysis was conducted to investigate the underlying factor structure of the items from the APSQ, the DBAS-10 and the PSAS-C. This analysis formed the basis of the creation of a new short scale: Sleep Worry 7. Binary logistic regressions were used to assess all scales' abilities to predict incident and persistent insomnia.
The overlap between the three scales was neither large enough to conclude that they are measuring the same construct, nor could it be confirmed that they measure three distinct questionnaire-specific cognitive processes within insomnia. The brief scale created within this study was able to predict persistent insomnia at similar levels to the three established scales combined, indicating that it captures important cognitions involved in the maintenance of insomnia. Measuring sleep-related cognitions with fewer items might be beneficial in both clinical contexts and research.
先前的报告强调，失眠研究中认知结构丰富是一个日益严重的问题。已经开发了几种测量与睡眠相关认知的问卷，并且有迹象表明不同的认知结构与用于将它们操作化的问题之间存在概念重叠。
本研究考察了三种用于测量失眠认知过程的既定问卷的收敛效度：睡眠焦虑与关注问卷（APSQ）、睡眠功能失调信念与态度量表（DBAS - 10）和睡前唤醒量表（PSAS - C）。另一个目的是探索如何构建一个更简短的量表，并研究该量表与既定量表相比预测新发和持续性失眠的能力。
2333名来自普通人群的参与者在基线时和18个月后完成了关于失眠症状和认知过程的调查。验证性因素分析用于研究量表的概念重叠以及独特因素。进行探索性因素分析以研究APSQ、DBAS - 10和PSAS - C项目的潜在因素结构。该分析构成了创建新的简短量表“睡眠担忧7”的基础。二元逻辑回归用于评估所有量表预测新发和持续性失眠的能力。
这三个量表之间的重叠程度既不足以得出它们测量相同结构的结论，也无法证实它们测量失眠内三个不同的问卷特定认知过程。本研究中创建的简短量表能够以与三个既定量表组合相似的水平预测持续性失眠，表明它捕捉到了与失眠维持相关的重要认知。在较少项目的情况下测量与睡眠相关的认知在临床环境和研究中可能都是有益的。
