Sleep Resilience is a Novel Dimension of Sleep Health that is Associated with Sleep-Related Impairment: A Confirmatory Factor Analysis, Internal Consistency, and Predictive Validity Assessment of the Sleep Resilience Questionnaire in a US Adult Sample

Study Objectives Sleep resilience is the ability to maintain effective emotional, cognitive, and physical functioning despite disruptions to sleep/circadian rhythms. While conceptually related to sleep health, no validated measure currently exists. This cross-sectional survey study aimed to validate a novel self-report measure of sleep resilience, the Sleep Resilience Questionnaire (SRQ), and examine its associations with demographic features, sleep disturbance, and sleep-related impairment. Methods Our convenience sample included 455 adults (Mean age=45±17) in the United States who completed a demographic survey, PROMIS Sleep Disturbance (PROMIS-SD) and Sleep-Related Impairment (PROMIS-SRI), and retrospective and prospective SRQ forms (English version 1). Exploratory and confirmatory factor analyses (EFA and CFA) evaluated the SRQ’s factor structure and internal consistency, and structural equation modeling examined associations with demographics, PROMIS-SD, and PROMIS-SRI. Results EFA and CFA supported a highly correlated two-factor retrospective SRQ structure and a unidimensional prospective SRQ structure with excellent fit and internal consistency (CFI & TLI>.99, RMSEA<.07, ω>.92). Lower sleep resilience was associated with greater sleep-related impairment (p<0.05) but not sleep disturbance. Younger age, men, higher education, greater number of dependents, and higher income were associated with lower sleep resilience in specific retrospective or prospective domains (p<0.05). Conclusions Findings suggest sleep resilience is a meaningful dimension of sleep health, associated with demographic and sleep-related impairments, and the SRQ forms appear to validly measure it. Despite limitations of the cross-sectional design, the SRQ may be useful for future research aimed at identifying potential intervention targets to improve sleep-related impairments.