A reliability generalization meta-analysis of the internal consistency and test-retest reliability of the pre-sleep arousal scale (PSAS)

PURPOSE: The Pre-Sleep Arousal Scale (PSAS) is a self-report tool for assessing cognitive and somatic arousal before sleep. While the English version is well-validated, research on translations is limited. This meta-analysis examines PSAS translations' internal consistency and reliability. METHODS: We conducted a comprehensive literature search using multiple databases to identify studies that reported the reliability of the PSAS. We used a random-effects meta-analysis model to pool estimates of internal consistency and test-retest reliability and explored potential moderators using subgroup analyses and meta-regression. To ensure transparency, we registered the study protocol, utilized the PRISMA checklist, and made all study code and data available on the Open Science Framework. RESULTS: Systematic review yielded a total 27 studies (reported in 25 publications) with 9354 participants employing eleven language versions of the PSAS. Meta-analysis showed good internal consistency for the total PSAS (0.88, 95%CI 0.86-0.90) as well as the cognitive (α = 0.89, 95%CI 0.88-0.90) and somatic (α = 0.80, 95%CI 0.77-0.83) subscales. The PSAS also displayed excellent test-retest reliability for the total scale (r = 0.87, 95%CI 0.84-0.90), cognitive subscale (α = 0.80, 95%CI 0.77-0.84) and somatic subscale (α = 0.70, 95%CI 0.67-0.74). Participant characteristics (age and sex) did not significantly affect results. CONCLUSIONS: This meta-analysis shows that the PSAS is a reliable tool for detecting pre-sleep arousal based on its high internal consistency and test-retest reliability. The PSAS is useful across languages but quality translation appears to be crucial. Recommendations are offered for future adaptations and clinical use.