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Abstract Introduction The construct of multidimensional sleep health is increasingly used to examine the impact of sleep on health. However, psychometric validation of self-report sleep health measures is limited. We developed the Ru-SATED 4.0 Multidimensional Sleep Health Scale to evaluate 6 sleep health dimensions (Regularity, Satisfaction, Alertness, Timing, Efficiency, Duration), including several alternative questions within dimensions. We assessed the comprehensibility and psychometric properties of Ru-SATED, yielding a finalized, valid measure of multidimensional sleep health among adults. Methods We conducted cognitive interviews (n=23) and lexile analysis. We then administered Ru-SATED and other self-reported sleep health measures via YouGov.com (n=2,000; stratified by age, sex assigned at birth, and racial/ethnic identity, representative of the U.S. population). We used factor analysis to identify the best combination of 6 items (1 for each dimension), then calibrated these 6 items using item response theory (IRT) Graded Response Model and explored the associations with legacy measures to establish Ru-SATED’s construct validity. Results Cognitive interviews evaluated 8 items across dimensions of sleep health (including 2 alternate items for alertness and 2 for duration) and confirmed the comprehensibility of the items/response options. The final set of 6 items had excellent model fit (RMSEA=0.08, SRMR=0.03, CFI=0.97, TLI=0.95) from factor analysis. In IRT calibration results, the location parameters ranged from -3.41 to 2.41 and the discrimination parameter ranged from 0.58 to 2.54, indicating the unique contributions of each item to the overall theta scores. Ru-SATED theta scores derived from IRT calibration had a mean of -0.01±0.83. Ru-SATED scores demonstrated acceptable convergent validity (|rs|=0.30 to 0.54) with other sleep scales (PSQI, PROMIS Sleep Disturbance, PROMIS Sleep-Related Impairment, Epworth Sleepiness Scale), and test-retest reliability (r=0.66) one month later. Ru-SATED scores significantly differed among those with (n=441, 22%) and without sleep diagnoses (n=1,558, 78%; Cohen’s d=0.95, 95% CI=0.84 to 1.06), indicating acceptable known-groups validity. Conclusion These findings support the psychometric validity of Ru-SATED 4.0 with an advantage of IRT-derived theta scores. Ru-SATED is a brief, easy-to-complete self-report measure of 6 dimensions of sleep health that can be easily scored and interpreted in clinical and research settings. Support (if any) Supported by an investigator-initiated, industry-sponsored research grant from Sleep Number Corporation (PI: Conlon).
Kolko et al. (Sat,) studied this question.