Examining the reliability and validity of the arabic version of the Glasgow Sleep Effort Scale (GSES)

Abdulmajeed Abdullah Alghamdi; Salma Yasser Abu-Saleh; Yara Abdullah Almohaya; Hind Khayran Alamri; Hadeel Ghazzawi; Khaled Trabelsi; Zahra Saif; Ahmed S BaHammam; Seithikurippu R Pandi-Perumal; Haitham Jahrami

doi:10.1007/s11325-024-03053-w

Examining the reliability and validity of the arabic version of the Glasgow Sleep Effort Scale (GSES)

Sleep Breath. 2024 May 13. doi: 10.1007/s11325-024-03053-w. Online ahead of print.

Authors

Affiliations

¹ Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain. haitham.jahrami@outlook.com.
² Department Nutrition and Food Technology, Jordan University of Science and Technology, Irbid, Jordan.
³ Department of Medicine, King Khalid University, 62529, Abha, Saudi Arabia.
⁴ Nutrition and Food Science Department, Agriculture School, The University of Jordan, P. O. Box 11942, Amman, Jordan.
⁵ High Institute of Sport and Physical Education of Sfax, Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, University of Sfax, 3000, Sfax, Tunisia.
⁶ Government Hospitals, Manama, Bahrain.
⁷ Department of Medicine, University Sleep Disorders Center and Pulmonary Service, King Saud University, Riyadh, KSA, Saudi Arabia.
⁸ The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia.
⁹ King Saud University Medical City, Riyadh, 11472, Saudi Arabia.
¹⁰ Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India.
¹¹ Division of Research and Development, Lovely Professional University, Phagwara, Punjab, 144411, India.
¹² Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.

PMID: 38735910
DOI: 10.1007/s11325-024-03053-w

Abstract

Background: Sleep effort refers to the cognitive and behavioral exertion involved in initiating and maintaining sleep. High sleep effort is increasingly recognized as perpetuating insomnia and poor sleep quality. Validated sleep effort scales enable the quantification of this construct in clinical and research settings. However, no Arabic version has been available. This study translated and validated the Glasgow Sleep Effort Scale (GSES) into Arabic to assess sleep effort in Arabic-speaking populations.

Method: The GSES was translated into Arabic using the forward-backward translation approach. This involved an initial Arabic translation from the source followed by a back translation into English to ensure accuracy. A total of 369 participants were recruited to assess the psychometric properties of the Arabic version of the GSES, specifically its reliability and validity. The reliability analysis included Cronbach's α, McDonald's ω, and test-retest reliability. Validity was examined using confirmatory factor analysis (CFA) to evaluate the unidimensionality of the scale and assess model fit. Convergent validity was also assessed through correlation analysis with the Athens Insomnia Scale (AIS) and the Generalized Anxiety Disorder-7 Scale (GAD-7).

Results: The Cronbach's α reliability coefficient and McDonald's ω for the scale were found to be 0.87 (95% CI: 0.85-0.89). The test-retest reliability was 0.95 (95% CI: 0.93 - 0.97) after two weeks. The one-factor model showed an acceptable fit, with a CFI of 0.96, a TLI of 0.94, and an SRMR of 0.04. Invariance analysis revealed that male and female participants conceptualized and responded to the GSES items similarly, without differences in factor loadings or scale characteristics between the sexes. The Arabic version of the GSES has good convergent validity, as shown by the significant correlation between the AIS and the GSES (r = 0.72, p < 0.001). Similarly, the GAD-7 score was significantly correlated with the GSES score (r = 0.77, p < 0.001).

Conclusion: This is the first study in which the GSES was validated in Arabic. This allows the scale to reliably gauge sleep effort among Arabic speakers, providing new clinical and research opportunities to understand how maladaptive sleep effort may contribute to insomnia and suboptimal sleep in this demographic population.

Keywords: Insomnia; Psychometrics; Sleep Effort; Validity.