Rasch analysis of the pre-sleep arousal scale in patients with acute insomnia disorder

Aike Wu; Yiqi Pu; Yuhan Zhao; Xue Luo; Leqin Fang; Bin Zhang

doi:10.1016/j.sleep.2024.05.022

Rasch analysis of the pre-sleep arousal scale in patients with acute insomnia disorder

Sleep Med. 2024 May 9:119:329-334. doi: 10.1016/j.sleep.2024.05.022. Online ahead of print.

Authors

Aike Wu¹, Yiqi Pu¹, Yuhan Zhao¹, Xue Luo¹, Leqin Fang¹, Bin Zhang²

Affiliations

¹ Department of Psychiatry, Sleep Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China; Key Laboratory of Mental Health of the Ministry of Education, Guangzhou, China.
² Department of Psychiatry, Sleep Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China; Key Laboratory of Mental Health of the Ministry of Education, Guangzhou, China. Electronic address: zhang73bin@hotmail.com.

PMID: 38749257
DOI: 10.1016/j.sleep.2024.05.022

Abstract

Background: Hyperarousal plays an essential role in the initiation and maintenance of insomnia, highlighting the need for a tool that measure the hyperarousal state during the early course of insomnia. Pre-sleep Arousal Scale (PSAS) is a self-report questionnaire to evaluate subjective pre-sleep arousal of insomnia. The aim of this study was to examine the psychometric properties of the PSAS among patients with acute insomnia disorder (AID) using Rasch analysis.

Methods: Totally 170 patients with AID from 31 public hospitals in China were recruited and completed the test. The psychometric properties of the PSAS were tested using Rasch analysis by Winsteps v5.4.1.0, including unidimensionality, local item independence, item fit, category diagnostics, reliability, item-person maps and differential item functioning (DIF) by age and gender.

Results: According to Rasch analysis, somatic and cognitive subscales were unidimensional and basically demonstrated good item-fit statistics. 4-point Likert scale may be more appropriate for PSAS. All items have a good reliability and separation. No gender and age bias were detected for the scale. However, the person arousal level is not well matched to item difficulty.

Conclusion: The present study further reveals appropriate psychometric properties of the PSAS in patients with AID and provides suggestions for refinements and supplements to the PSAS.

Keywords: Acute insomnia disorder; Pre-sleep arousal scale; Psychometrics; Rasch analysis.