Cross-cultural adaptation and measurement properties of the Athlete Sleep Screening Questionnaire (ASSQ) for Chinese elite athletes

The objectives of this study were to translate the Athlete Sleep Screening Questionnaire (ASSQ) into a simplified Chinese version (ASSQ-CHN) and test its properties. Using a methodological study, a total of 160 elite athletes participated, and 133 athletes completed the experiment. Statistical results show the following: (1) a total of 4 factors were obtained by using exploratory factor analysis conducted on the ASSQ-CHN (sleep difficulty score, travel impact, sleep behaviour and habit, and electronic device use before bedtime). The sleep difficulty score (SDS) part consisted of items 1, 3, 4, 5, and 6. (2) the SDS showed adequate internal consistency (Cronbach's alpha = 0.74), as well as test-retest reliability (ICC2,1 = 0.79, 95% CI 0.72-0.85), standard error of measurement = 1.37 points and minimum detectable change = 3.24 points, with no floor or ceiling effects. This suggests that the real change in ASSQ-CHN (SDS) score should be over 3.24 points and the measurement tool can distinguish between subjects with the highest or lowest scores. (3) the SDS was strongly correlated with the PSQI (rs = 0.74, P < 0.01). The correlation between SDS and SF-36 was only moderately correlated with general health (rs = -0.33, P < 0.01), and there was low or no significant correlation with other items. (4) the ASSQ-CHN (SDS) mean score of the sleep disorder group was significantly higher than that of the healthy groups (P < 0.01). The ASSQ-CHN is equivalent to the original version in terms of language and measurement properties. It can be used as an effective and reliable sleep screening tool to evaluate athletes' sleep status.