Development and psychometric evaluation of the Children's Sleep-Wake Scale

Objective: To describe the development and psychometric evaluation of the Children's Sleep-Wake Scale (CSWS), a caregiver-report measure of behavioral sleep quality in 2- to 8-year-old children. Design: Five studies using independent samples were completed to generate, refine, and finalize the item pool, as well as to confirm the factor structure and to assess the reliability and validity of the CSWS. Setting: Field. Measures: CSWS, sleep diary, and actigraphy. Results: Confirmatory factor analysis supported the theoretically proposed 5-factor structure (Going to Bed, Falling Asleep, Maintaining Sleep, Reinitiating Sleep, Returning to Wakefulness). The final questionnaire included 25 items, with items rated on a 6-point scale (Never, Once in Awhile, Sometimes, Quite Often, Frequently-if not Always, and Always); higher scores indicate better sleep quality. We found excellent internal consistency reliability for subscales and the total scale (alpha = .81-alpha = .91), strong test-retest reliability (r = 0.67-r - 0.84: all P values < .001), moderate-to-strong correlations between CSWS subscale scores and corresponding parental diary ratings (r = 0.58-r - 0.72; all P values < .001), and weak-to-moderate correlations between CSWS subscales and actigraphic measures (r = 0.38-r = 0.61: all P values < .001). CSWS subscale scores discriminated 4 extreme groups, thus supporting the construct validity of the scale. Conclusion: These collective findings indicate that the CSWS has adequate reliability and validity for research instruments and suggest that it is a convenient tool for assessing behavioral sleep quality in preschool-aged and school-aged children. (C) 2016 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.