Children Sleep Habits Questionnaire (CSHQ): Psychometric validation in Indian School Children

Abstract

Objective: Validity studies on scales of sleep-related habits and problems for pediatric population are few, and cross-validation with Indian population has not been reported. This study was designed to assess the psychometric properties of a parent-rated measure of sleep habits i.e. Children Sleep Habits Questionnaire (CSHQ) in Indian school going children Methods: Cross-sectional data were examined for 371 primary school going children from Pre-Nursery to 3 rd class. Reliability testing and psychometric validation using principal component analysis was carried out. Results: Our study cohort achieved a mean score of 49.35 (S.D. 7.6).Though CSHQ scale items had a good overall internal consistency (Cronbach's alpha 0.77), its subscales had poor reliability. Data analysis conducted by excluding the youngest school children (class Pre-Nursery) significantly improved the internal consistency alphas of the various subscales, indicating better reliability of CSHQ subscales in the older age groups in our setting. On comparison with Visual Analogue Scale (VAS) for global sleep rating, CSHQ showed good concurrent validity. Construct validity of CSHQ was evaluated by principal factor analysis which extracted 8 underlying latent factors (with eigen value >1) matching original CSHQ domains. However, these latent factors explained only 48.2% of total variance in the data. Principal Component Analysis (PCA) of CSHQ in our study cohort also favors shortening of original 33-item scale to a shorter 23-item scale with better acceptability for parents. Conclusions: The CSHQ is a reliable and internally consistent scale, and it is useful optional tool for assessing sleep problems in Indian school children.