COSMIN database

Assessing quality of sleep in patients with rheumatoid arthritis

Wells, G. A., Li, T., Kirwan, J. R., Peterson, J., Aletaha, D., Boers, M., Bresnihan, B., Dougados, M., Idzerda, L., Nicklin, J., Suarez-Almazor, M., Welch, V., and Tugwell, P. S.
We sought to identify instruments assessing sleep quality that measure the domains of sleep applicable to rheumatoid arthritis (RA) patients and are feasible to use and have appropriate reliability, validity, and responsiveness properties. A systematic review of sleep instruments was conducted. In particular, domains related to sleep that were assessed in the instruments were identified and evaluated. Feasibility characteristics and psychometric properties of instruments were reviewed. At OMERACT 9, the preparatory work was described at the plenary session of the Patient Perspective Workshop, and the tasks of 3 breakout groups in ranking and scoring the domains and sleep instruments were outlined. Each breakout group considered different aspects of sleep: sleep domains, feasibility, and psychometric properties. The rapporteur for each breakout group reported back to the plenary on the domains and sleep instruments that achieved the highest rank/score. The systematic review identified 45 sleep instruments of interest. Based on these instruments, 14 domains of sleep were identified. The top ranked domains were: Sleep Adequacy (1), Sleep Maintenance (2), Sleep Initiation (3) and Daytime Functioning (4). The top ranked instruments on feasibility were: Athens Insomnia Scale (2.3), Medical Outcome Study (MOS) Sleep (4.0), Insomnia Severity Index (4.9), and Women's Health Insomnia Rating Scale (5.5). The highest scored instruments on psychometric properties were: Athens Insomnia Scale (13.6), Sleep Assessment Questionnaire (13), Pittsburgh Sleep Diary (12), and MOS Sleep (11). Sleep domains have been reviewed, and several sleep instruments have been identified. These instruments should be considered for use in planned clinical trials of RA patients to assess their applicability.
J Rheumatol
0315-162X (Print)
Publication year:
Symptom status:
Cognitive/mental state
Physical state
Functional status:
Cognitive/mental functioning
Adults (18-65)
Seniors (65+)
Diseases of and symptoms related to the musculoskeletal system and connective tissue
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
3 - Diaries
AIS - Athens Insomnia Scale
ATSI - Accumulated Time with Sleepiness Scale
BNSQ - Basic Nordic Sleep Questionnaire
BSIQ - Brock Sleep and Insomnia Questionnaire
DBAS - Dysfunctional Beliefs and Attitudes about Sleep Scale
DSD - Daily Sleep Diary
ESDQ - Espie Sleep Disturbance Questionnaire
ESS - Epworth Sleepiness Scale
FOSQ - Functional Outcomes of Sleep Questionnaire
GCTI - Glasgow Content of Thoughts Inventory
HS - Hyperarousal Scale
ISI - Insomnia Severity Index
JSEQ - Jenkins Sleep Evaluation Questionnaire
KSD - Karolinska Sleepiness Diary
KSS - Karolinska Sleepiness Scale
LSEQ - Leeds Sleep Evaluation Questionnaire
MOS-Sleep - Medical Outcomes Study Sleep Scale
PSAS - Pre-Sleep Arousal Scale
PSD - Pittsburgh Sleep Diary
PSI - Post Sleep Inventory
PSQI - Pittsburgh Sleep Quality Index
PSS - Pictorial Sleepiness Scale
QOLI - Quality of Life of Insomniacs
RDSS - Rotterdam Daytime Sleepiness Scale
RSS - Resistance to Sleepiness Scale
SAMI - Sleep Associated Monitoring Index
SAQ - Sleep Assessment Questionnaire
SBSR - Sleep Behaviour Self Rating Scale
SBS - Sleep Beliefs Scale
SDQ Dutch - Sleep Disorders Questionnaire-Dutch
SDQ - Sleep Disorders Questionnaire
SDQ - Sleep Dissatisfaction Questionnaire
SEI - Sleep Effects Index
SEQ - Sleep Evaluation Questionnaire
SHI - Sleep Hygiene Index
SMHSQ - St. Mary’s Hospital Sleep Questionnaire
SQ - Sleep Questionnaire
SQS - Sleep Quality Scale
SSES - Sleep Self Efficacy Scale
SSS - Stanford Sleepiness Scale
STQ - Sleep Timing Questionnaire
SWAI - Sleep-Wake Activity Inventory
VSH Sleep Scale - Verran and Snyder-Halpern Sleep Scale
WHIIRS - Women’s Health Initiative Insomnia Rating Scale