Adolescent Sleep Wake Scale

Instrument Name: Adolescent Sleep Wake Scale

Abbreviation: ASWS

Points for Consideration:

None

Description of Tool:

The Adolescent Sleep-Wake Scale (ASWS) is a 28-item PRO developed to measure sleep quality in adolescents (12-18 years).The ASWS was revised based on the results of an exploratory factor analysis, resulting in a 10-item PRO. Respondents are asked to indicate how often sleep behaviors have occured during the past month using a 6-level scale ranging from 1= “Always”, 2=“Frequently-if not always”, 3=“Quite often”, 4=“Sometimes”, 5=“Once in a while” to 6=“Never”. A higher score indicates better sleep quality.

Other Related Tools (if applicable):

The Children's Sleep-Wake Scale (CSWS) consists of 25 items and is an ObRO measure for use in children 2-8 years old.

Minimum Qualification Required by COA Administrator: No degree requirement

Comment:

The Adolescent Sleep-Wake Scale is based on and includes items similar in content to those on the Children’s Sleep-Wake Scale.

Year: Date developed: 2005 Date revised: 2015

Objective of Development:

To measure sleep quality in adolescents aged 12-18 years

Population of Development: Age range (therapeutic indication):

Age range: 12-18 years (No therapeutic indication)

Pediatric Population(s) in which COA has been used:

Adolescents aged 12-18 years with non-disease related chronic pain, sickle cell disease, traumatic brain injury or depressive disorders

COA type: PRO

Number of Items Original ASWS: 28 Revised ASWS: 10

Mode of Administration: Self-administered

Data Collection Mode: Paper and pen administration

Time for Completion: No information

Response Scales: 6-point Likert scale ranging from 1="Always", 2="Frequently-if not always", 3="Quite often", 4="Sometimes", 5="Once in a while", 6="Never"

Summary of Scoring:

Available scores: Mean subscale scores for each dimension and a full-scale sleep-quality score (ASWS total; mean of 5 subscales) can be obtained. Reverse scoring is needed for some items. Scores range from 1 to 6.

Weighting: No

Score interpretation: Higher scores=Better sleep quality.

Evidence of Literature Review: None identified

Evidence of Instrument Review: None identified

Evidence of Clinical or Expert Input: None identified

Evidence of concept elicitation in target patient population: None identified

Evidence of a Saturation Grid: None identified

Evidence for Selection of Data Collection Method: None identified

Recall/Observation Period: Past month

Evidence for Selection of Reponse Options: None identified

Evidence of cognitive interviewing of draft instrument in target patient population: None identified

Evidence of Preliminary Scoring of Items and Domains: None identified

Evidence related to respondent and administrator burden: None identified

Evidence of a Conceptual Framework: None identified

Evidence of an item-tracking matrix: None identified

Evidence related to item selection: Yes

Evidence of re-testing the final version: None identified

Internal consistency (Cronbach's alpha): Yes

Evidence of internal consistency: LeBourgeois MK (2005) - Method: Cronbach's alpha - Results: 0.80-0.86 - Population/Disease: Adolescents aged 12-17 years old; n=776 Italian; n=572 American Essner B (2015) - Method: Cronbach's alpha - Results: 0.78-0.81 - Population/Disease: Adolescents aged 12-18 years old with and without pediatric health conditions; n=491

Test-retest Reliability (ICC):

None identified

Inter-rater/ inter-interviewer reliability (kappa):

None identified

Evidence of test-retest or inter-rater reliability: None identified

Concurrent validity (convergent, divergent):

None identified

Known-group validity:

Yes

Evidence of Translatability Assessment: None identified

Evidence related to missing data: None identified

Evidence for Selection of Recall Period: None identified

Evidence of Administration Instructions and Training Provided: None identified

Evidence of concurrent validity: None identified

Evidence of known-groups validity: Essner B (2015) - Measure/Groups of patients: Adolescents with chronic pain conditions vs healthy adolescents - Method: Independent samples t-tests - A priori hypotheses: It was expected that youth with chronic pain would report significantly lower subjective sleep quality ratings on all newly derived factors as compared to youth in the healthy adolescent comparison group. - Were hypotheses confirmed: Partially confirmed - Results: Adolescents with chronic pain reported significantly poorer overall sleep quality [(M = 3.61, M = 4.13), t(361) =−5.36, p< .01], and more problems with falling asleep and reinitiating sleep [(M = 3.88, M = 4.74), t(275.05) = −6.92, p < .01] and returning to wakefulness [(M = 2.44, M = 3.28), t(191.14) =−6.37, p < .01]. However, contrary to hypotheses, adolescents with chronic pain (M = 3.93) reported fewer problems with going to bed than healthy adolescents [(M = 3.66), (t(361) =2.10, p = .04)]. - Population/disease: Adolescents aged 12-18 years old, n=249 with chronic pain conditions and n=114 healthy adolescents

Evidence of ability to detect change over time: None identified

Ability to detect change (Responsiveness):

None identified

Responder Thresholds:

None identified

Evidence of responder thresholds: None identified

LeBourgeois MK, Giannotti F, Cortesi F, Wolfson AR, Harsh J. The relationship between reported sleep quality and sleep hygiene in Italian and American adolescents. Pediatrics. 2005 Jan;115(1 Suppl):257-65. doi: 10.1542/peds.2004-0815H. PMID: 15866860; PMCID: PMC3928632. Full Text Article: https://pubmed.ncbi.nlm.nih.gov/15866860/

Essner B, Noel M, Myrvik M, Palermo T. Examination of the Factor Structure of the Adolescent Sleep-Wake Scale (ASWS). Behav Sleep Med. 2015;13(4):296-307. Full Text Article: https://pubmed.ncbi.nlm.nih.gov/24742264/

LeBourgeois MK, Harsh JR. Development and psychometric evaluation of the Children's Sleep-Wake Scale. Sleep Health. 2016 Sep;2(3):198-204 Full Text Article: https://pubmed.ncbi.nlm.nih.gov/28066802/

None identified

None identified

Yes

Original language: English for the USA

Translations and adaptations found in Google Scholar:
Chinese
German
Turkish

Chinese:
Yang, YT.C., Chang, HY., Hsu, CY. et al. Chinese translation and validation of the adolescent sleep wake scale. Sleep Science Practice 6, 9 (2022). https://doi.org/10.1186/s41606-022-00078-6

German:
Sommer, A., Grochowska, K., Grothus, S., Claus, B. B., Stahlschmidt, L., & Wager, J. (2021). The German version of the revised Adolescent Sleep-Wake Scale (rASWS)–A validation study in pediatric pain patients and school children. Sleep Medicine, 81, 194-201.

Turkish:
Bozkurt, A., Uygur, O. F., & Demirdogen, E. Y. (2023). Turkish adaptation and validation of the adolescent sleep-wake scale. Sleep Medicine Research, 14(4), 234-239.

Original ASWS author: Monique K. LeBourgeois
Contact:
Department of Psychiatry and Human Behavior, Sleep and Chronobiology Research Laboratory E. P. Bradley Hospital/Brown Medical School
Providence, Rhode Island
E-mail address: monique_lebourgeois@brown.edu

Revised ASWS author: Bonnie Essner
Contact:
Bonnie Essner, Seattle Children’s Research Institute, M/S CW8-6, PO Box 5371, Seattle, WA 98121
E-mail address: bonnie.essner@seattlechildrens.org.

None identified

None identified

https://pmc.ncbi.nlm.nih.gov/articles/PMC3928632/pdf/nihms-547463.pdf

https://pmc.ncbi.nlm.nih.gov/articles/PMC4201644/pdf/nihms-595892.pdf