Mizan sleep quality and Sleep Hygiene Index MiSQuaSHI: a psychometric investigation

OBJECTIVE: Poor sleep quality and unhealthy sleep hygiene practices are often correlated and co-existing. However, there is no single validated tool to assess both sleep quality and sleep hygiene practices. Therefore, this study presents psychometric validation findings of an instrument developed to assess both sleep quality and sleep hygiene practices. MATERIAL AND METHODS: A sample (n=395, age = 21.9±4.2 years, body mass index = 20.86±3.22kg/m2, male = 328, female = 67) from Mizan-Tepi University, Ethiopia, completed this cross-sectional study involving the perceived stress scale 10 (PSS -10), the generalized anxiety disorder-7 scale (GAD-7), the Mizan sleep quality and sleep hygiene index (MiSQuaSHI), the Leeds sleep evaluation questionnaire-Mizan (LSEQ-M) and a socio-demographics tool. RESULTS: No significant skewness, kurtosis, and ceiling/floor effect were seen in the MiSQuaSHI total score. The discriminative validity was favored by significant differences (8 item scores, MiSQuaSHI total and factor scores) in students with moderate-severe GAD than normal. The concurrent validity test found an area under the curve (AUC) of 0.81 (CI 0.76-0.85; p<.0001) with a sensitivity and specificity of 62% and 88%, respectively at the cut-off score of 7.5 with the LSEQ-M. The divergent validity was evidenced by correlations of MiSQuaSHI total score with both GAD -7 (r=0.24) and PSS -10 (r=0.20). The internal consistency was adequate (Cronbach’s alpha=0.70). Exploratory factor analysis (EFA) results were inconsistent. However, confirmatory factor analysis (CFA) found that the 5-factor model had the best fit. DISCUSSION: The findings support the validity of the MiSQuaSHI as a global measure of poor sleep quality associated with poor sleep hygiene.