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How patients with insomnia interpret and respond to the consensus sleep diary: a cognitive interview study
Christina Bini1,2, Carina Hjelm3, Amanda Hellström4
1Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Alfred Nobels allé 23, Huddinge, SE-141 83, Sweden. christina.bini@ki.se.
Journal of Patient-Reported Outcomes
|February 20, 2024
Summary
The Swedish Consensus Sleep Diary (CSD) has comprehension and recall issues in insomnia patients. Therapists should guide patients on instructions to improve sleep diary accuracy.
Area of Science:
- Sleep Medicine
- Psychometrics
Background:
- The Consensus Sleep Diary (CSD) is a common tool for assessing subjective sleep quality.
- While psychometric evaluations support its validity, further research is needed, particularly for translated versions.
Purpose of the Study:
- To evaluate the test content and response processes of a Swedish translation of the CSD in patients with insomnia disorder.
Main Methods:
- Cognitive interviewing was used with 13 primary care patients diagnosed with insomnia disorder.
- Iterative, reparative analysis examined test content, while descriptive deductive analysis explored response process themes (comprehension, retrieval, decision, judgment).
Main Results:
- Patients struggled with adhering to instructions, impacting overall comprehension.
- Recall difficulties arose when the diary wasn't completed immediately upon waking or before bed.
- Ambiguous interpretation of sleep concepts and insufficient response options hindered accurate reporting.
Conclusions:
- The Swedish CSD, like its original version, can be affected by memory lapses if not completed promptly.
- Therapist guidance on instruction adherence is crucial for enhancing the accuracy of patient-reported sleep data.
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