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Published on: April 7, 2020
Internal consistency of the pediatric daytime sleepiness scale: a meta-analysis across diverse populations
Haitham Jahrami1,2, Waqar Husain3, Amir H Pakpour4
1Government Hospitals, Manama, Bahrain.
Insights
This meta-analysis confirms the Pediatric Daytime Sleepiness Scale (PDSS) has high internal consistency for assessing childhood sleepiness. Findings support its international use in non-clinical settings.
Area of Science:
- Pediatric Psychology
- Psychometric Evaluation
- Sleep Medicine
Background:
- The Pediatric Daytime Sleepiness Scale (PDSS) is widely used to assess sleepiness in children and adolescents.
- Assessing the internal consistency reliability of the PDSS across diverse populations and cultures is crucial for its valid application.
- Existing research necessitates a comprehensive synthesis to confirm the PDSS's psychometric properties.
Purpose of the Study:
- To conduct a meta-analysis evaluating the internal consistency reliability of the Pediatric Daytime Sleepiness Scale (PDSS).
- To synthesize data from multiple studies to determine the overall reliability of the PDSS in assessing daytime sleepiness.
- To explore potential sources of heterogeneity and publication bias in PDSS reliability studies.
Main Methods:
- A systematic literature search was performed across 18 databases for studies reporting PDSS reliability using Cronbach's alpha.
- A random-effects model was utilized to calculate the pooled Cronbach's alpha, with heterogeneity assessed using I², Tau², and H² statistics.
- Subgroup, meta-regression, sensitivity, and publication bias analyses (funnel plots, Egger's regression, trim-and-fill) were conducted.
Main Results:
- Nine studies comprising 8064 participants were included in the meta-analysis.
- The pooled Cronbach's alpha for the PDSS was 0.77 (95% CI 0.75–0.80), indicating high internal consistency.
- Significant heterogeneity was observed (I²=87.88%), but subgroup and sensitivity analyses did not reveal significant moderators or influential studies; no publication bias was detected.
Conclusions:
- The meta-analysis provides strong evidence for the high internal consistency reliability of the PDSS in non-clinical pediatric populations across various groups and cultures.
- The findings support the global application of the PDSS for evaluating daytime drowsiness in children and adolescents.
- Further validation studies are recommended to establish the PDSS's utility in clinical populations for diagnostic and treatment purposes.
Abstract:
The Pediatric Daytime Sleepiness Scale (PDSS) is a common tool for assessing daytime sleepiness in children and adolescents. Despite its widespread use, its internal consistency reliability across populations and cultures is still being assessed. This meta-analysis synthesizes data from multiple studies to assess the PDSS's internal consistency. A comprehensive review of 18 databases was conducted to gather studies examining the reliability of PDSS using Cronbach's alpha. A random-effects model was employed to calculate the overall Cronbach's alpha, while the I2 statistic and Tau2 estimate assessed the consistency between studies. Subgroup analyses, meta-regression, and sensitivity analyses were performed to explore and verify the reasons for any observed differences. Additionally, funnel plot inspection, Egger's regression, and trim-and-fill method were used to evaluate publication bias. The meta-analysis included nine studies with a total of 8064 participants (k = 9). The estimated pooled Cronbach's alpha was 0.77 (95% CI 0.75 to 0.80), indicating high internal consistency. Significant heterogeneity was detected (I2 = 87.88%, Tau2 = 0.001, H2 = 8.25). The prediction interval (0.69 to 0.86) suggested that most individual studies reported acceptable to excellent internal consistency. Subgroup and sensitivity analyses did not identify any unduly influential studies or significant moderators (age, sex). No evidence of publication bias was found using multiple assessment methods. The current meta-analysis confirms the high internal consistency reliability of the PDSS across varied study groups and cultures in non-clinical populations. While the findings support the international use of PDSS to assess daytime drowsiness in children and adolescents, validation in clinical populations remains necessary to establish its utility in diagnostic and treatment contexts. Registration Open Science Framework (OSF) https://doi.org/10.17605/OSF.IO/F7M3Z.
Supplementary Information:
The online version contains supplementary material available at 10.1007/s41105-025-00603-x.
