Related Experiment Video
Updated: Jun 9, 2026

Association Between Sleep Quality and Cognitive Symptoms in Patients with Major Depressive Disorder
Published on: April 26, 2024
Considering Substance Use in Dysfunctional Beliefs About Sleep: Validation of the DBAS-S
Mary Beth Miller1,2, Cassandra L Boness3,4, Sydney D Shoemaker2
1Department of Psychiatry, University of Missouri, Columbia, MO, USA.
Objective:
Alcohol and cannabis are commonly used as sleep aids that inadvertently perpetuate symptoms of insomnia over time, but substance use is not a standard component of sleep assessments. This pre-registered study aimed to expand the validity and clinical utility of the Dysfunctional Beliefs about Sleep Scale (DBAS) by incorporating substance use expectancies for sleep.
Method:
After using cognitive interviewing to improve the content validity of items (N = 24, age M = 33.3y, 83% female), iterative factor analyses and tests of external validation were used to refine and psychometrically evaluate the revised scale (full sample N = 966, age M = 42.6, 60% female, 65% with at least mild insomnia).
Results:
The final set of 11 items was best represented by two factors (9 sleep and 2 substance use items; r = 0.15). The sleep subscale was strongly correlated with the DBAS-16 (r = 0.95, p < .001) and demonstrated measurement invariance across those who did (n = 309) and did not (n = 318) drink alcohol. The substance use subscale (β = 0.16, p < .001) accounted for a small but significant amount of unique variance in insomnia severity (sleep subscale β = 0.59, p < .001) and demonstrated concurrent and prospective associations with alcohol/cannabis use. Surprisingly, the single cannabis belief item was more strongly associated with cannabis use than longer validated scales of cannabis sleep expectancies.
Conclusions:
The substance use version of the DBAS (DBAS-S) is a brief, reliable, and valid measure of dysfunctional sleep beliefs and substance use expectancies that will improve clinical practice by flagging substance use as a potential contributor to insomnia for clinicians.
More Related Videos
06:23A Chronic Sleep Fragmentation Model using Vibrating Orbital Rotor to Induce Cognitive Deficit and Anxiety-Like Behavior in Young Wild-Type Mice
Published on: September 22, 2020
07:54Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Related Concept Videos
Substance Use Disorders Affecting Sleep
Understanding the concepts of physical dependence,...
Sleepwalking and Sleep Talking
Factors that increase the likelihood of sleepwalking include sleep deprivation and alcohol consumption. Contrary to common beliefs, it is safe...
CNS Depressants: Barbiturates and Benzodiazepines
REM Sleep Behavior Disorder
RBD is significantly associated with...
Insufficient Sleep and Sleep Deprivation
Sleep deprivation is a more severe form of sleep loss...
Management of Insomnia