What Do Patient-Reported Sleep Measures Assess? A Content Analysis

Current systematic review analysed the content of generic patient-reported sleep measures (PRSMs) using (1) the International Classification of Functioning, Disability and Health (ICF) and (2) semantic analysis. A literature search identified 27 PRSMs applicable across multiple sleep disorders. Meaningful concepts within items of these PRSMs were linked to ICF categories using standardised linking rules. Additionally, semantic relations (contextual, causal, temporal or state descriptive) among these concepts were explored. An overview of the ICF content covered within and across questionnaires was compiled. Three main findings emerged. First, the majority of concepts were linked to the ICF component body functions (71.5%), indicating a focus on physiological and psychological symptoms, while activities and participation (14.7%), environmental factors (3.5%), and personal factors (2.2%) were less represented. Second, semantic analysis revealed that multidimensional content often framed symptoms within activities rather than measuring the functional or environmental impact of sleep disorders. Third, the operationalization of similar constructs varied across PRSMs, and their questionnaire labels could diverge from actual item content. This study provides a standardised database source for content-based evaluation, comparison and selection of PRSMs. Clinicians and researchers should be aware of the conceptual scope of PRSMs to ensure alignment with their specific clinical or research objectives. Recommendations are offered to guide sleep medicine measurement towards a more comprehensive approach integrating biological, psychological, social, environmental and personal aspects.