Validation and Psychometric Evaluation of the French Version of the Pre-Sleep Arousal Scale (PSAS) in a Large Adult...

Insomnia is the most prevalent sleep disorder and constitutes a major global public health challenge. Given the central role of hyperarousal in insomnia, the Pre-Sleep Arousal Scale has become a widely used instrument to assess the cognitive and somatic components of pre-sleep arousal. However, the absence of a validated French version has limited its use in French-speaking populations. The objective of this study was to translate, culturally adapt and validate a French version of the PSAS. Data were collected from 8075 adults who completed an online sleep questionnaire including the Pre-Sleep Arousal Scale, the Insomnia Severity Index, the Hospital Anxiety and Depression Scale and the Epworth Sleepiness Scale. Internal consistency, factorial structure, test-retest reliability, and convergent, discriminant and criterion validity were evaluated. The French version demonstrated good internal consistency (Cronbach's α = 0.89), with satisfactory reliability for the somatic subscale (α = 0.79) and excellent reliability for the cognitive subscale (α = 0.91). Confirmatory and exploratory factor analyses consistently supported the original two-factor structure. Test-retest reliability indicated good temporal stability across a two-week interval. Convergent validity was supported by significant moderate-to-strong correlations with insomnia severity, anxiety and depression, while weak associations with daytime sleepiness supported discriminant validity. Criterion validity was confirmed by significantly elevated PSAS scores in individuals with insomnia compared to good sleepers. These findings indicate that the French version of the PSAS is a reliable and valid instrument for assessing pre-sleep arousal in clinical and research settings and provides a valuable tool for the evaluation of insomnia-related hyperarousal.