Scientific inveStigAtionSStudy objectives: To evaluate the psychometric properties and clinical significance of a new scale for measuring daytime fatigue associated with insomnia: The Flinders Fatigue Scale (FFS). Methods: The 7-item FFS was used in two separate studies. Study 1 was an on-line validation study involving 1093 volunteers (mean [SD] age = 38.6 [14.7] y, 626 poor sleepers, 467 good sleepers) in a crosssectional design; Study 2 investigated the clinical sensitivity of the FFS on 113 insomnia patients (mean [SD] age = 48.3 [15.0] y) in response to a 5-week cognitive-behavior therapy for insomnia (CBT-I) program. Results: The FFS had an internal consistency of 0.91; it comprised a single factor, accounting for 67% of the total variance. Poor sleepers in Study 1 scored significantly higher than good sleepers on the FFS (p < 0.0001).In Study 2, significant reductions in FFS scores were found in response to CBT-I (p < 0.0001). These reductions in fatigue correlated with improvements on subjective sleep parameters (all p < 0.0001). The FFS showed good discriminant validity with the Epworth Sleepiness Scale. conclusions: The Flinders Fatigue Scale is a brief, clinically sensitive measure with strong psychometric properties.

To help alleviate the widespread health problem created by poor sleep, health organizations invest considerable resources into public sleep education. Yet there is limited research to support the notion that sleep education leads to better sleep quality, whether for poor sleepers or the general population. The present study examined the relationships between sleep knowledge, sleep practice and sleep quality in a sample of 946 participants (mean age = 38.5 years, SD = 14.4, 67% women), 394 of whom were identified as poor sleepers (mean age = 41.4 years, SD = 15.2, 58% women). An online questionnaire was used to cross-sectionally test these relationships for the poor sleepers, as well as the entire sample. Sleep knowledge was significantly related to sleep practice for the entire sample, but not for the poor sleepers. However, significant moderate relationships between sleep practice and sleep quality were found for both poor sleepers and the entire sample. Further analysis showed that sleep practice mediated the relationship between sleep knowledge and sleep quality for the entire sample. However, when other factors known to affect sleep quality (e.g. age and gender) were controlled, there was no significant relationship between knowledge and sleep quality. These results indicate that current sleep education may not be effective in improving sleep quality, particularly for poor sleepers. Further research into additional factors (e.g. dysfunctional beliefs) influencing sleep quality, and the implementation of accurate sleep knowledge are needed.