Spanish Translation and Cross-Language Validation of a Sleep Habits Questionnaire for Use in Clinical and Research Settings

Abstract

Study Objectives: To translate, back-translate and crosslanguage validate (English/Spanish) the Sleep Heart Health Study Sleep Habits Questionnaire for use with Spanish-speakers in clinical and research settings. Methods: Following rigorous translation and back-translation, this cross-sectional cross-language validation study recruited bilingual participants from academic, clinic, and communitybased settings (N = 50; 52% women; mean age 38.8 ± 12 years; 90% of Mexican heritage). Participants completed English and Spanish versions of the Sleep Habits Questionnaire, the Epworth Sleepiness Scale, and the Acculturation Rating Scale for Mexican Americans II one week apart in randomized order. Psychometric properties were assessed, including internal consistency, convergent validity, scale equivalence, language version intercorrelations, and exploratory factor analysis using PASW (Version18) software. Grade level readability of the sleep measure was evaluated. Results: All sleep categories (duration, snoring, apnea, insomnia symptoms, other sleep symptoms, sleep disruptors, restless legs syndrome) showed Cronbach α, SpearmanBrown coeffi cients and intercorrelations ≥ 0.700, suggesting robust internal consistency, correlation, and agreement between language versions. The Epworth correlated signifi cantly with snoring, apnea, sleep symptoms, restless legs, and sleep disruptors) on both versions, supporting convergent validity. Items loaded on 4 factors accounted for 68% and 67% of the variance on the English and Spanish versions, respectively. Conclusions S C I E N T I F I C I N V E S T I g A T I O N SS leep research over the past two decades has shown associations between sleep disorders and chronic disease, 1-7 poorer health-related quality of life, 8,9 increased health and work-related costs, and travel and work-related accidents.10,11 Prevalence rates for insomnia, the most commonly reported sleep complaint, range from 20% to 40% of the population, depending on the defi ned severity and frequency, 12 and is suggested to have a bidirectional relationship with several chronic conditions including depression and cardiovascular disease.13,14 Prevalence rates for obstructive sleep apnea syndrome range from 2% to 4%, 7 and rates for restless legs syndrome range from 5% to 15% in the general population.15 Snoring (48%), feeling unrested (26.5%), and insuffi cient sleep (26%) are leading sleep problems identifi ed in a population-based study.5 These and other sleep disruptions can contribute to excessive daytime sleepiness, 16 making sleep disorders signifi cant contributors to disability, morbidity, and mortality. 1,5,7,11,17,18 Despite the growing clinical and public health concerns regarding sleep disorders, few studies have examined associations between sleep and race/ethnicity in the United States. A majority of extant racial/ethnic studies compared African Americans with and without sleep disorders, or comparing African and Caucasian Americans on sleep disordered breathing, snoring, sleep architecture, insomnia sympt...

Impact of sleep and dialysis mode on quality of life in a Mexican population

“…Sleep symptoms questions were rated on a 5-point Likert-type scale from ‘Never’ to Almost Always.’ The SHQ, developed for the SHHS, has been used in a variety of investigations and is accepted as an appropriate means of characterizing sleep health. The Spanish version of the SHQ was cross-language validated by Baldwin and colleagues and shows excellent agreement with the English version (21).…”

Disparities in Sleep Health and Potential Intervention Models

“…Sleep interventions require attention to socio-contextual factors, perhaps more so for those experiencing discrimination, racism, and poverty. Innovative Spanish/English sleep education and promotion training modules have been developed and successfully pilot tested among health providers in the United States, Mexico, and the US-Mexico border32 ; these eliminate the contribution of language barriers to sleep health. .…”

The Pregnancy in Polycystic Ovary Syndrome II study: baseline characteristics and effects of obesity from a multicenter randomized clinical trial

“…(19) The Sleep Habits Questionnaire was adapted from the Sleep Heart Health Study. (20) The questionnaire addresses several categories of sleep disorders: (1) sleep duration weekdays and weekends (2 items); (2) snoring (3 items); (3) breathing pauses/apnea (4 items); (4) insomnia symptoms (3 items); (5) sleep symptoms, including insufficient sleep, daytime sleepiness, nightmares, leg jerks, leg cramps, and need for sleep aids (12 items); (6) sleep quality, including perception of depth and duration of sleep (3 items); and (7) restless legs syndrome (10 items). There is an additional category that assesses potential sleep disruptors, including sinusitis, room noise, temperature, pain, and frequent toileting (9 items).…”