A cross-sectional validation study of the verran and snyder-halpern sleep scale and the factors influencing sleep questionnaire in Dutch hospitals.

More than half of hospitalized patients reported poorer sleep quality in the hospital than at home.

• 51% (n=354) of 693 respondents reported poorer sleep than at home.
• The study population included patients from internal medicine and surgical wards in six Dutch teaching hospitals.
• Over half of respondents were aged 50-74 years and stayed in multi-occupancy rooms for more than four nights.

The most commonly reported sleep disturbances in Dutch hospital wards included uncomfortable beds, pain, noisy ventilation, patient noise, and equipment alarms.

• These disturbances were identified among 693 respondents completing the questionnaire.
• Both environmental (noisy ventilation, equipment alarms) and patient-related (pain, patient noise) factors were prominent.
• Uncomfortable beds were also among the top reported disturbances.

Confirmatory Factor Analysis supported a three-factor model for the Dutch VSH and a one-factor model for the Dutch FISQ.

• CFA was conducted following COSMIN guidelines.
• The VSH uses a visual analogue scale format.
• The FISQ uses a 5-point Likert scale format.
• Both instruments underwent a forward-backward translation process prior to validation.

Daytime sleep was significantly associated with more nighttime disturbance and lower sleep effectiveness.

• Daytime sleep was linked to more disturbance (β=0.13 [95% CI: 0.03, 0.23]).
• Daytime sleep was linked to lower sleep effectiveness (β=-0.11 [95% CI: -0.19, -0.03]).
• Associations were identified through regression analyses of patient characteristics and sleep hygiene factors.

Fewer nighttime sleep hours were strongly associated with lower sleep effectiveness and increased sleep disturbance.

• Fewer sleep hours were associated with lower sleep effectiveness (β=0.57 [95% CI: 0.48, 0.66]).
• Fewer sleep hours were associated with increased disturbance (β=-0.59 [95% CI: -0.67, -0.50]).
• These were among the strongest associations found in the regression analyses.

More frequent sleep interruptions were associated with higher sleep disturbance and increased need for sleep supplementation.

• More frequent sleep interruptions were associated with higher sleep disturbance (β=-0.22 [95% CI: -0.30, -0.15]).
• More frequent sleep interruptions were associated with increased need for sleep supplementation (β=-0.11 [95% CI: -0.21, 0.00]).
• The confidence interval for the sleep supplementation association just includes zero, indicating a borderline association.

The Dutch translations of the VSH and FISQ were determined to be valid and reliable tools for assessing sleep quality and hygiene in Dutch hospital patients.

• Validation followed COSMIN guidelines.
• Both instruments underwent cross-cultural adaptation via forward-backward translation.
• A total of 693 respondents completed the questionnaire across six Dutch teaching hospitals.
• Psychometric properties were assessed including Confirmatory Factor Analysis.