Construction of a standard rating scale to estimate sleep onset and the analysis of influencing factors

In this study, we developed a ratings scale for estimating sleep onset that would be capable of providing quantitative evaluations of the quality of the sleep onset process. We also examined factors affecting sleep onset using a questionnaire consisting of two separate clusters of items: the first, consisting of 9 items, related to the quality of sleep onset; and the second, consisting of 56 items, related to factors with apparent effects on sleep onset. The questionnaire was administered to 515 day-workers (range: 25-44 years old) for standardization. Each item was weighted based on the distribution of subject responses to determine discrimination. The reliability coefficient alpha for the questionnaire was high, exceeding 0.8. Of 41 items set out as potential factors affecting sleep onset, the results of the questionnaire indicated that five factors consisting of 26 items could be isolated as most likely affecting sleep onset. Path analysis indicated that sleep onset is more commonly affected by factors present at bedtime than factors related to sleep quality the previous night, or to daytime activities.