The Children's Sleep Habits Questionnaire (CSHQ): Psychometric properties of a survey instrument for school-aged children

Study Objectives: To present psychometric data on a comprehensive, parent-r eport sleep screening instrument designed for school-aged children, the Chi ldren's Sleep Habits Questionnaire (CSHQ). The CSHQ yields both a total sco re and eight subscale scores, reflecting key sleep domains that encompass t he major medical and behavioral sleep disorders in this age group. Design: Cross-sectional survey. Setting: Three elementary schools in New England, a pediatric sleep disorde rs clinic in a children's teaching hospital. Participants: Parents of 469 school-aged children, aged 4 through 10 years (community sample), and parents of 154 patients diagnosed with sleep disord ers in a pediatric sleep clinic completed the CSHQ. Interventions: N/A Measurements and Results: The CSHQ showed adequate internal consistency for both the community sample ((mu =0.68) and the clinical sample (mu =0.78); alpha coefficients for the various subscales of the CSHQ ranged from 0.36 ( Parasomnias) to 0.70 (Bedtime Resistance) for the community sample, and fro m 0.56 (Parasomnias) to 0.93 (Sleep-Disordered Breathing) for the sleep cli nic group. Test-retest reliability was acceptable (range 0.62 to 0.79). CSH Q individual items, as well as the subscale and total scores were able to c onsistently differentiate the community group from the sleep-disordered gro up, demonstrating validity. A cut-off total CSHQ score of 41 generated by a nalysis of the Receiver Operator Characteristic Curve (ROC) correctly yield ed a sensitivity of 0.80 and specificity of 0.72. Conclusions: The CSHQ appears to be a useful sleep screening instrument to identify both behaviorally based and medically-based sleep problems in scho ol-aged children.