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Sleep Assessment Questionnaire - Moldofsky
Availability
Please visit this website for more information about the instrument: Sleep Assessment Questionnaire or contact Dr. Harvey Moldofsky, at http://www.sleepmed.to/
Classification
Supplemental Highly – Recommended: Myalgic encephalomyelitis/Chronic fatigue syndrome (ME/CFS)
Short Description of Instrument
A 17-item questionnaire divided into 6 subscales, that is used to screen for potential sleep disorders so that further testing can confirm disorders.
 
Population: Adults
Comments
Unger et al., 2004 reports, "sensitivities varying between 79% -100% and specificities between 68% - 96% for detection of abnormality in the respective primary sleep disorder group." Sensitivity and specificity for non-restorative sleep scale is also supposedly good (based on abstract). Intraclass correlation coefficient of 0.97. For obstructive sleep apnea (OSA), the Sleep Assessment Questionnaire (SAQ) was shown to be responsive to successful treatment as measured by polysomnography (PSG); all scores on SAQ declined with treatment with the most significant decline on the OSA subscale. Authors also tested feasibility and found most subjects did not have problems understanding/ completing the SAQ. The ease of use was also note in the Unger et al., 2004 study.
Scoring
The scale is scored via proprietary system maintained by the authors.
Rationale/Justification
Strengths/Advantages:
It has been used successfully in ME/CFS subjects before, with many subjects showing abnormalities on the test. In particular, in a different cohort than the origination one, ME/CFS subjects were 24 times more likely and 16 times more likely to have abnormal scores for non-restorative sleep and restlessness subscales compared to non-fatigued groups and had the highest odds ratios compared to multiple other groups (Moldofsky et al., 2000). This corresponds to the other studies which show unrefreshing sleep to be the most common sleep symptom. The non-restorative scale was tested specifically in FM and ME/CFS subjects.
 
Weaknesses/Limitations:
There is limited documentation of psychometric characteristics in the much of the data is from abstracts and writing to the authors of the questionnaire for more details yielded no response. Proprietary scoring system and fee associated. The other subscales were validated in non-ME/CFS groups.
Construct Validity: 1) Construct validity: principal component analysis yielded 6 subscales corresponding to common categories of sleep disorders (OSA, PLMD, sleep schedule disorder, insomnia/hypersomnia, non-restorative sleep, excessive daytime sleepiness); 2) Criterion/ Divergent validity: Subjects with any sleep disorders as diagnosed by PSG had different scores than normal subjects; PSG-diagnosed sleep disorders had higher scores corresponding to the subscale of the SAQ compared to normals and to healthy; 3) Criterion validity: Specifically for FM and ME/CFS, the non-restorative subscale was tested against such subjects with PSG-proven alpha-wave intrusion.
References
Cesta A, Moldofsky H, Sammut C. The University of Toronto Sleep Assessment Questionnaire (SAQ). Sleep Res. 1996;25:486.
 
Cesta A, Moldofsky H, Sammut C. The University of Toronto Sleep Assessment Questionnaire (SAQ). Sleep Res. 1997;26:646.
 
Cesta A, Moldofsky H, Sammut C. The sensitivity and specificity of the Sleep Assessment Questionnaire© (SAQ©) as a measure of non-restorative sleep. Sleep. 1999;22(1 Suppl):14. http://www.sleepmed.to/sleep/SAQ%20Abstract.pdf
 
Mansfield RW, Cesta A, Sammut C, Moldofsky H. The sensitivity and specificity of the Sleep Assessment Questionnaire© in the identification of patients with insomnia, restless legs syndrome/periodic limb movement disorder, and narcolepsy/idiopathic hypersomnia. Sleep. 2000;23(Suppl.2): A381.
 
Moldofsky H, Cesta A, Sammut C, Unger ER, Nisenbaum R., Reeves WC. Sleep disorders in a population-based study of chronic fatiguing illnesses with Sleep Assessment Questionnaire©. Sleep. 2000;23(Suppl.2): A67.
 
Reeves WC, Nisenbaum R, Moldofsky H, Cesta A, Sammut C, Reyes M, Unger ER, Sleep assessment in population-based study of chronic fatigue syndrome, Sleep. 2003;26: A370.
 
Sleep Assessment Questionnaire Description available at: https://www.sleepmed.to
 
Unger ER, Nisenbaum R, Moldofsky H, et al. Sleep assessment in a population-based study of chronic fatigue syndrome. BMC Neurology. 2004;4:6.
Recommended Instrument for
Recommended Instrument for: ME/CFS
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