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Restorative Sleep Questionnaire (RSQ)
Availability
Please visit this website for more information about the Restorative Sleep Questionnaire (RSQ):
Classification
Exploratory: Myalgic encephalomyelitis/Chronic fatigue syndrome (ME/CFS)
Short Description of Instrument
9-item scale assessing symptoms over the last week, meant to help assess non-restorative sleep
 
Population: Adult subjects, with and without self-reported or polysomnographically-confirmed problems initiating/ maintaining sleep
 
Construct measured: Non-restorative sleep, in subjects with and without difficulty initiating/ maintaining sleep
Generic vs. disease specific: Generic.
 
Means of administration: Written.  
 
Intended respondent: Study participant
 
# of items: 9.
 
# of subscales and names of sub-scales: N/A.
 
# of items per sub-scale: N/A.
Scoring
A total score is calculated as the average of the questionnaire items. The total score ranges from 0 to 100, with higher scores indicating better restorative sleep. A minimum of five items must be completed, otherwise the scale is considered as “missing”. To convert the average score to a 0–100 scale, the following transformation is used:  RSQ-W Total Score = {RSQ-W Average Score Across Completed Items – 1.0}*25 (3 out of the 9 items are "reversed scored" where a higher number selected on the scale by the subject is reversed when scoring e.g., 5 becomes 1, 4 becomes 2, etc.)
Rationale/Justification
Validity:
1) Content validity - 3 focus groups and 2 expert panels help generate and narrow down items; 2) Factor analysis yielded a univariate factor; 3) Tested against 15 different scales (Table 2 of paper); 4) Tested against polysomnographic parameters; 5) Assessed for convergent and divergent validity among 5 different groups (healthy controls and sleep-deprived subjects, subjects with arthritis, and a cohort with adequate sleep initiation and maintenance but a complaint of “nonrestorative” sleep in a community-based sample); 6) Compared scores across 3 different groups (healthy controls, insomniacs with PSG verified sleep maintenance and/or sleep onset difficulties)
 
Advantages:
1) Only 9 items; 2) Easily scored; 3) Assesses and important symptom; 4) Made to assess non-restorative sleep, regardless of if subjects have difficulty initiating or maintaining sleep (ME/CFS subjects likely have different combinations of non-restorative sleep, problems getting to sleep, problems staying asleep, etc.); 5) Appears to be rigorously constructed; 6) Test-retest and internal consistency reliability was more than 0.8 (excellent);and 7) RSQ more highly correlated with vitality than with depression/ anxiety (so less likely mood symptoms could account for higher score)
 
Limitations:
1) Not yet tested in ME/CFS patients.
References
Drake CL, Hays RD, Morlock R, et al. Development and Evaluation of a Measure to Assess Restorative Sleep. J Clinical Sleep Med. 2014;10(7):733–741.
Recommended Instrument for
ME/CFS
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