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Adolescent Sleep Hygiene Scale Revised (ASHSr)
Please visit this website for more information about the instrument: Adolescent Sleep Hygiene Scale Revised (ASHSr)
Exploratory: Myalgic encephalomyelitis/Chronic fatigue syndrome (ME/CFS) and Spinal Cord Injury (SCI)-Pediatric (ages 12 and older)
Short Description of Instrument
The Adolescent Sleep Hygiene Scale Revised (ASHSr) sleep assessment for adolescents contains 24 items measuring sleep inhibiting and sleep facilitating practices. There are 9 subscale scores: physiological (5 items), cognitive (6 items), emotional (3 items), sleep environment (4 items), daytime sleep (1 item), substances (2 items), sleep stability (4 items), bedtime routine (1 item and bed sharing (2 items). (Storfer-Isser et al., 2013) It differs from the original 32-item ASHS in that one item was added to the daytime sleep factor; one item was added to the sleep stability factor; and "the bed/bedroom sharing factor and two items that comprised it were omitted." (Storfer-Isser et al., 2013).
A 6-point ordinal rating scale: 1 = Never (0%); 2 = Once in a while (20%); 3 = Sometimes (40%); 4 = Quite often (60%); 5 = Frequently, if not always (80%); 6 = Always (100%) is used to indicate how often each item occurred during the past month. All but the Bedtime Routine question I use a bedtime routine (e.g., bathing, brushing teeth, reading) are reverse-coded with higher scores indicating better sleep hygiene. "Each subscale score is calculated by taking the average of the items comprising that subscale, and the mean of the subscale scores is used to create the total sleep hygiene score." (Storfer-Isser et al., 2013).
The Adolescent Sleep Hygiene Scale was originally adapted from the Children's Sleep Hygiene Scale (LeBourgeois, et al., 2005). LeBourgeois and colleagues reported on the relationship between self-reported sleep quality and sleep hygiene in Italian and American adolescents (LeBourgeois, et al., 2005).
Psychometric Properties:
The psychometric properties of the Adolescent Sleep Hygiene Scale Revised were further examined by Storfer-Isser (2013) and Lin et al., (2018) using confirmatory factor analysis = 0.64 to 0.88. Test-restest reliability = 0.72 to 0.90. (Lin et al., 2018).
Translated into Persian.
This instrument is useful in assessing the sleep hygiene issues which are common confounding issue in adolescent ME/CFS.
LeBourgeois MK, Giannotti F, Cortesi F, Wolfson AR, Harsh J. The Relationship Between Reported Sleep Quality and Sleep Hygiene in Italian and American Adolescents. Pediatrics. 2005;115(1 0):257-265.
Chehri A, Khazaie H, Eskandari S, Khazaie S, Holsboer-Trachsler E, Brand S, Gerber M. Validation of the Farsi version of the revised Adolescent Sleep Hygiene Scale (ASHSr): a cross-sectional study. BMC Psychiatry. 2017;17(1):408.
de Bruin EJ, van Kampen RK, van Kooten T, Meijer AM. (2014). Psychometric properties and clinical relevance of the adolescent sleep hygiene scale in Dutch adolescents. Sleep Med. 2004;15(7):789-797.
Harsh JR, Easley A, LeBourgeois MK. An instrument to measure children's sleep hygiene [abstract]. Sleep. 2000;25:A316.
LeBourgeois MK, Giannotti F, Cortesi F, Wolfson A, Harsh J. (2004). Sleep hygiene and sleep quality in Italian and American adolescents. Ann N Y Acad Sci. 2004;1021:352-354.
Lin CY, Strong C, Siu AMH, Jalilolghadr S, Nilsen P, BrostrÖm A, Pakpour AH. Validating the Persian Adolescent Sleep Hygiene Scale-Revised (ASHSr) using comprehensive psychometric testing methods. Sleep Med. 2018;50:63-71.
Meltzer LJ, Brimeyer C, Russell K, Avis KT, Biggs S, Reynolds AC, Crabtree VM. The Children's Report of Sleep Patterns: validity and reliability of the Sleep Hygiene Index and Sleep Disturbance Scale in adolescents. Sleep Med. 2014;15(12):1500-1507.
Storfer-Isser A, LeBourgeois M, Harsh J, Tompsett C, Redline S. Psychometric Properties of the Adolescent Sleep Hygiene Scale (ASHS). J Sleep Res. 2013;22(6):707-716.


Document last updated June 2020