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Background and Purpose: Sleep hygiene is one factor that contributes to poor sleep in breast cancer survivors but is poorly measured. The purposes of this study were to (a) evaluate the psychometric properties of the Sleep Hygiene Awareness and Practice Scale (SHAPS) and (b) compare SHAPS scores between midlife women with and without breast cancer. Methods: Cross-sectional, descriptive data from a single-blinded, controlled hot flash intervention trial. Results: 194 women (88 breast cancer survivors; 106 menopausal women). Reliability of the three sections of the SHAPS was inadequate with Cronbach's alphas ranging from 0.23 to 0.67. Sleep hygiene practices were modestly correlated with global sleep quality in both groups. Conclusions: Findings suggest the SHAPS would need to be revised to be a psychometrically sound measure of sleep hygiene awareness and practice.
Keywords: sleep; sleep hygiene; symptom management; menopause; breast cancer; measurement
Inadequate sleep hygiene awareness and practices contribute to poor sleep. Sleep hygiene is defined as knowledge and practices that facilitate quality nighttime sleep and full-daytime alertness (American Academy of Sleep Medicine, 2005). Sleep hygiene practices can be variable and change over time because sleep behaviors change (Brown, Buboltz, & Soper, 2002). Examples of proper sleep hygiene include avoiding excessive daytime napping, caffeine use, and avoiding light exposure and strenuous exercise before bedtime. Inadequate sleep hygiene practices that contribute to poor sleep can also be related to prescription and over-the-counter sleep medication misuse and abuse. A recent survey found that 90% of American men and women watch television at least 1 hr before bed, which can contribute to insomnia symptoms (National Sleep Foundation, 2008). The survey also reported that 85% of respondents admitted to often misusing or abusing sleep aids to promote sleep (National Sleep Foundation, 2008). These findings are consistent with an increase in emergency room visits in 2010 related to prescription sleep medications, where menopausal women disproportionately reflected 67% of those cases (Substance Abuse and Mental Health Services Administration & Center for Behavioral Health Statistics and Quality, 2014).
In research studies, there are three standardized sleep hygiene questionnaires. Two instruments, the Sleep Hygiene Index (Cho, Kim, & Lee, 2013; Mastin, Bryson, & Corwyn, 2006) and Sleep Hygiene Self-Test (Blake & Gómez, 1998), both have been validated with moderate-to-low reliability (a 5 .54-.66). The...