Towards a valid, reliable measure of sleep effort


Dr Niall M. Broomfield, Department of Psychological Medicine, Gartnavel Royal Hospital, University of Glasgow, 1055 Great Western Road, Glasgow G12 0XH, UK. Tel.: 0141 211 3904; fax: 0141 357 4899; e-mail:


A frequent clinical observation is that patients with insomnia strive to control their sleep. However, sleep is an involuntary physiological process, which cannot be placed under full voluntary control. Therefore, direct, voluntary attempts to control sleep may actually exacerbate and perpetuate insomnia. To date, no reliable scale has been available to test this hypothesis directly. Moreover, while sleep effort is a core International Classification of Sleep Disorders – Revised criterion for psychophysiological insomnia, clinicians lack a reliable measure with which to assess the construct. In this initial scale validation study, we present psychometric data for the Glasgow Sleep Effort Scale based on a relatively small but representative sample of patients with insomnia and good sleepers. The clinical and research value of the new scale is discussed and future research directions are described.