An investigation into pre-sleep cognitive arousal

Hyperarousal is one component that has been theorized to have an important role in insomnia models, though it is a broad concept, and is challenging to measure. There is a need for reliable and valid measures of hyperarousal in insomnia models to develop the knowledge base and for clinicians to be able to measure this construct. One widely used measure that measures cognitive and somatic arousal during the pre-sleep period is the Pre-Sleep Arousal Scale. The current review aimed to identify, summarise and critically evaluate the quality of this Scale. The review identified ten relevant studies that assessed the psychometric properties of this scale and evaluated them against measurement criteria recommended by Terwee et al., (2007). The most robust evidence for the PSAS was found for content validity and internal consistency. Some psychometric weakness was found for factor structure, test-retest reliability, interpretability, criterion, and construct validity, which was often due to methodological flaws in studies. The Pre-Sleep Arousal Scale was found to have promising psychometric properties, however, further research by validation studies of higher quality is required to establish these psychometric properties with greater confidence, to increase the applicability of the PSAS in research and clinical settings.