The Anxiety and Preoccupation about Sleep Questionnaire (APSQ)


There has been a steady growth in interest in the importance of intrusive and worrisome thinking in the maintenance of insomnia. Given the importance of sleep-related worry in chronic insomnia, it is vital for research and clinical purposes to develop and psychometrically validate measures that specifically pinpoint such worry. Several measures have already been developed and, at least partly, validated. Given the potential limitations of earlier instruments, the Anxiety and Preoccupation about Sleep Questionnaire (APSQ) appears for two reasons to be a promising measure. First, the APSQ is short and designed to index the intensity of worry specifically for insomnia. This might turn the APSQ into a potentially important instrument for research and clinical purposes. Second, the APSQ is sensitive to the effects of treatment. Third, the APSQ captures worry both at nighttime and daytime, and, based on recent psychological models underscoring insomnia as a 24-hour phenomenon, the APSQ might thus be an improvement compared to the previously published instruments. No other instrument tapping sleep-related worry for insomnia has a focus on both nighttime and daytime worry.


Two-factor solution (70.7% of the variance): worries about the consequences of poor sleep and worries about the uncontrollability of sleep. First factor: items 1-5 and 7. Second factor: items 6 and 8-10.
Internal consistency: the total APSQ scale α = .93, for the first factor α = .91, and for the second factor α = .86. Discriminant validity between those with insomnia, poor sleep and normal sleep. Associated with subjective sleep parameters and daytime impairment.

Author of Tool:

Allison G. Harvey and Nicole Tang

Key references:

Jansson-Fröjmark, M., Harvey, A.G., Lundh, L.G., Norell-Clarke, A., & Linton, S.J. (2011). Psychometric properties of an insomnia-specific measure of worry: The Anxiety and Preoccupation about Sleep Questionnaire. Cognitive Behaviour Therapy, 40, 65-76.

Tang, N.K.Y., & Harvey, A.G. (2004). Correcting distorted perception of sleep in insomnia: A novel behavioural experiment? Behaviour Research and Therapy, 42, 27-39.

Primary use / Purpose:

To index sleep-related worry in those with insomnia or associated sleep disorders.


On the scales provided below, please rate each of the following statements for how true they are for you during the past month.

1     2      3      4      5      6      7      8      9      10

Not true                                                                   Very true

  1. I worry about the amount of sleep I am going to get every night 1
  2. I worry about how the amount of sleep I had last night is going to affect my day time performance
  3. I worry about how the amount of sleep I get is going to afflict my health
  4. I worry about how much the amount of sleep I get will weaken my social ability
  5. I worry about how much the amount of sleep I get will shake my mood
  6. I worry about my loss of control over sleep
  7. I worry about my ability to stay awake and alert during the day
  8. I put great effort into trying to rectify my sleep problems
  9. My failure to rectify my sleep problems troubles me a lot
  10. My worry about sleep is persistent