We chose the GSDS to measure sleep disturbance

We chose the GSDS to measure sleep disturbance has conceptual congruency with physical fatigue.

The first 20 items of the GSDS assess sleep disturbance in the past week within seven domains (GSDS subscales): difficulty falling asleep (1 item), waking up during sleep (1 item), waking up before the sleep cycle ends (1 item), sleep quality (3 items), sleep quantity or sleep time (2 items), daytime sleepiness (7 items), and consumption of substances to aid sleep (5 items).

The original GSDS contains 6 items in the last subscale, but Lee (2007) deleted 1 item (frequency of smoking marijuana) because having marijuana is illegal in Taiwan. To determine our sampling adequacy, we calculated the KaiserMeyerOlkin measure of sampling adequacy, which was 0.841.

Thus, we ran principal component factor analysis for the Chinese GSDS-Sleep Disturbance subscale with varimax rotation and found a five-factor solution that explained 59.38% of total variance. Another GSDS item asks whether any unusual sleep problems were experienced in the past week.

If yes, respondents complete the Interference with Daily Life subscale (7 items) to assess the frequency and degree to which these seven problems interfered with their daily activities.

The frequency for each item (problem) is rated from 0 (never) to 10 (every day), and the degree of interference is rated from 0 (no interference) to 10 (severe interference). Higher scores indicate greater sleep disturbance and higher levels of interference. Cronbachs a-values for the first seven subscales and interference subscales in this study were 0.82 and 0.95, respectively.

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