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0326 Dreams as a Dimension of Sleep Health: Expanding the RU-SATED Model

Emily Feldman, Danica C. Slavish

SLEEPJ May 1, 2026 DOI: 10.1093/sleep/zsag091.0326 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Psychometric validation study Peer reviewed
Sample size 501
Population Undergraduate students (67% female, 6% gender diverse; 44% White; mean age 19.35 years, SD 2.13)
Measures RU-SATED, Pittsburgh Sleep Quality Index, Insomnia Severity Index, Glasgow Sleep Appraisal Questionnaire, Epworth Sleepiness Scale, Medical Outcomes Study Sleep Scale, PROMIS Sleep Disturbance, Nightmare Distress Index, Disturbing Dreams and Nightmare Severity Index, Nightmare Severity Index, Alcohol Use Disorders Identification Test (AUDIT)
Key points The RU-SATED showed strong convergent and discriminant validity with established sleep measures, and an expanded version including a dream item ('I sleep through the night without being awakened by dreams') showed acceptable factor structure, convergent validity with nightmare measures, and the strongest incremental validity across sleep outcomes (ΔR² = 0.012-0.028). The authors argue dreams represent a distinct component of sleep health warranting assessment.

Abstract

The RU-SATED measure (Buysse, 2014) is a 6-item scale assessing sleep health dimensions: Regularity, Satisfaction, Alertness, Timing, Efficiency, and Duration. This study aimed to (1) establish convergent and discriminant validity of the RU-SATED with established sleep measures, and (2) evaluate three candidate items to expand the scale to include dream health (RU-SATED-D). Undergraduate participants (N = 501; 67% female, 6% gender diverse; 44% White; M age = 19.35, SD = 2.13) completed the RU-SATED, three candidate dream items, nine established sleep/nightmare measures (Pittsburgh Sleep Quality Index, Insomnia Severity Index, Glasgow Sleep Appraisal Questionnaire, Epworth Sleepiness Scale, Medical Outcomes Study Sleep Scale, PROMIS Sleep Disturbance, Nightmare Distress Index, Disturbing Dreams and Nightmare Severity Index, Nightmare Severity Index), and the Alcohol Use Disorders Identification Test (AUDIT) for discriminant validity. Three candidate items assessing dream-related sleep disturbances were evaluated using exploratory factor analysis (EFA), with each item tested individually alongside the original 6 RU-SATED items, plus convergent validity with nightmare indices and incremental validity analyses. RU-SATED items showed strong convergent validity with sleep measures (|r| = 0.11-0.72, p < 0.05) and weaker correlations with AUDIT (r = -0.19 to 0.00), supporting discriminant validity. Single-factor models for each candidate dream item demonstrated acceptable fit (RMSEA = 0.036-0.047, TLI = 0.953-0.968), with factor loadings of 0.273-0.503. All items showed strong convergent validity with nightmare measures (r = 0.26-0.45, p < 0.001). The item “I sleep through the night without being awakened by dreams” displayed superior incremental validity across sleep outcomes (ΔR² = 0.012-0.028, p < 0.05). RU-SATED demonstrated strong convergent and discriminant validity with established sleep measures. The expanded RU-SATED-D scale demonstrated strong psychometric properties, supporting dreams as a distinct component of sleep health warranting assessment. Support (if any)