Cross-cultural adaptation and psychometric validation of the Arabic version of the Orofacial Awakening Symptoms Questionnaire (OFASQ)

Background: Making a measure of orofacial pain available for use among Arabic-speakers might contribute to the development of prevention and therapeutic programs that consider psychosocial and behavioral determinants of the Lebanese population. This study aimed to translate, culturally adapt, and validate the Arabic version of the Orofacial Awakening Symptoms Questionnaire (OFASQ) among Lebanese adults. Methods: A cross-sectional web-based survey was conducted during August–September 2025 and included 427 participants (mean age = 27.5 ± 10.6 years; 56% women). The OFASQ was translated to Arabic using the forward–backward translation protocol. Results: Confirmatory Factor Analysis (CFA) supported a single-factor structure with good fit indices (χ2/df = 2.67, Comparative Fit Index (CFI) = 0.970, Tucker-Lewis Index (TLI) = 0.941, Root Mean Square Error of Approximation (RMSEA) = 0.144 (90%Confidence Interval (CI): 0.086–0.207), and Standardized Root Mean Square Residual (SRMR) = 0.033). Internal consistency was good (Cronbach’s α = 0.85). Measurement invariance across gender was established, with females scoring higher than males on the OFASQ. For criterion validity, higher OFASQ scores were significantly associated with worse sleep quality, more insomnia severity, and higher migraine. Conclusions: The Arabic OFASQ displayed reliability, validity, and cultural appropriateness for evaluating orofacial awakening indicators of bruxism and temporomandibular disorders in Arabic-speaking populations, validating its use in both clinical and research settings.

Orofacial pain; Orofacial Awakening Symptoms Questionnaire; Psychometric properties; Validation; Arabic

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