BACKGROUND:
Public health systems increasingly rely on quality-of-life (QoL) measures to inform surveillance, priority-setting, and resource allocation. Generic QoL instruments are commonly used because they enable comparisons across populations. However, this standardised approach may inadequately capture the specific functional, psychological, and social burden of sleep-related conditions, potentially leading to under-recognition of need and inequities in health system responses.

AIM:
To assess whether generic QoL instruments adequately reflect the health impacts captured by sleep-specific measures in individuals with diagnosed sleep disorders, and to explore implications for public health monitoring and policy.

METHODS:
Data from 1,230 Australians with sleep disorders were analysed. Two generic instruments (EQ-5D-5L, SF-36) were compared with three sleep-specific tools (ISI, ESS, PSQI). Exploratory and confirmatory factor analyses were used to identify underlying latent constructs and latent path analysis, guided by the International Classification of Functioning, Disability and Health (ICF) framework, examined conceptual overlap between generic and condition-specific metrics.

RESULTS:
Correlations between generic and sleep-specific dimensions were low to moderate (0.05–0.68). Three latent factors emerged from the EFA but none of the generic instrument dimensions aligned with sleep-specific traits. Structural relationships between factors were only moderate (path coefficients 0.15–0.31), and generic CFA models failed to converge, indicating limited sensitivity to condition-specific burden.

CONCLUSIONS:
Generic QoL tools may mask important dimensions of sleep health burden, threatening the accuracy of population surveillance and fairness of resource distribution. Strengthening public health evaluation frameworks requires integrating condition-specific instruments to support responsive, equitable, and evidence-informed health policy.