Validation of Self-Reported Sleep Against Actigraphy

Abstract

BackgroundSelf-report remains the most practical and cost-effective method for epidemiologic sleep studies involving large population-based samples. Several validated questionnaires have been developed to assess sleep, but these tools are lengthy to administer and may be impractical for epidemiologic studies. We examined whether a 3-item sleep questionnaire, similar to those typically used in epidemiologic studies, closely corresponded with objective measures of sleep as assessed using actigraphy monitoring.MethodsEligible participants were Western Australian women aged 18 to 80 years. Participants completed a sleep questionnaire, wore a wrist actigraph for 7 nights, and completed a brief daily sleep log. Objective actigraphy measurements for 56 participants were summarized by mean and mode and compared with the subjective reports, using weighted kappa and delta.ResultsData collected from the questionnaire showed poor agreement with objectively measured sleep, with kappas ranging from −0.19 to 0.14.ConclusionsOur results indicate that sleep questions typically used in epidemiologic studies do not closely correspond with objective measures of sleep as assessed using actigraphy. The findings have implications for studies that have used such sleep questions. A means of appropriately measuring sleep as a risk factor in epidemiologic studies remains to be determined.

Recent Evidence on Worldwide Trends on Sleep Duration

“…The difference between objective measures and the responses to these simple questions is also biased-the further the respondent's objective sleep duration is A g e s≥18 Repeat cross-sectional data from national time-use surveys 1975,1980,1985,1990,1995,2000,2005 (7) Time-use-weekly sleep (7- See also an updated report to 2009 for changes in timing of sleep and only a ten minute increase in sleep duration [15] from 7 h the greater the discrepancy, at least in younger people with mental health issues [17]. Other studies comparing simple self-report to actigraphic measures of sleep have found only very modest correlations [18][19][20] but unfortunately have not reported the agreement plots. Despite their presumed 'face validity' (they appear like they should measure sleep duration), simple questions about sleep duration remain an unvalidated instrument and it is not entirely clear what exactly is being measured by them [21].…”

Self‐Reported Sleep Duration and Quality and Cardiovascular Disease and Mortality: A Dose‐Response Meta‐Analysis

“…Another study of 2086 Hispanic Americans suggests a moderate correlation between self‐reported sleep and actigraphy results 98. A smaller study that compared self‐reported sleep and actigraphy in 56 participants reported a poor agreement between sleep duration and quality, as assessed by a questionnaire and objectively measured sleep 99. In addition, a different analysis of 63 patients who were overweight and obese individuals and who underwent actigraphy also reported a weak correlation between usual sleep time and actigraph estimates 100.…”

Systematic review of the relationships between sleep duration and health indicators in school-aged children and youth

“…While actigraphy can have its own challenges, it generally provides a good objective estimate of sleep duration (Sadeh 2011). In contrast, sleep questions typically used in epidemiologic studies do not agree very well with objective measures of sleep as assessed using actigraphy (Girschik et al 2012). This can certainly have implications for studies that are using self-reported sleep and it emphasizes the need for more accurate measures of sleep duration in future studies.…”