An Investigation into the Strength of the Association and Agreement Levels between Subjective and Objective Sleep Duration in Adolescents

Abstract

Study ObjectivesThe majority of adolescent sleep research has utilized self-reported sleep duration and some have based information on a solitary question. Whilst some have claimed to have validated sleep survey data with objective actigraphy measures in adolescents, the statistical approach applied only demonstrates the strength of the association between subjective and objective sleep duration data and does not reflect if these different methods actually agree.MethodsData were collected as part of the Midlands Adolescents Schools Sleep Education Study (MASSES). Adolescents (n=225) aged 11-13 years provided estimates for weekday, weekend and combined sleep duration based on self-reported survey data, a 7-day sleep diary, and wrist-worn actigraphy.ResultsWe assessed the strength of the relationship as well as agreement levels between subjective and objectively determined sleep duration (weekday, weekend and combined). Subjective diary sleep duration was significantly correlated with actigraphy estimates for weekday and weekend sleep duration r=0.30, p≤0.001 and r=0.31, p≤0.001 respectively. Pitman’s test demonstrated no significant difference in the variance between weekend sleep duration (r=0.09, p=0.16) and combined sleep duration (r=0.12, p=0.08) indicating acceptable agreement between actigraphy and sleep diary sleep duration only. Self-reported sleep duration estimates (weekday, weekend and combined) did not agree with actigraphy determined sleep duration.ConclusionsSleep diaries are a cost-effective alternative to survey/questionnaire data. Self-reported measures of sleep duration in adolescents do not agree with actigraphy measures and should be avoided where possible. Previous adolescent sleep studies that have utilized self-reported survey data may not provide a complete representation of sleep on the outcome measure of interest.

Insufficient Sleep in Adolescents and Young Adults: An Update on Causes and Consequences

“…It is important to note that studies comparing selfreported sleep duration with objectively measured sleep amounts (ie, with actigraphy) suggest that self-reports of sleep often overestimate actual sleep duration, signifying that the problem of chronic sleep loss in adolescents may be even greater than the data indicate. 12 US-based 4,13 and international studies 5,6,14 revealed that as students get older, sleep durations decline. The National Sleep Foundation Sleep in America Poll 4 found that by the 12th grade, 75% of students self-reported sleep durations of less than 8 hours of sleep per night compared with 16% of sixth graders.…”

“…25 However, higher socioeconomic status is not necessarily protective because studies have also shown that youth from households with higher socioeconomic status have shorter sleep durations. 16,26 For older adolescents, additional environmental factors, such as after-school employment, 16 striving for good grades, 5,6,12 socializing, 27,28 participation in sports and other extracurricular activities, and lack of parental monitoring or rules about bedtimes, can further interfere with sleep durations. 6,29,30 School start times are reviewed later in the present report.…”

The Impact of Sleep Debt on Excess Adiposity and Insulin Sensitivity in Patients with Early Type 2 Diabetes Mellitus

“…Average weekday sleep duration was then calculated by adding sleep duration from Sunday through to Thursday and dividing by 5. 13 Similarly, average weekend sleep duration was derived in the same manner by adding sleep duration for Friday and Saturday and dividing by 2. 13 We then derived weekday sleep debt (average weekend sleep duration minus average weekday sleep duration).…”

“…13 Similarly, average weekend sleep duration was derived in the same manner by adding sleep duration for Friday and Saturday and dividing by 2. 13 We then derived weekday sleep debt (average weekend sleep duration minus average weekday sleep duration). Participants were also asked to complete 7-day sleep diaries at 6 and 12 months post-intervention.…”

Sadly Awake: Short Sleep Duration and Depressive Symptoms among Adolescents

“…Adolescents' estimates of sleep duration are strongly correlated with objective measurement in weekday sleep reports, and only moderately correlated in weekend sleep reports [15,16]. Selfreport validity may be significantly enhanced by daily diary entries [20].…”