Validation of Self-Reported Sleep Against Actigraphy

Background Self-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. Methods Eligible 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. Results Data collected from the questionnaire showed poor agreement with objectively measured sleep, with kappas ranging from −0.19 to 0.14. Conclusions Our 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.

[1]  A. Feinstein,et al.  High agreement but low kappa: I. The problems of two paradoxes. , 1990, Journal of clinical epidemiology.

[2]  A. Hofman,et al.  Disagreement between subjective and actigraphic measures of sleep duration in a population‐based study of elderly persons * , 2008, Journal of sleep research.

[3]  A. Tamakoshi,et al.  Association of sleep duration with mortality from cardiovascular disease and other causes for Japanese men and women: the JACC study. , 2009, Sleep.

[4]  L. Fritschi,et al.  Reliability of a Sleep Quality Questionnaire for Use in Epidemiologic Studies , 2012, Journal of epidemiology.

[5]  D. Kripke,et al.  Mortality associated with sleep duration and insomnia. , 2002, Archives of general psychiatry.

[6]  E. van Cauter,et al.  The metabolic consequences of sleep deprivation. , 2007, Sleep medicine reviews.

[7]  T H Monk,et al.  The Pittsburgh Sleep Diary , 1994, Journal of sleep research.

[8]  Lijing L. Yan,et al.  Intra-individual daily and yearly variability in actigraphically recorded sleep measures: the CARDIA study. , 2007, Sleep.

[9]  A. Petrie,et al.  Method agreement analysis: a review of correct methodology. , 2010, Theriogenology.

[10]  Markku Partinen,et al.  Sleep duration and breast cancer: a prospective cohort study. , 2005, Cancer research.

[11]  C. Guilleminault,et al.  Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. , 2004, Sleep.

[12]  R. Stafford,et al.  Principles and Practice of Sleep Medicine , 2001 .

[13]  D. Skene,et al.  Comparison between subjective and actigraphic measurement of sleep and sleep rhythms , 1999, Journal of sleep research.

[14]  J. Shaver,et al.  Stress Exposure, Psychological Distress, and Physiological Stress Activation in Midlife Women With Insomnia , 2002, Psychosomatic medicine.

[15]  Nick Glozier,et al.  Is sleep duration related to obesity? A critical review of the epidemiological evidence. , 2008, Sleep medicine reviews.

[16]  S. Kuriyama,et al.  Sleep duration and the risk of prostate cancer: the Ohsaki Cohort Study , 2008, British Journal of Cancer.

[17]  A. Trentham-Dietz,et al.  Duration of sleep and breast cancer risk in a large population‐based case–control study , 2006, Journal of sleep research.

[18]  S. Kagamimori,et al.  Validity of Child Sleep Diary Questionnaire among Junior High School Children , 2005, Journal of epidemiology.

[19]  David P White,et al.  A prospective study of sleep duration and mortality risk in women. , 2004, Sleep.

[20]  J. Chiou,et al.  Validation of the Taiwanese version of the Athens Insomnia Scale and assessment of insomnia in Taiwanese cancer patients. , 2011, Journal of pain and symptom management.

[21]  Tokie Anme,et al.  Utility of Subjective Sleep Assessment Tools for Healthy Preschool Children: A Comparative Study Between Sleep Logs, Questionnaires, and Actigraphy , 2010, Journal of epidemiology.

[22]  Bo Hedblad,et al.  Incidence of diabetes in middle-aged men is related to sleep disturbances. , 2004, Diabetes care.

[23]  R. Bootzin,et al.  Derivation of research diagnostic criteria for insomnia: report of an American Academy of Sleep Medicine Work Group. , 2004, Sleep.

[24]  H. Shimizu,et al.  Sleep disturbance and onset of type 2 diabetes. , 2004, Diabetes care.

[25]  A. M. Andrés,et al.  Chance-corrected measures of reliability and validity in K K tables , 2005, Statistical methods in medical research.

[26]  A. Harvey,et al.  The subjective meaning of sleep quality: a comparison of individuals with and without insomnia. , 2008, Sleep.

[27]  D Minors,et al.  The Subjective Meaning of Good Sleep, An Intraindividual Approach Using the Karolinska Sleep Diary , 1994, Perceptual and motor skills.

[28]  Jovelyn Du-Quiton,et al.  Validation of actigraphy to assess circadian organization and sleep quality in patients with advanced lung cancer , 2011, Journal of circadian rhythms.

[29]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[30]  Markku Partinen,et al.  Sleep and mortality: a population-based 22-year follow-up study. , 2007, Sleep.

[31]  Y Ohno,et al.  Sleep patterns and total mortality: a 12-year follow-up study in Japan. , 2000, Journal of epidemiology.

[32]  S. Walter,et al.  Sample size and optimal designs for reliability studies. , 1998, Statistics in medicine.

[33]  Jesse Green,et al.  A systematic review of patient-reported outcome instruments measuring sleep dysfunction in adults , 2012, PharmacoEconomics.

[34]  A. Sadeh,et al.  The role of actigraphy in sleep medicine. , 2002, Sleep medicine reviews.

[35]  Daniel J Buysse,et al.  The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research , 1989, Psychiatry Research.

[36]  Scott Davis,et al.  Factors associated with objective (actigraphic) and subjective sleep quality in young adult women. , 2005, Journal of psychosomatic research.

[37]  S. Kuriyama,et al.  Sleep duration and the risk of breast cancer: the Ohsaki Cohort Study , 2008, British Journal of Cancer.

[38]  Sonia Ancoli-Israel,et al.  Towards an understanding of self‐reports of sleep , 2002, Journal of sleep research.

[39]  L. Berkman,et al.  Mortality risk associated with sleeping patterns among adults. , 1983, Sleep.

[40]  Gahan Fallone,et al.  Evidence for the validity of a sleep habits survey for adolescents. , 2003, Sleep.

[41]  J. Yesavage,et al.  Perceptions of life stress and chronic insomnia in older adults. , 1995, Psychology and Aging.

[42]  Paul J Rathouz,et al.  Self-Reported and Measured Sleep Duration: How Similar Are They? , 2008, Epidemiology.

[43]  C. Pollak,et al.  The role of actigraphy in the study of sleep and circadian rhythms. , 2003, Sleep.