Article

Agreement rates between actigraphy, diary, and questionnaire for children's sleep patterns

Child Development Center, University Children's Hospital Zurich, Steinwiesstrasse 75, CH-8032 Zurich, Switzerland.
JAMA Pediatrics (Impact Factor: 4.25). 05/2008; 162(4):350-8. DOI: 10.1001/archpedi.162.4.350
Source: PubMed

ABSTRACT To describe sleep-wake patterns in kindergarten children by measures derived from questionnaire, diary, and actigraphy and to report rates of agreement between methods according to Bland and Altman.
Cross-sectional study, data from 7 nights of actigraph recordings and sleep diary and from a questionnaire.
Children studied in their homes.
Fifty children, aged 4 to 7 years.
Sleep start, sleep end, assumed sleep, actual sleep time, and nocturnal wake time derived from different methods.
Differences between actigraphy and diary were +/- 28 minutes for sleep start, +/- 24 minutes for sleep end, and +/- 32 minutes for assumed sleep, indicating satisfactory agreement between methods, whereas for actual sleep time and nocturnal wake time, agreement rates were not sufficient (+/- 106 minutes and +/- 55 minutes, respectively). Agreement rates between actigraphy and questionnaire as well as between diary and questionnaire were insufficient for all variables. Sex and age of children and socioeconomic status did not influence the differences between methods for all variables.
Actigraphy and diary may be interchangeably used for the assessment of sleep start, sleep end, and assumed sleep but not for nocturnal wake times. The diary is a cost-effective and valid source of information about children's sleep-schedule times, while actigraphy may provide additional information about nocturnal wake times or may be used if parents are unable to report in detail. It is insufficient to collect information by a questionnaire or an interview asking about children's normal sleep patterns.

0 Bookmarks
 · 
230 Views
  • 03/2015; 1(1):44-49. DOI:10.1016/j.sleh.2014.12.001
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Parental ratings of poor sleep have been associated with early onset of substance use and substance-related problems during adolescence and young adulthood. Children of alcohol-dependent parents have an increased risk for depression as well as substance-related problems. We conducted the current study to describe sleep-wake patterns in children of alcoholics (COAs) compared to non-alcoholic families (NCOAs), to explore the relationships among sleep assessment methods by groups, and to report rates of agreement between methods by group. We assessed subjective (sleep diaries) and objective (actigraphy-measured) sleep in children with (N=68) and without (N=24) a parental history of alcohol use disorder between 7.2 and 12.9 (mean 10.2 +/-1.2) years of age. Children were instructed to complete the sleep diaries with assistance from parents only if needed. Parents provided descriptions of their child's sleep in a Pediatric Sleep Questionnaire (PSQ). Results showed that COAs reported sleeping slightly less time at night and were more likely to nap during the day. Actigraphy captured fewer hours of sleep and more nighttime motor activity. Sleep diary variables were highly correlated with parent reports on the PSQ, except for bedtimes in some COAs, which were later than parent's estimations. Conclusion: School-aged COAs showed small but significant differences in their sleep characteristics compared to NCOAs. COA self-reported sleep diaries agreed with parental reports, but differed significantly from actigraphy measurements of sleep continuity. Insufficient sleep in COAs may be an additional risk factor as they approach adolescence. Identifying sleep problems early on in life may have important implications for prevention and intervention for mood and substance use disorders. There are a myriad of potential factors that could contribute to the early onset of substance use, including, additive and interactive genetic variations, environmental factors, and childhood psychiatric disorders. Genetic factors account for about 50% of the risk for alcoholism [16]. Children of alcohol-dependent parents have an increased risk for depression as well as substance-related problems [17]. Differences in sleep or circadian rhythms may predispose to early substance use in children deemed at high risk [18], but it is not clear how such differences predispose to the development of substance related symptoms once drinking has begun. Methodological examination of sleep in the pediatric population The use of actigraphy is a method to assess normal and disturbed sleep-wake patterns in children. It is easy to use in the home environment compared to PSG. Actigraphy has been well validated as a way to measure sleep-wake patterns, sleep quality, and quantity in normal healthy children [19,20]. Studies on actigraphy in children (ages ranging from infants to 12 years of age) are typically accompanied by a sleep diary completed by the parent(s) [19,21-24]. High correlations have been found between actigraphy and parent reported sleep start and stop times [24] and with " trouble sleeping " Abbreviations COA: Children of Alcoholic; NCOA: Not a Child of an Alcoholic; SOL: Sleep Onset Latency; WASO: Wake time After Sleep Onset; TST: Total Sleep Time; SE: Sleep Efficiency
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Sleep is a vital physiological behavior in children's development, and as such it is important to be able to efficiently and accurately assess whether children display difficulties with sleep quality and quantity. The Children's Sleep Habits Questionnaire [CSHQ; (1)] is one of the most commonly used assessment tools for pediatric sleep. However, this instrument has never been validated against the gold standard of sleep measurement [i.e., polysomnography (PSG)], and studies comparing it to actigraphy are limited. Therefore, the current study assessed the validity of four subscales of the CSHQ via direct comparison with PSG and actigraphy for 30 typically developing school-aged children (ages 6-12). No significant correlations between relevant CSHQ subscales and PSG variables were found. In terms of the actigraphy variables, only the CSHQ Night Wakings subscale achieved significance. In addition, sensitivity and specificity analyses revealed consistently low sensitivity and high specificity. Overall, the CSHQ Sleep Onset Delay, Sleep Duration, Night Wakings, and Sleep Disordered Breathing subscales showed low construct validity and diagnostic validity. These results underscore that caution should be taken when using the CSHQ as the sole screening tool for sleep problems in children.
    Frontiers in Psychiatry 01/2014; 5:188. DOI:10.3389/fpsyt.2014.00188

Full-text (2 Sources)

Download
5 Downloads
Available from
Jan 6, 2015