Utility of Subjective Sleep Assessment Tools for Healthy Preschool Children: A Comparative Study Between Sleep Logs, Questionnaires, and Actigraphy

Abstract

BackgroundSleep pattern is an important factor in a child’s mental, behavioural and physical status. To evaluate the sleep patterns of children, subjective tools such as sleep logs and questionnaires are still widely used in addition to objective methods of sleep assessment. Despite the established correlation between subjective and objective sleep variables, the characteristic features of subjective assessment have not been elucidated.MethodsTo investigate the characteristics of parental sleep assessment (daily sleep log and brief questionnaire) in preschool children, a 7-day actigraphic sleep study was conducted in 48 healthy 5-year-old children.ResultsSleep schedule variables in the parental reports generally correlated well with actigraphic assessment of sleep patterns; however, sleep periods were longer in parental reports than in actigraphic recordings. Although the daily sleep log was better correlated with actigraphy, the brief questionnaire showed a good correlation with sleep pattern on weekday actigraphic assessments. Parental reports recorded fewer than 10% of the night wakings recorded by actigraphy.ConclusionsSubjective sleep assessments remain useful, although their utility depends on the purpose and size of the study in question. However, knowledge of the potential biases and characteristics of such assessments is essential for correct interpretation of the data.

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“…Report of a moderate/severe sleep problem determined the child's trial eligibility. We used caregiver report because (1) parent perception of a sleep problem is a key driver of help-seeking behavior, (2) the definition of what constitutes a sleep problem from a research perspective remains a hotly debated topic, 30 (3) subjective measures are more cost-effective and feasible to use than objective measures for determination of child sleep problems in large population-based settings, 31 and (4) parent report captures behavioral bedtime problems better than actigraphy.…”