Related Experiment Video
Updated: Dec 28, 2025
Breakfast Habits among Schoolchildren in the City of Uruguaiana, Brazil
Published on: July 29, 2020
Validity of the Brief Infant Sleep Questionnaire (BISQ) in Brazilian children
Bianca Del-Ponte1, Mariana O Xavier1, Diego G Bassani2
1Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
Insights
The Brief Infant Sleep Questionnaire (BISQ) shows high specificity, validating its use for assessing childhood sleep quality in large studies. Parents' reports are reliable indicators of sleep issues.
Area of Science:
- Pediatrics
- Sleep Medicine
- Epidemiology
Background:
- Assessing sleep quality in infants and young children is crucial for developmental health.
- Parental questionnaires are common tools, but their validity requires rigorous evaluation.
- The Brief Infant Sleep Questionnaire (BISQ) is a widely used screening tool.
Purpose of the Study:
- To validate the Brief Infant Sleep Questionnaire (BISQ) for assessing sleep quality in children.
- To compare BISQ-defined sleep indicators with objective actigraphy measurements.
- To determine the sensitivity, specificity, and predictive values of BISQ indicators across different infant ages.
Main Methods:
- A validation study involving 586 children from the Pelotas 2015 Birth Cohort.
- BISQ administered to mothers at 3, 6, 12, and 24 months.
- Objective sleep data collected via actigraphy (Actiwatch wGT3X-BT) for comparison.
Main Results:
- High specificity (>85%) for BISQ indicators like >3 wakings/night and <9h total sleep duration across all ages.
- Accuracy was notable for <9h total sleep at 3, 6, 12 months and >3 wakings at 24 months.
- Sensitivity for any BISQ indicator decreased with age, while specificity increased.
Conclusions:
- The BISQ demonstrates high specificity, supporting its validity for epidemiological research on childhood sleep.
- Parental reports via BISQ are reliable for identifying potential sleep-related problems in young children.
- The findings support the use of BISQ in large-scale population studies.
Objective:
To investigate the validity of the Brief Infant Sleep Questionnaire (BISQ), in assessing sleep quality in childhood.
Methods:
This was a validation study with children from the Pelotas 2015 Birth Cohort. BISQ was applied to mothers when their children were 3, 6, 12, and 24 months of age. The poor sleep indicators analysed, as defined by BISQ, were >3 wakings per night, nocturnal wakefulness >1 h and total sleep duration <9/24 h, compared to number of wakings per night and nocturnal and total sleep duration defined by actigraphy taken as the gold standard. The Actiwatch wGT3X-BT device was used by the child consecutively during five days at three and six months and for three days at 12 and 24 months. At each age the prevalence, sensitivity, specificity, accuracy, and positive (PPV) and negative predictive values (NPV) of each sleep indicator was calculated.
Results:
A total of 586 children were enrolled in the study. Nocturnal wakefulness >1 h was the most frequent indicator at all ages, with higher sensitivity (varying from 27.5% at six months to 54.8% at three) and lower specificity (53.4% at three months to 79.4% at six months), in comparison to the other sleep indicators. Specificity for >3 wakings and total sleep duration <9 h was greater than 85.0% at all the ages. Higher accuracies were observed for total sleep <9 h at 3 (85.6%), 6 (88.2%) and 12 months (73.6%) and for > 3 wakings at 24 months (84.5%). The sensitivity for the presence of at least one indicator decreased with age from 56.0% at three months to 35.8% at 24 months, whereas the specificity increased from 50.6% at three months to 63.8% at 24 months.
Conclusion:
The high specificity of the BISQ sleep parameters supports the validity of parents' reports on sleep-related problems in childhood for use in epidemiological studies.
