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Comparison Between Actigraphy Records and Parental Reports of Child's Sleep
Catarina Perpétuo1, Marília Fernandes1, Manuela Veríssimo1
1William James Center for Research, ISPA - Instituto Universitário, Lisbon, Portugal.
Insights
Actigraphy and parental questionnaires (CSHQ) show weak agreement for measuring sleep in preschoolers. Parents overestimate sleep times compared to actigraphy, suggesting a need for complementary use of both methods in research and clinical practice.
Area of Science:
- Pediatric Sleep Medicine
- Child Development Research
Background:
- Sleep significantly impacts preschool-aged children's development.
- Actigraphy and parental questionnaires are common sleep assessment tools, but their agreement in young children is understudied.
- Parental reports often overestimate sleep duration, while actigraphy may increase reported night awakenings.
Purpose of the Study:
- To compare actigraphy data with parental reports from the Children's Sleep Habits Questionnaire (CSHQ).
- To assess agreement on bedtime, wake-up time, total sleep duration, and wake after sleep onset (WASO) in preschool children.
- To evaluate the clinical utility of each method for assessing pediatric sleep patterns.
Main Methods:
- Employed the Bland-Altman technique to compare actigraphy and CSHQ data.
- Included 46 preschool-aged children (3-6 years) and their parents.
- Analyzed sleep schedule variables including bedtime, wake-up time, total sleep time, and WASO.
Main Results:
- Significant differences and weak agreements were found between actigraphy and CSHQ measurements.
- Parents tended to overestimate bedtime and wake-up times compared to actigraphy.
- Discrepancies included ±52 min for weekly bedtime, ±38 min for weekly wake-up time, ±159 min for total sleep time, and ±62 min for WASO.
Conclusions:
- Actigraphy and CSHQ show unsatisfactory agreement for assessing sleep parameters in preschool children.
- Each instrument has tendencies to overestimate or underestimate specific sleep metrics.
- Complementary use of both actigraphy and CSHQ is recommended for better clinical practice and research in pediatric sleep.
Abstract:
Given the impact of sleep in several domains of a child's development, the comparison between actigraphy and parental questionnaires is of great importance in preschool-aged children, an understudied group. While parental reports tend to overestimate sleep duration, actigraphy boosts the frequency of night-waking's. Our primary goal was to compare actigraphy data and parental reports (Children's Sleep Habits Questionnaire, CSHQ), regarding bedtime, wake-up time, sleep duration, and wake after sleep onset (WASO), using the Bland-Altman technique. Forty-six children, age 3-6 years, and their parents participated. Results suggest that, despite existing associations between sleep schedule variables measured by both methods (from r = 0.57 regarding bedtime at weekends to r = 0.86 regarding wake-up time during the week, ps), differences between them were significant and agreements were weak, with parents overestimating bedtimes and wake-up times in relation to actigraphy. Differences between actigraphy and CSHQ were ± 52 min for weekly bedtime, ± 38 min for weekly wake-up time, ±159 min for total sleep time, and ± 62 min for WASO, indicating unsatisfactory agreement between methods. Correlations between actigraphy data and CSHQ dimensions are also explored. Our study contributes to the knowledge of the characteristics of each instrument, along with their tendency to overestimate and underestimate certain sleep parameters. We conclude that a complementary use of both instruments would better inform clinical practice and research on a child's sleep.
