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Updated: Sep 23, 2025

Collecting Sleep, Circadian, Fatigue, and Performance Data in Complex Operational Environments
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Discrepancy between subjective and objective sleepiness in adolescents.

Oyunsuren Munkhjargal1, Yasunori Oka2, Sakurako Tanno2

  • 1Department of Regional Pediatrics and Perinatology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon, Ehime, 791-0295, Japan; Center for Sleep Medicine, Ehime University Hospital, 454 Shitsukawa, Toon, Ehime, 791-0295, Japan.

Sleep Medicine
|May 15, 2022
PubMed
Summary

Discrepancies between how sleepy adolescents feel and objective sleepiness measures are common. Neurodevelopmental disorders, age, and bedtime influence subjective sleepiness without objective findings.

Keywords:
AdolescenceEpworth sleepiness scaleMultiple sleep latency testObjective sleepinessSubjective sleepiness

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Area of Science:

  • Pediatric Sleep Medicine
  • Neurodevelopmental Disorders
  • Sleep Physiology

Background:

  • Subjective and objective measures of daytime sleepiness often lack correlation in clinical practice.
  • Understanding this discrepancy is crucial for accurate diagnosis and management of sleep disorders in adolescents.

Purpose of the Study:

  • To investigate the frequency of discrepancy between subjective and objective sleepiness in an adolescent cohort.
  • To identify predictors associated with these discrepancies, particularly subjective sleepiness without objective findings.

Main Methods:

  • Evaluated 211 pediatric patients (aged 10-18) with sleep disorder symptoms.
  • Assessed subjective sleepiness using the Japanese Epworth Sleepiness Scale and objective sleepiness via the Multiple Sleep Latency Test.
  • Employed multivariable logistic regression to identify discrepancy-related factors.

Main Results:

  • A significant discrepancy rate of 46.4% was observed between subjective and objective sleepiness.
  • Subjective sleepiness without objective sleepiness occurred in 35.5% of patients, while objective sleepiness without subjective sleepiness occurred in 10.9%.
  • Neurodevelopmental disorders were associated with subjective sleepiness (OR, 4.12) and concordant sleepiness (OR, 7.54).

Conclusions:

  • Nearly half of adolescents experience a mismatch between perceived and measured sleepiness, with subjective overestimation being more common.
  • Factors like age, bedtime, and neurodevelopmental disorders significantly predict subjective sleepiness in the absence of objective findings.
  • These findings highlight the complexity of assessing adolescent sleepiness and the importance of considering comorbid conditions.