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Validation of the newly developed Sleep Screening Questionnaire Children and Adolescents (SSQ-CA) with objective
Cecilie Paulsrud1, Steffen U Thorsen2, Pernille Helms1
1Steno Diabetes Center Copenhagen, Denmark; Department of Pediatrics, Herlev and Gentofte University Hospital, Denmark.
Insights
The Sleep Screening Questionnaire Children and Adolescents (SSQ-CA) is a reliable tool for assessing sleep disturbances in children and adolescents aged 6-17. It shows acceptable validity when used alongside objective sleep measures.
Area of Science:
- Pediatric Sleep Medicine
- Psychometrics
- Child and Adolescent Health
Background:
- Validated pediatric sleep questionnaires are scarce, particularly those covering a wide age range and various sleep disturbances.
- The development of reliable and objective tools for assessing sleep in children is crucial for early diagnosis and intervention.
Purpose of the Study:
- To develop and validate the Sleep Screening Questionnaire Children and Adolescents (SSQ-CA) for children aged 6-17.
- To compare the SSQ-CA's performance against objective sleep parameters like actigraphy and polysomnography.
Main Methods:
- The SSQ-CA was developed by a multidisciplinary panel and face-validated.
- A cross-sectional study involved 128 participants (aged 6-17) who completed the SSQ-CA twice, wore actigraphy, and underwent home polysomnography.
- Exploratory factor analyses, reliability, and validity assessments were conducted.
Main Results:
- The SSQ-CA demonstrated adequate internal consistency (0.54-0.92) and test-retest reliability (0.71-0.87).
- Total sleep time from SSQ-CA correlated significantly with actigraphy and polysomnography.
- Specific subscales showed varying correlations with objective measures, indicating complementary information.
Conclusions:
- The SSQ-CA is a reliable screening tool for sleep disturbances in children and adolescents aged 6-17.
- Its acceptable criterion validity, especially for specific subscales, supports its use in conjunction with objective sleep assessments.
- The questionnaire appears valuable for identifying sleep issues by capturing subjective experiences that may differ from objective findings.
Objectives:
Objectively validated pediatric sleep questionnaires covering a broader age range and different sleep disturbances are lacking, therefore we developed the Sleep Screening Questionnaire Children and Adolescents (SSQ-CA) and compared it with objective sleep parameters.
Methods:
This child-reported questionnaire was developed by a multidisciplinary panel and face validated. In a cross-sectional prospective design, participants aged 6-17, answered the questionnaire twice with 21-28 days in between, wore actigraphy (AG) and kept a sleep diary for seven nights and home-polysomnography (PSG) for one of these nights. Exploratory factor analyses (EFA), reliability and validity assessments were performed.
Results:
Of the 139 participants, 128 (F:47.7%, AG: n = 128, PSG: n = 59), were included in the analyses. Mean age: 11.3 years (SD: 2.9). EFA revealed 11 factors and 40 items loading above r = 0.4. Subscale internal consistency: 0.54-0.92. Subscale test-retest reliability: r = 0.71-0.87. Total sleep time (TST) from SSQ-CA on weekdays correlated with PSG (r = 0.48, p = 0.001) and with AG (r = 0.75, p < 0.001). The subscale total score for "Sleep duration and latency" correlated with TST from AG (r = -0.19, p = 0.03) and sleep latency (r = 0.31, p < 0.001), but not for PSG variables. The subscale "Awakenings" showed no correlation with objective measures whereas "Circadian rhythm" correlated to AG-derived mid-sleep time (r = 0.34, p < 0.001).
Conclusions:
The SSQ-CA shows adequate reliability for the 6-17-year-olds and acceptable criterion validity for two subscales. It appears to be a useful tool for screening for sleep disturbances in combination with objective tools as the subjective and objective parameters seem to uncover different aspects of sleep.
