Characterizing device-measured sleep in observational health research using compositional data analysis: a systematic...

Compositional data analysis (CoDA) is widely used to examine the associations between one's balance of movement behaviors (sedentary behavior, physical activity, and sleep) and health outcomes. Existing reviews have primarily focused on reporting standards for physical activity and sedentary behavior, but have not considered the contribution of sleep reporting to our understanding of CoDA.Purpose To characterize device-based sleep data measurement, processing, and reporting in studies using CoDA to examine associations between movement behaviors and health indicators.Methods A systematic search was conducted in seven databases, along with supplemental strategies (forward and backward citation searches and expert review). Observational studies published since 2015 that employed CoDA approaches using isometric log-ratio transformations to examine the associations between movement behavior compositions utilizing device-based measures of sleep and health outcomes were included. Data extraction included items based on sleep actigraphy measurement, processing, and reporting practices recommended by the American Academy of Sleep Medicine. The National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies was used to assess study quality.Results Among the 70 included studies (n = 60 cross-sectional, n = 10 longitudinal), few articles reported key sleep measurement and processing information. Most articles (n = 67) included only one sleep component in the time-use composition, and less than half of the articles (n = 29) acknowledged sleep-related limitations. Reports were classified as having good (n = 60) or poor (n = 10) study quality.Conclusions This review identified inconsistencies in the measurement, processing, and reporting of device-measured sleep in studies using CoDA. Varying protocols and reporting on sleep data processing highlight the need for adoption of current standardized approaches and reporting practices. Future research should prioritize transparency and consistency to improve the validity and comparability of findings on sleep's role as a key component of the integrative 24-h approach to health.