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      Validation of Self-Reported Sleep Against Actigraphy

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          Abstract

          Background

          Self-report remains the most practical and cost-effective method for epidemiologic sleep studies involving large population-based samples. Several validated questionnaires have been developed to assess sleep, but these tools are lengthy to administer and may be impractical for epidemiologic studies. We examined whether a 3-item sleep questionnaire, similar to those typically used in epidemiologic studies, closely corresponded with objective measures of sleep as assessed using actigraphy monitoring.

          Methods

          Eligible participants were Western Australian women aged 18 to 80 years. Participants completed a sleep questionnaire, wore a wrist actigraph for 7 nights, and completed a brief daily sleep log. Objective actigraphy measurements for 56 participants were summarized by mean and mode and compared with the subjective reports, using weighted kappa and delta.

          Results

          Data collected from the questionnaire showed poor agreement with objectively measured sleep, with kappas ranging from −0.19 to 0.14.

          Conclusions

          Our results indicate that sleep questions typically used in epidemiologic studies do not closely correspond with objective measures of sleep as assessed using actigraphy. The findings have implications for studies that have used such sleep questions. A means of appropriately measuring sleep as a risk factor in epidemiologic studies remains to be determined.

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          Most cited references33

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          Statistical methods for assessing agreement between two methods of clinical measurement.

          In clinical measurement comparison of a new measurement technique with an established one is often needed to see whether they agree sufficiently for the new to replace the old. Such investigations are often analysed inappropriately, notably by using correlation coefficients. The use of correlation is misleading. An alternative approach, based on graphical techniques and simple calculations, is described, together with the relation between this analysis and the assessment of repeatability.
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            Self-reported and measured sleep duration: how similar are they?

            Recent epidemiologic studies have found that self-reported duration of sleep is associated with obesity, diabetes, hypertension, and mortality. The extent to which self reports of sleep duration are similar to objective measures and whether individual characteristics influence the degree of similarity are not known. Eligible participants at the Chicago site of the Coronary Artery Risk Development in Young Adults Study were invited to participate in a 2003-2005 ancillary sleep study; 82% (n = 669) agreed. Sleep measurements collected in 2 waves included 3 days each of wrist actigraphy, a sleep log, and questions about usual sleep duration. We estimate the average difference and correlation between subjectively and objectively measured sleep by using errors-in-variables regression models. Average measured sleep was 6 hours, whereas the average from subjective reports was 6.8 hours. Subjective reports increased on average by 34 minutes for each additional hour of measured sleep. Overall, the correlation between reported and measured sleep duration was 0.47. Our model suggests that persons sleeping 5 hours over-reported their sleep duration by 1.2 hours, and those sleeping 7 hours over-reported by 0.4 hours. The correlations and average differences between self-reports and measured sleep varied by health, sociodemographic, and sleep characteristics. In a population-based sample of middle-aged adults, subjective reports of habitual sleep are moderately correlated with actigraph-measured sleep, but are biased by systematic over-reporting. The true associations between sleep duration and health may differ from previously reported associations between self-reported sleep and health.
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              The metabolic consequences of sleep deprivation.

              The prevalence of diabetes and obesity is increasing at an alarming rate worldwide, and the causes of this pandemic are not fully understood. Chronic sleep curtailment is a behavior that has developed over the past 2-3 decades. Laboratory and epidemiological studies suggest that sleep loss may play a role in the increased prevalence of diabetes and/or obesity. Current data suggest the relationship between sleep restriction, weight gain and diabetes risk may involve at least three pathways: (1) alterations in glucose metabolism; (2) upregulation of appetite; and (3) decreased energy expenditure. The present article reviews the current evidence in support of these three mechanisms that might link short sleep and increased obesity and diabetes risk.
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                Author and article information

                Journal
                J Epidemiol
                J Epidemiol
                JE
                Journal of Epidemiology
                Japan Epidemiological Association
                0917-5040
                1349-9092
                5 September 2012
                28 July 2012
                2012
                : 22
                : 5
                : 462-468
                Affiliations
                [1 ]Western Australian Institute for Medical Research, The University of Western Australia, Nedlands, Australia
                [2 ]School of Population Health, The University of Western Australia, Crawley, Australia
                [3 ]Centre for Clinical Research in Neuropsychiatry, Graylands Hospital, and School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, Australia
                Author notes
                Address for correspondence. Jennifer Girschik, B Hlth Sc (Hons), Western Australian Institute for Medical Research, B Block, Ground Floor, Hospital Ave, Nedlands WA 6009, Australia (e-mail: jennifer.girschik@ 123456uwa.edu.au ).
                Article
                JE20120012
                10.2188/jea.JE20120012
                3798642
                22850546
                4fe90678-e42e-419b-94dc-77309fbcafd5
                © 2012 Japan Epidemiological Association.

                This is an open access article distributed under the terms of Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 31 January 2012
                : 5 April 2012
                Categories
                Original Article

                sleep,sleep duration,sleep quality,validity,actigraphy
                sleep, sleep duration, sleep quality, validity, actigraphy

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