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. 2019 Sep 11:11:197-206.
doi: 10.2147/NSS.S217867. eCollection 2019.

Subjective sleep measurement: comparing sleep diary to questionnaire

David C Mallinson  1 , Maria E Kamenetsky  1 , Erika W Hagen  1 , Paul E Peppard  1
Affiliations

Subjective sleep measurement: comparing sleep diary to questionnaire

David C Mallinson et al. Nat Sci Sleep. .

Abstract

Purpose: The sleep diary is the gold standard of self-reported sleep duration, but its comparability to sleep questionnaires is uncertain. The purpose of this study was to compare self-reported sleep duration between a sleep diary and a sleep questionnaire and to test whether sleep-related disorders were associated with diary-questionnaire differences in sleep duration.

Participants and methods: We compared self-reported sleep duration from 5,432 questionnaire-sleep diary pairs in a longitudinal cohort of 1,516 adults. Participants reported sleep information in seven-day sleep diaries and in questionnaires. Research staff abstracted average sleep durations for three time periods (overall; weekday; weekend) from diaries and questionnaires. For each time period, we evaluated diary-questionnaire differences in sleep duration with Welch's two-sample t-tests. Using linear mixed effects regression, we regressed overall diary-questionnaire sleep duration difference on several participant characteristics: reporting any insomnia symptoms, having sleep apnea, sex, body mass index, smoking status, Short Form-12 Physical Health Composite Score, and Short Form-12 Mental Health Composite Score.

Results: The average diary-reported overall sleep duration (7.76 hrs) was longer than that of the questionnaire (7.07 hrs) by approximately 41 mins (0.69 hrs, 95% confidence interval: 0.62, 0.76 hrs). Results were consistent across weekday- and weekend-specific differences. Demographic-adjusted linear mixed effects models tested whether insomnia symptoms or sleep apnea were associated with diary-questionnaire differences in sleep duration. Insomnia symptoms were associated with a 17 min longer duration on the diary relative to the questionnaire (β=0.28 hrs, 95% confidence interval: 0.22, 0.33 hrs), but sleep apnea was not significantly associated with diary-questionnaire difference. Female sex was associated with greater diary-questionnaire duration differences, whereas better self-reported health was associated with lesser differences.

Conclusion: Diaries and questionnaires are somewhat disparate methods of assessing subjective sleep duration, although diaries report longer duration relative to questionnaires, and insomnia symptoms may contribute to greater perceived differences.

Keywords: comparison; self-reported sleep; sleep log; surveys.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Histograms of baseline diary-reported and questionnaire-reported overall sleep durations in the retirement and sleep trajectories study (n=1,516)a. Key: Dark gray indicates questionnaire-reported sleep duration; light gray indicates sleep diary-reported sleep duration; dashed lines indicate the mean sleep duration for their respective measure. Each bar represents a 15 min block of sleep duration. aThere were 5,313 questionnaire-diary pairs for 1,516 study participants, and each participant returned at least one of potentially four questionnaire-diary pairs throughout the study duration. We used baseline questionnaire-diary pairs to generate the histograms.
Figure 2
Figure 2
Bland-Altman plots of diary-reported and questionnaire-reported sleep durations by insomnia symptom status (A) and sleep apnea status in the retirement and sleep trajectories study (B) (n=5,313)a. Key: Circles indicate “No insomnia symptoms”; x’s indicate “Any insomnia symptom”; squares indicate “No self-reported sleep apnea”; stars indicate “Self-reported sleep apnea”; solid lines indicate the mean sleep duration difference; dashed lines indicate plus or minus two standard deviations from the mean sleep duration difference. Average of Sleep Durations = (diary-reported overall sleep duration + questionnaire-reported overall sleep duration)/2. Sleep Duration Difference = (diary-reported overall sleep duration) – (questionnaire-reported overall sleep duration). aThere were 5,313 questionnaire-diary pairs for 1,516 study participants, and each participant returned at least one of potentially four questionnaire-diary pairs throughout the study duration.
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