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Self-reported sleep duration and timing: A methodological review of event definitions, context, and timeframe of related questions

By Rebecca Robbins, Stuart Quan, Laura K Barger, Charles A Czeisler, Maya Frazy-Witzer, Matthew D Weaver, Ying Zhang, Susan Redline, Elizabeth B Klerman

Posted 11 Sep 2020
medRxiv DOI: 10.1101/2020.09.09.20191379

Background Clinical practice guidelines and population health recommendations are derived from studies that include self-reported data. Small semantic differences in question wording and response scales, may significantly affect the response. We conducted a methodological review to assess the variation in event definition(s), context (i.e., work- versus free-day), and timeframe of sleep timing and duration questions. Methods We queried multiple databases of sleep, medicine, public health, and psychology for survey-based studies and/or publications with sleep duration and/or timing questions. The text of these questions was extracted and thematically analyzed by two trained coders. Results We identified 49 surveys that included sleep duration and/or timing questions. Sample sizes of participants in the reviewed publications using these surveys ranged from 93 to 1,185,106. For sleep duration questions, participants were asked to report nocturnal sleep (22/43), sleep in the past 24-hours (15/43), their major sleep episode (3/43), or no event definition was given (3/43). Among bedtime questions, participants were asked to report the time into bed (17/40), fall asleep time (10/40), or first attempt to sleep (13/40). For wake time questions, participants were asked to report their out of bed time (3/36), the time they get up (6/36), or their wake up time (27/36). Context (e.g., work versus free day) guidance was provided in 18/43 major sleep duration questions, 31/40 bedtime questions, and 30/36 wake time questions. Timeframe (e.g., the past 4 weeks) was provided in 6/43 major sleep episode duration questions, 9/40 bedtime questions, and 3/36 wake time questions. Among the surveys analyzed, only one question asked about the method of awakening (e.g., spontaneously or by alarm clock), 15 questions assessed sleep latency, and eight measured napping. Conclusion There is large variability in the event definition(s), context, and timeframe of questions relating to duration, bed/wake times, latency, and napping. This work may inform future efforts at data harmonization for meta-analyses, provide options for question wording for researchers and clinicians, and be used to identify candidate questions for future surveys.

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