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Estimating adolescent sleep patterns: parent reports versus adolescent self-report surveys, sleep diaries, and actigraphy

Estimating adolescent sleep patterns: parent reports versus adolescent self-report surveys, sleep... Nature and Science of Sleep Dovepress open access to scientific and medical research Open Access Full Text Article O R i G i NAL R ESEARCH Estimating adolescent sleep patterns: parent reports versus adolescent self-report surveys, sleep diaries, and actigraphy 1,2 Michelle A Short Background: In research and clinical contexts, parent reports are often used to gain informa- tion about the sleep patterns of their adolescents; however, the degree of concordance between Michael Gradisar parent reports and adolescent-derived measures is unclear. The present study compares parent Leon C Lack 1 estimates of adolescent sleep patterns with adolescent self-reports from surveys and sleep Helen R Wright diaries, together with actigraphy. Alex Chatburn Methods: A total of 308 adolescents (59% male) aged 13–17 years completed a school sleep School of Psychology, Flinders habits survey during class time at school, followed by a 7-day sleep diary and wrist actigraphy. University, Centre for Sleep Parents completed the Sleep, Medical, Education and Family History Survey. Research, University of South Australia, Adelaide, South Australia, Results: Parents reported an idealized version of their adolescent’s sleep, estimating signifi - Australia cantly earlier bedtimes on both school nights and weekends, significantly later wake times on weekends, and significantly more sleep than either the adolescent self-reported survey, sleep diary, or actigraphic estimates. Conclusion: Parent reports indicate that the adolescent averages a near-optimal amount of sleep on school nights and a more than optimal amount of sleep on weekends. However, adolescent-derived averages indicate patterns of greater sleep restriction. These results illustrate the importance of using adolescent-derived estimates of sleep patterns in this age group and the importance of sleep education for both adolescents and their parents. Keywords: concordance, parent, sleep, sleep measurement, survey, actigraphy Introduction Adolescent sleep patterns are measured in different ways. Many studies have relied 1–6 upon survey data to estimate adolescent sleep patterns, either using parent report, adolescent self-report surveys, or sleep diaries, but fewer have utilized actigraphic estimates of sleep. There is some uncertainty around the differences in results obtained 7,9 10 by these different methods, and around parent reporting in particular. One study found that parents of children aged 3–10 years overestimated their child’s sleep by an average of one hour and 53 minutes per night, compared with concurrently recorded actigraphic estimates. Parents may be susceptible to socially desirable responding when estimating the sleep patterns of their child. Further, parent reports of their adolescent’s sleep may align more closely with the time that adolescents spend in their Correspondence: Michelle A Short bedroom at night, because parents are not aware of the length of time spent awake Centre for Sleep Research, University after lights out. Given the many biopsychosocial factors which predispose adolescents of South Australia, GPO Box 2100, Adelaide SA 5001, Australia to later sleep-onset times (such as circadian phase delay, changes in accumulation of Tel +61 8 8302 1966 homeostatic sleep pressure, and increased academic and social responsibilities), plus Fax +61 8 8302 6623 Email [email protected] the propensity for adolescents to access computers, mobile phones, and music players submit your manuscript | www.dovepress.com Nature and Science of Sleep 2013:5 23–26 Dovepress © 2013 Short et al, publisher and licensee Dove Medical Press Ltd. This is an Open Access article http://dx.doi.org/10.2147/NSS.S38369 which permits unrestricted noncommercial use, provided the original work is properly cited. Short et al Dovepress after bedtime, parents may not be in a position to provide diary just before they went to bed each night and as soon as 12,13 accurate estimates of sleep. An exception to this may be they woke in the morning. Adolescents indicated exact times wake times, as parents of adolescents become less involved for all sleep variables. in regulating bedtimes but more involved in waking them In order to provide an objective measure of sleep, ado- in the morning. lescents wore MicroMini Motionlogger activity monitors This is a concern that has substantial ramifications in both (Ambulatory Monitoring, Ardsley, NY, USA) on the non- clinical and research settings. If parents are not able to describe dominant wrist. Data were digitized in one-minute epochs their adolescent’s sleep patterns accurately, it calls into question using zero crossing mode, with a sensitivity of 0.05 g, and previous research which has used this methodology. In addition, analyzed with Action W2 software using the Sadeh algorithm. if parents do not have an accurate estimation of their teen’s sleep, Diary data were used to define the scoring interval for sleep especially if they overestimate their sleep, they may not be aware according to the procedure outlined by Acebo et al. While of problematic levels of restricted sleep and so may not provide sleep onset is a biological state change that can be inferred the support required to address this. To address this concern, the from actigraphic movement data, bedtime is a behavioral phe- present study compared adolescent survey, sleep diary, and acti- nomenon that cannot be captured by analysis of movement. graphic estimates of sleep and time in bed with parent-reported Unfortunately, the activity monitors used were not equipped sleep. Consistent with the findings of Dayyat et al among with an event marker function to capture bedtime. As such, children aged 3–10 years, it is hypothesized that parent reports data regarding bedtime were collected from self-reported and will significantly overestimate sleep duration compared with parent-reported surveys and sleep diaries only. adolescent-derived estimates and actigraphy. It is also hypoth- Parents completed the Sleep, Medical, Education and esized that parents will significantly underestimate the lateness Family History Survey developed by Carskadon et al at the of adolescent bedtimes, but there will be no significant differ - Sleep for Science research laboratory at Brown University ence between parent and adolescent reports of wake times. (Carskadon, unpublished data, 1999). In addition to demo- The present study extends the previous work by including graphic items, this tool contains questions about the time adolescent-reported survey and sleep diary data in addition when the adolescent went to bed and woke up on school to actigraphy. (Sunday to Thursday) nights and weekends (Friday and Saturday nights). Materials and methods Results Participants One-way repeated-measures analyses of variance with post In total, 308 adolescents of mean age 15.6 ± 0.94 (range 13–17) hoc comparisons were utilized to compare average values years (59% male) with a parent or caregiver (77.2% mothers, of sleep parameters according to measurement mode, using 18.9% fathers, and 3.9% another family members/caregivers) the Statistical Program for the Social Sciences version 20 participated in this study. Participants were drawn from (SPSS Inc, Chicago, IL, USA). Analyses of variance were eight high schools in South Australia and were in years 9, conducted separately for school nights and weekend nights 10, and 11. Mean school start time was 8:32 am (standard for each sleep parameter. Table 1 shows mean values for sleep deviation 0.28 hours). The study had no exclusion criteria, variables according to measurement mode (either actigraphy, and adolescents were reimbursed for their time with a $40 gift sleep diary, self-report survey, or parent report), together with voucher. The Flinders University Social and Behavioral mean differences between parent reports and each measure Research Ethics Committee and the Department of Education and the signic fi ance of any differences observed. Bonferroni and Children’s Service approved this study. adjustments were made to allow for multiple comparisons. Measures The results of this study demonstrate significant and Adolescents completed a modified Sleep Habits Survey substantial differences between the averages estimated by during class time at school. This survey contained items actigraphy, sleep diary, and self-report of the adolescents relating to bedtime, wake time, and total sleep time for both and those reported by parents. Parents reported that their school nights and weekends. For the following week, they adolescents went to bed 14–18 minutes earlier and obtained completed a sleep diary morning and night, which asked 35–45 minutes more sleep on school nights compared with adolescents to record their daily bedtime, wake time, and adolescent-derived estimates. On weekends, parents reported sleep duration. Adolescents were asked to fill out the sleep that their adolescents went to bed 18–35 minutes earlier, submit your manuscript | www.dovepress.com Nature and Science of Sleep 2013:5 Dovepress Dovepress Parent reports of teen sleep Table 1 Mean values for sleep parameters from parent report compared to wrist actigraphy, sleep diary, and self-report survey, together with mean (±se) differences Variable Parent Actigraphy Diary Survey X X Diff (±se) P* X Diff (±se) P* X Diff (±se) P* School night Sleep period 8 h 51 m 8 h 06 m 45 m (2.92) 8 h 16 m 35 m (3.13) 8 h 10 m 41 m (4.26) ,0.001 ,0.001 ,0.001 Bedtime 10:09 pm – – – 10:28 pm 10:24 pm -18 m (0.04) ,0.001 -14 m (0.04) ,0.001 Wake time 6:57 am 7:03 am ns 7:07 am 6:54 am ns -6 m (0.04) -10 m (0.03) ,0.001 -3 m (0.02) Weekends Sleep period 10 h 01 m 8 h 29 m 1 h 32 m (6.17) ,0.001 8 h 41 m 1 h 21 m (6.09) ,0.001 9 h 21 m 40 m (6.72) ,0.001 Bedtime 11:20 pm – – – 11:38 pm 11:54 am -18 m (0.07) ,0.001 -35 m (0.07) ,0.001 Wake time 9:16 am 8:26 am 51 m (0.09) 8:30 am 47 m (0.08) 9:22 am 6 m (0.08) ns ,0.001 ,0.001 Notes: Actigraphic sleep period was calculated as the time elapsed from sleep onset to sleep offset; *bonferroni adjustment used to adjust for multiple comparisons. and obtained 40–92 minutes more sleep per night than overestimating wake times by 48–50 minutes. This finding adolescent-derived estimates. Parent wake time estimates on is unexpected, and inconsistent with previous findings. It school days were more similar to the reports derived from may be that parents are less involved in adolescent wake their adolescents, with only sleep diary estimates being a times on weekends when compared with school mornings, signic fi ant, but small, 10 minutes later than the parent report. and so are not able to provide accurate wake time estimates. Unlike wake times on school mornings, parent estimates of In addition, adolescents are more likely to maintain quiet weekend sleep were more divergent, with parents estimating wakefulness in the morning without disturbing their parent/s wake times occurring 47–51 minutes later than adolescent than are younger children. sleep diary and actigraphic estimates. The survey reported The differences between parent and adolescent and that weekend wake times were not significantly different actigraphic estimates of sleep are important, and show that from parent reports. adolescent sleep is likely to be much more restricted than their parents believe. In fact, parent reports reveal that they Discussion believe their teens are obtaining a near-optimal amount of How should we measure sleep. This is significant on two levels. The first important adolescent sleep? implication of these findings regards the utility of parent To the authors’ knowledge, this is the first study to compare reports for sleep research. Previous studies that have utilized parent reports of adolescent sleep with adolescent self-report, parent reports to estimate sleep are called into question. At sleep diary self-report, and actigraphy in typically develop- the very least, it is likely that these reports overestimate sleep ing adolescents. When comparing the different ways of col- and underestimate bedtimes. The present study provides sup- lecting data on adolescent sleep, significant differences in port for the use of adolescent reports in preference to parent results were obtained depending on the method used. Parents reports of teen sleep. Secondly, it highlights the importance reported a much more idealized sleep pattern, estimating of educating parents about teen sleep. It may be that because that their adolescent went to bed earlier and obtained more teens are less visible than younger children after they go to sleep on both school nights and on weekends than did the bed, parents assume that they are asleep, when in fact they adolescent. These results are consistent with those found in are likely to be awake. Particularly with the presence of a younger children. While there were some significant dif - wide array of electronic media in the bedroom and the bio- ferences in school morning wake time estimates between logical propensity toward phase delay and wakefulness in the parent reports and actigraphic and sleep diary estimates, evening, teens may quietly maintain wakefulness well into 17,18 these differences were small. Parents may be more accu- the night without parental awareness. Parents can have an rate in estimating their teens’ school morning wake times important role in regulating the sleep patterns of adolescents, compared with bedtimes because of the diminished parental with associated improvements in daytime functioning, but involvement in regulating adolescent bedtimes and increased are unlikely to act if they are not aware that their teens is not involvement in waking teens for school with increasing age. obtaining sufficient sleep. On weekends, the difference between parent reports and sleep A strength of this study is the range of sleep measures diary and actigraphy was greater for wake time, with parents obtained, in particular sleep diary and actigraphy, in a submit your manuscript | www.dovepress.com Nature and Science of Sleep 2013:5 Dovepress Short et al Dovepress 6. Laberge L, Petit D, Simard C, Vitaro F, Tremblay RE, Montplasir J. relatively large sample of adolescents and parents. The Development of sleep patterns in early adolescence. J Sleep Res. present study highlights the importance of relying upon 2001;10:59–67. adolescent-derived estimates to obtain data on sleep patterns 7. Wolfson AR, Carskadon MA, Acebo C, et al. Evidence for the validity of a sleep habits survey for adolescents. Sleep. 2003;26:213–216. in this age group. In addition, parent education is indicated 8. Gradisar M, Gardner G, Dohnt H. Recent worldwide sleep patterns to enable parents to have a more accurate picture of their and problems during adolescence: a review and meta-analysis of age, region, and sleep. Sleep Med. 2010;12:110–118. adolescents’ sleep. 9. Short MA, Gradisar M, Lack L, Wright H, Carskadon MA. The dis- crepancy between actigraphic and sleep diary measures of sleep in Acknowledgment adolescents. Sleep Med. 2012;13:378–384. 10. Dayyat EA, Spruyt K, Molfese DL, Gozal D. Sleep estimates in This work was conducted at the Flinders University of South children: parental versus actigraphic assessments. Nat Sci Sleep. Australia and was funded by the Australian Research Council 2011;3:115–123. 11. Pauls CA, Stemmler G. Substance and bias in social desirability (grant DP0881261). responding. Pers Individ Dif. 2003;35:263–275. 12. Jenni OG, Achermann P, Carskadon MA. Homeostatic sleep regulation Disclosure in adolescents. Sleep. 2005;28:1446–1454. 13. National Sleep Foundation. Sleep in America Poll 2006. Washington, The authors declare no conflicts of interest in this work. DC. Available from: http://www.sleepfoundation.org/article/sleep- america-polls/2006-teens-and-sleep. Accessed November 16, 2012. 14. Wolfson AR, Carskadon MA. Sleep schedules and daytime functioning References in adolescents. Child Dev. 1998;69:875–887. 1. Iglowstein I, Jenni OG, Molinari L, Largo RH. Sleep duration from 15. Acebo C, Sadeh A, Seifer R, et al. Estimating sleep patterns with activity infancy to adolescence: reference values and generational trends. monitoring in children and adolescents: how many nights are necessary Pediatrics. 2003;111:302–307. for reliable measures? Sleep. 1999;22:95–103. 2. Gangwisch JE, Babiss LA, Malaspina D, Turner JB, Zammit GK, Posner K. 16. Short MA, Gradisar M, Lack LC, Wright HR, Dohnt H. The sleep pat- Earlier parental set bedtimes as a protective factor against depression terns and well-being of Australian adolescents. J Adolesc. October 19, and suicidal ideation. Sleep. 2010;33:97–106. 2012. [Epub ahead of print.] 3. Smaldone A, Honig JC, Byrne MW. Sleepless in America: inadequate 17. Cain N, Gradisar M. Electronic media use and sleep in school-age sleep and relationships to health and wellbeing of our nations’ children. children and adolescents: a review. Sleep Med. 2010;11:735–742. Pediatrics. 2007;119:529–537. 18. Taylor DJ, Jenni OG, Acebo C, Carskadon MA. Sleep tendency during 4. Gregory AM, Van der Ende J, Willis TA, Verhulst FC. Parent-reported extended wakefulness: insights into adolescent sleep regulation and sleep problems during development and self-reported anxiety/depression, behavior. J Sleep Res. 2005;14:239–244. attention problems, and aggressive behavior later in life. Arch Pediatr 19. Short MA, Gradisar M, Wright H, Lack LC, Dohnt H, Carskadon MA. Adolesc Med. 2008;162:330–335. Time for bed: parent-set bedtimes associated with improved sleep and 5. Pirinen T, Kolho KL, Simola P, Ashorn M, Aronen ET. Parent and self- daytime functioning in adolescents. Sleep. 2011;34:797–800. report of sleep problems and daytime tiredness among adolescents with inflammatory bowel disease and their population based controls. Sleep. 2010;33:1487–1495. Nature and Science of Sleep Dovepress Publish your work in this journal Nature and Science of Sleep is an international, peer-reviewed, open original research, clinical & epidemiological studies, reviews & evalu- access journal covering all aspects of sleep science and sleep medicine, ations, case reports and extended reports. The manuscript management including the neurophysiology and functions of sleep, the genetics of system is completely online and includes a very quick and fair peer- sleep, sleep and society, biological rhythms, dreaming, sleep disorders and review system, which is all easy to use. Visit http://www.dovepress.com/ therapy, and strategies to optimize healthy sleep. 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Estimating adolescent sleep patterns: parent reports versus adolescent self-report surveys, sleep diaries, and actigraphy

Short, Michelle A; Gradisar, Michael; Lack, Leon C; Wright, Helen R; Chatburn, Alex
Nature and Science of Sleep , Volume 5 – Feb 12, 2013
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Pubmed Central
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© 2013 Short et al, publisher and licensee Dove Medical Press Ltd.
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1179-1608
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10.2147/NSS.S38369
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Abstract

Nature and Science of Sleep Dovepress open access to scientific and medical research Open Access Full Text Article O R i G i NAL R ESEARCH Estimating adolescent sleep patterns: parent reports versus adolescent self-report surveys, sleep diaries, and actigraphy 1,2 Michelle A Short Background: In research and clinical contexts, parent reports are often used to gain informa- tion about the sleep patterns of their adolescents; however, the degree of concordance between Michael Gradisar parent reports and adolescent-derived measures is unclear. The present study compares parent Leon C Lack 1 estimates of adolescent sleep patterns with adolescent self-reports from surveys and sleep Helen R Wright diaries, together with actigraphy. Alex Chatburn Methods: A total of 308 adolescents (59% male) aged 13–17 years completed a school sleep School of Psychology, Flinders habits survey during class time at school, followed by a 7-day sleep diary and wrist actigraphy. University, Centre for Sleep Parents completed the Sleep, Medical, Education and Family History Survey. Research, University of South Australia, Adelaide, South Australia, Results: Parents reported an idealized version of their adolescent’s sleep, estimating signifi - Australia cantly earlier bedtimes on both school nights and weekends, significantly later wake times on weekends, and significantly more sleep than either the adolescent self-reported survey, sleep diary, or actigraphic estimates. Conclusion: Parent reports indicate that the adolescent averages a near-optimal amount of sleep on school nights and a more than optimal amount of sleep on weekends. However, adolescent-derived averages indicate patterns of greater sleep restriction. These results illustrate the importance of using adolescent-derived estimates of sleep patterns in this age group and the importance of sleep education for both adolescents and their parents. Keywords: concordance, parent, sleep, sleep measurement, survey, actigraphy Introduction Adolescent sleep patterns are measured in different ways. Many studies have relied 1–6 upon survey data to estimate adolescent sleep patterns, either using parent report, adolescent self-report surveys, or sleep diaries, but fewer have utilized actigraphic estimates of sleep. There is some uncertainty around the differences in results obtained 7,9 10 by these different methods, and around parent reporting in particular. One study found that parents of children aged 3–10 years overestimated their child’s sleep by an average of one hour and 53 minutes per night, compared with concurrently recorded actigraphic estimates. Parents may be susceptible to socially desirable responding when estimating the sleep patterns of their child. Further, parent reports of their adolescent’s sleep may align more closely with the time that adolescents spend in their Correspondence: Michelle A Short bedroom at night, because parents are not aware of the length of time spent awake Centre for Sleep Research, University after lights out. Given the many biopsychosocial factors which predispose adolescents of South Australia, GPO Box 2100, Adelaide SA 5001, Australia to later sleep-onset times (such as circadian phase delay, changes in accumulation of Tel +61 8 8302 1966 homeostatic sleep pressure, and increased academic and social responsibilities), plus Fax +61 8 8302 6623 Email [email protected] the propensity for adolescents to access computers, mobile phones, and music players submit your manuscript | www.dovepress.com Nature and Science of Sleep 2013:5 23–26 Dovepress © 2013 Short et al, publisher and licensee Dove Medical Press Ltd. This is an Open Access article http://dx.doi.org/10.2147/NSS.S38369 which permits unrestricted noncommercial use, provided the original work is properly cited. Short et al Dovepress after bedtime, parents may not be in a position to provide diary just before they went to bed each night and as soon as 12,13 accurate estimates of sleep. An exception to this may be they woke in the morning. Adolescents indicated exact times wake times, as parents of adolescents become less involved for all sleep variables. in regulating bedtimes but more involved in waking them In order to provide an objective measure of sleep, ado- in the morning. lescents wore MicroMini Motionlogger activity monitors This is a concern that has substantial ramifications in both (Ambulatory Monitoring, Ardsley, NY, USA) on the non- clinical and research settings. If parents are not able to describe dominant wrist. Data were digitized in one-minute epochs their adolescent’s sleep patterns accurately, it calls into question using zero crossing mode, with a sensitivity of 0.05 g, and previous research which has used this methodology. In addition, analyzed with Action W2 software using the Sadeh algorithm. if parents do not have an accurate estimation of their teen’s sleep, Diary data were used to define the scoring interval for sleep especially if they overestimate their sleep, they may not be aware according to the procedure outlined by Acebo et al. While of problematic levels of restricted sleep and so may not provide sleep onset is a biological state change that can be inferred the support required to address this. To address this concern, the from actigraphic movement data, bedtime is a behavioral phe- present study compared adolescent survey, sleep diary, and acti- nomenon that cannot be captured by analysis of movement. graphic estimates of sleep and time in bed with parent-reported Unfortunately, the activity monitors used were not equipped sleep. Consistent with the findings of Dayyat et al among with an event marker function to capture bedtime. As such, children aged 3–10 years, it is hypothesized that parent reports data regarding bedtime were collected from self-reported and will significantly overestimate sleep duration compared with parent-reported surveys and sleep diaries only. adolescent-derived estimates and actigraphy. It is also hypoth- Parents completed the Sleep, Medical, Education and esized that parents will significantly underestimate the lateness Family History Survey developed by Carskadon et al at the of adolescent bedtimes, but there will be no significant differ - Sleep for Science research laboratory at Brown University ence between parent and adolescent reports of wake times. (Carskadon, unpublished data, 1999). In addition to demo- The present study extends the previous work by including graphic items, this tool contains questions about the time adolescent-reported survey and sleep diary data in addition when the adolescent went to bed and woke up on school to actigraphy. (Sunday to Thursday) nights and weekends (Friday and Saturday nights). Materials and methods Results Participants One-way repeated-measures analyses of variance with post In total, 308 adolescents of mean age 15.6 ± 0.94 (range 13–17) hoc comparisons were utilized to compare average values years (59% male) with a parent or caregiver (77.2% mothers, of sleep parameters according to measurement mode, using 18.9% fathers, and 3.9% another family members/caregivers) the Statistical Program for the Social Sciences version 20 participated in this study. Participants were drawn from (SPSS Inc, Chicago, IL, USA). Analyses of variance were eight high schools in South Australia and were in years 9, conducted separately for school nights and weekend nights 10, and 11. Mean school start time was 8:32 am (standard for each sleep parameter. Table 1 shows mean values for sleep deviation 0.28 hours). The study had no exclusion criteria, variables according to measurement mode (either actigraphy, and adolescents were reimbursed for their time with a $40 gift sleep diary, self-report survey, or parent report), together with voucher. The Flinders University Social and Behavioral mean differences between parent reports and each measure Research Ethics Committee and the Department of Education and the signic fi ance of any differences observed. Bonferroni and Children’s Service approved this study. adjustments were made to allow for multiple comparisons. Measures The results of this study demonstrate significant and Adolescents completed a modified Sleep Habits Survey substantial differences between the averages estimated by during class time at school. This survey contained items actigraphy, sleep diary, and self-report of the adolescents relating to bedtime, wake time, and total sleep time for both and those reported by parents. Parents reported that their school nights and weekends. For the following week, they adolescents went to bed 14–18 minutes earlier and obtained completed a sleep diary morning and night, which asked 35–45 minutes more sleep on school nights compared with adolescents to record their daily bedtime, wake time, and adolescent-derived estimates. On weekends, parents reported sleep duration. Adolescents were asked to fill out the sleep that their adolescents went to bed 18–35 minutes earlier, submit your manuscript | www.dovepress.com Nature and Science of Sleep 2013:5 Dovepress Dovepress Parent reports of teen sleep Table 1 Mean values for sleep parameters from parent report compared to wrist actigraphy, sleep diary, and self-report survey, together with mean (±se) differences Variable Parent Actigraphy Diary Survey X X Diff (±se) P* X Diff (±se) P* X Diff (±se) P* School night Sleep period 8 h 51 m 8 h 06 m 45 m (2.92) 8 h 16 m 35 m (3.13) 8 h 10 m 41 m (4.26) ,0.001 ,0.001 ,0.001 Bedtime 10:09 pm – – – 10:28 pm 10:24 pm -18 m (0.04) ,0.001 -14 m (0.04) ,0.001 Wake time 6:57 am 7:03 am ns 7:07 am 6:54 am ns -6 m (0.04) -10 m (0.03) ,0.001 -3 m (0.02) Weekends Sleep period 10 h 01 m 8 h 29 m 1 h 32 m (6.17) ,0.001 8 h 41 m 1 h 21 m (6.09) ,0.001 9 h 21 m 40 m (6.72) ,0.001 Bedtime 11:20 pm – – – 11:38 pm 11:54 am -18 m (0.07) ,0.001 -35 m (0.07) ,0.001 Wake time 9:16 am 8:26 am 51 m (0.09) 8:30 am 47 m (0.08) 9:22 am 6 m (0.08) ns ,0.001 ,0.001 Notes: Actigraphic sleep period was calculated as the time elapsed from sleep onset to sleep offset; *bonferroni adjustment used to adjust for multiple comparisons. and obtained 40–92 minutes more sleep per night than overestimating wake times by 48–50 minutes. This finding adolescent-derived estimates. Parent wake time estimates on is unexpected, and inconsistent with previous findings. It school days were more similar to the reports derived from may be that parents are less involved in adolescent wake their adolescents, with only sleep diary estimates being a times on weekends when compared with school mornings, signic fi ant, but small, 10 minutes later than the parent report. and so are not able to provide accurate wake time estimates. Unlike wake times on school mornings, parent estimates of In addition, adolescents are more likely to maintain quiet weekend sleep were more divergent, with parents estimating wakefulness in the morning without disturbing their parent/s wake times occurring 47–51 minutes later than adolescent than are younger children. sleep diary and actigraphic estimates. The survey reported The differences between parent and adolescent and that weekend wake times were not significantly different actigraphic estimates of sleep are important, and show that from parent reports. adolescent sleep is likely to be much more restricted than their parents believe. In fact, parent reports reveal that they Discussion believe their teens are obtaining a near-optimal amount of How should we measure sleep. This is significant on two levels. The first important adolescent sleep? implication of these findings regards the utility of parent To the authors’ knowledge, this is the first study to compare reports for sleep research. Previous studies that have utilized parent reports of adolescent sleep with adolescent self-report, parent reports to estimate sleep are called into question. At sleep diary self-report, and actigraphy in typically develop- the very least, it is likely that these reports overestimate sleep ing adolescents. When comparing the different ways of col- and underestimate bedtimes. The present study provides sup- lecting data on adolescent sleep, significant differences in port for the use of adolescent reports in preference to parent results were obtained depending on the method used. Parents reports of teen sleep. Secondly, it highlights the importance reported a much more idealized sleep pattern, estimating of educating parents about teen sleep. It may be that because that their adolescent went to bed earlier and obtained more teens are less visible than younger children after they go to sleep on both school nights and on weekends than did the bed, parents assume that they are asleep, when in fact they adolescent. These results are consistent with those found in are likely to be awake. Particularly with the presence of a younger children. While there were some significant dif - wide array of electronic media in the bedroom and the bio- ferences in school morning wake time estimates between logical propensity toward phase delay and wakefulness in the parent reports and actigraphic and sleep diary estimates, evening, teens may quietly maintain wakefulness well into 17,18 these differences were small. Parents may be more accu- the night without parental awareness. Parents can have an rate in estimating their teens’ school morning wake times important role in regulating the sleep patterns of adolescents, compared with bedtimes because of the diminished parental with associated improvements in daytime functioning, but involvement in regulating adolescent bedtimes and increased are unlikely to act if they are not aware that their teens is not involvement in waking teens for school with increasing age. obtaining sufficient sleep. On weekends, the difference between parent reports and sleep A strength of this study is the range of sleep measures diary and actigraphy was greater for wake time, with parents obtained, in particular sleep diary and actigraphy, in a submit your manuscript | www.dovepress.com Nature and Science of Sleep 2013:5 Dovepress Short et al Dovepress 6. Laberge L, Petit D, Simard C, Vitaro F, Tremblay RE, Montplasir J. relatively large sample of adolescents and parents. The Development of sleep patterns in early adolescence. J Sleep Res. present study highlights the importance of relying upon 2001;10:59–67. adolescent-derived estimates to obtain data on sleep patterns 7. Wolfson AR, Carskadon MA, Acebo C, et al. Evidence for the validity of a sleep habits survey for adolescents. Sleep. 2003;26:213–216. in this age group. In addition, parent education is indicated 8. Gradisar M, Gardner G, Dohnt H. Recent worldwide sleep patterns to enable parents to have a more accurate picture of their and problems during adolescence: a review and meta-analysis of age, region, and sleep. Sleep Med. 2010;12:110–118. adolescents’ sleep. 9. Short MA, Gradisar M, Lack L, Wright H, Carskadon MA. The dis- crepancy between actigraphic and sleep diary measures of sleep in Acknowledgment adolescents. Sleep Med. 2012;13:378–384. 10. Dayyat EA, Spruyt K, Molfese DL, Gozal D. Sleep estimates in This work was conducted at the Flinders University of South children: parental versus actigraphic assessments. Nat Sci Sleep. Australia and was funded by the Australian Research Council 2011;3:115–123. 11. Pauls CA, Stemmler G. Substance and bias in social desirability (grant DP0881261). responding. Pers Individ Dif. 2003;35:263–275. 12. Jenni OG, Achermann P, Carskadon MA. Homeostatic sleep regulation Disclosure in adolescents. Sleep. 2005;28:1446–1454. 13. National Sleep Foundation. Sleep in America Poll 2006. Washington, The authors declare no conflicts of interest in this work. DC. Available from: http://www.sleepfoundation.org/article/sleep- america-polls/2006-teens-and-sleep. Accessed November 16, 2012. 14. Wolfson AR, Carskadon MA. Sleep schedules and daytime functioning References in adolescents. Child Dev. 1998;69:875–887. 1. Iglowstein I, Jenni OG, Molinari L, Largo RH. Sleep duration from 15. Acebo C, Sadeh A, Seifer R, et al. Estimating sleep patterns with activity infancy to adolescence: reference values and generational trends. monitoring in children and adolescents: how many nights are necessary Pediatrics. 2003;111:302–307. for reliable measures? Sleep. 1999;22:95–103. 2. Gangwisch JE, Babiss LA, Malaspina D, Turner JB, Zammit GK, Posner K. 16. Short MA, Gradisar M, Lack LC, Wright HR, Dohnt H. The sleep pat- Earlier parental set bedtimes as a protective factor against depression terns and well-being of Australian adolescents. J Adolesc. October 19, and suicidal ideation. Sleep. 2010;33:97–106. 2012. [Epub ahead of print.] 3. Smaldone A, Honig JC, Byrne MW. Sleepless in America: inadequate 17. Cain N, Gradisar M. Electronic media use and sleep in school-age sleep and relationships to health and wellbeing of our nations’ children. children and adolescents: a review. Sleep Med. 2010;11:735–742. Pediatrics. 2007;119:529–537. 18. Taylor DJ, Jenni OG, Acebo C, Carskadon MA. Sleep tendency during 4. Gregory AM, Van der Ende J, Willis TA, Verhulst FC. Parent-reported extended wakefulness: insights into adolescent sleep regulation and sleep problems during development and self-reported anxiety/depression, behavior. J Sleep Res. 2005;14:239–244. attention problems, and aggressive behavior later in life. Arch Pediatr 19. Short MA, Gradisar M, Wright H, Lack LC, Dohnt H, Carskadon MA. Adolesc Med. 2008;162:330–335. Time for bed: parent-set bedtimes associated with improved sleep and 5. Pirinen T, Kolho KL, Simola P, Ashorn M, Aronen ET. Parent and self- daytime functioning in adolescents. Sleep. 2011;34:797–800. report of sleep problems and daytime tiredness among adolescents with inflammatory bowel disease and their population based controls. Sleep. 2010;33:1487–1495. Nature and Science of Sleep Dovepress Publish your work in this journal Nature and Science of Sleep is an international, peer-reviewed, open original research, clinical & epidemiological studies, reviews & evalu- access journal covering all aspects of sleep science and sleep medicine, ations, case reports and extended reports. The manuscript management including the neurophysiology and functions of sleep, the genetics of system is completely online and includes a very quick and fair peer- sleep, sleep and society, biological rhythms, dreaming, sleep disorders and review system, which is all easy to use. Visit http://www.dovepress.com/ therapy, and strategies to optimize healthy sleep. 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