PROMIS Sleep Disturbance and Sleep-Related Impairment in Adolescents: Examining Psychometrics Using Self-Report and Actigraphy

Abstract

Background: The National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS) has self-reported health measures available for both pediatric and adult populations, but no pediatric measures are available currently in the sleep domains.

Objective: The purpose of this observational study was to perform preliminary validation studies on age-appropriate, self-reported sleep measures in healthy adolescents.

Methods: This study examined 25 healthy adolescents' self-reported daytime sleepiness, sleep disturbance, sleep-related impairment, and sleep patterns. Healthy adolescents completed a physical exam at the National Institutes of Health Clinical Center (Bethesda, MD), had no chronic medical conditions, and were not taking any chronic medications. The Cleveland Adolescent Sleepiness Questionnaire (CASQ), PROMIS Sleep Disturbance (v. 1.0; 8a), and PROMIS Sleep-Related Impairment (v. 1.0; 8b) questionnaires were completed, and sleep patterns were assessed using actigraphy.

Results: Total scores on the three sleep questionnaires were correlated (all Spearman's r > .70, p < .001). Total sleep time determined by actigraphy was negatively correlated with the CASQ (p = .01), PROMIS Sleep Disturbance (p = .02), and PROMIS Sleep-Related Impairment (p = .02).

Discussion: The field of pediatric sleep is rapidly expanding, and researchers and clinicians will benefit from well-designed, psychometrically sound sleep questionnaires. Findings suggest the potential research and clinical utility of adult versions of PROMIS sleep measures in adolescents. Future studies should include larger, more diverse samples and explore additional psychometric properties of PROMIS sleep measures to provide age-appropriate, validated, and reliable measures of sleep in adolescents.

Conflict of interest statement

The authors have no conflicts of interest to report.

Figures

FIGURE 1

Sleep questionnaire score correlations in adolescents. Spearman correlations assessed the relationships among CASQ, PROMIS Sleep Disturbance total score, and PROMIS Sleep Related Impairment total score. Spearman correlations and nominal p-values are shown.

FIGURE 2

Sleep questionnaire and total sleep time correlations in adolescents. Spearman correlations assessed the relationships among CASQ, PROMIS Sleep Disturbance, and PROMIS Sleep-Related Impairment total scores with total sleep time (daily average over a one-week period) measured by actigraphy. Spearman correlations and nominal p-values are shown.