Measurement bias in adolescent sleep duration: Comparison of self-reported and actigraphy-assessed sleep duration among adolescents in the Future of Families and Child-Wellbeing Study

青少年睡眠时长测量偏差:未来家庭与儿童福祉研究中青少年自述睡眠时长与活动记录仪评估睡眠时长的比较

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Abstract

OBJECTIVES: To assess differences and potential measurement bias in adolescent sleep duration, we compared self-report and actigraphy-assessed sleep duration in the Future of Families and Child Wellbeing Study (age 15 wave). METHODS: Participants (N = 634; mean age 15.4 years; 51% Black, 30% Hispanic, and 18% White) self-reported typical weekday and weekend bedtimes and waketimes before wearing a wrist actigraph for 1 week. Linear regression models estimated concordance between self-reported and actigraphy-assessed sleep duration overall and stratified by race, ethnicity, and socioeconomic status (primary caregiver education and household income-to-poverty threshold ratio). Agreement of sleep duration categories [short (<8 hours), recommended (8-10 hours), and long (>10 hours)] was estimated using Kappa statistics. RESULTS: Self-reported sleep duration overestimated actigraphy-assessed duration by 27.87 minutes (95% CI: 34.96, 20.78) after adjustment. Agreement between duration categories was 73% (ƙw = 0.12, 95% CI: 0.07, 0.18). The mean difference was larger on weekends (74.3 ± 144.7 minutes) than weekdays (27.5 ± 92.7 minutes). Within-group analyses showed self-reported duration overestimated actigraphy-assessed duration for Black adolescents and those with lower socioeconomic status (i.e., primary caregivers with a high school education or less). CONCLUSIONS: Reliance on self-report may misclassify sleep duration and underestimate insufficient sleep, particularly in marginalized groups, underscoring the need to understand measurement bias when objective measures are unavailable.

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