Mother Knows Best? Comparing Child Report and Parent Report of Sleep Parameters With Polysomnography

Study objectives: Parent report or child report is commonly used to obtain information on sleep in children. Data are lacking comparing the validity of parent-reported versus child-reported sleep parameters.

Methods: A total of 285 children (age 9 to 17 years) from the Tucson Children's Assessment of Sleep Apnea community cohort study were assessed. Parent report and child report of total sleep time (TST), sleep latency (SL), and sleep efficiency (SE) for a single night were compared to polysomnography (PSG). Intraclass correlations (ICCs) were used to evaluate agreement between child report, parent report, and PSG findings.

Results: When compared to PSG, children overestimated TST by a median of 32 minutes (interquartile range [IQR] 6 to 68), whereas parents overestimated TST by 36 minutes (IQR 13-70) (P = .006). Children overestimated SL by 4 minutes (IQR -8 to 20), whereas parents overestimated SL by 2 minutes (IQR -10 to 13) (P = .001). Children overestimated SE by 5% (IQR 0% to 11%), whereas parents overestimated SE by 6% (IQR 2% to 11%, P = .04). Both child-reported TST (ICC 0.722, P < .001) and parent-reported TST (ICC 0.776, P < .001) agreed substantially with PSG. Child-reported SL (ICC 0.467, P < .001) and parent-reported SL (r = .419, P < .001) moderately agreed with PSG. Least agreement with PSG was seen between child-reported SE (ICC 0.404, P < .001) and parent-reported SE (ICC 0.473, P < .001), but significant agreement was still present.

Conclusions: When compared to PSG, children overestimate TST to a smaller degree than their parents and overestimate SL to a larger degree than their parents, but these differences appear small. Child and parent reports appear to be equally valid for TST, SL, and SE.