Concordance between self-reported and actigraphy-assessed sleep duration among African-American adults: findings from the Jackson Heart Sleep Study

• Type of Material: Article
• Authors: Chandra L. Jackson, National Institutes of Health; Julia B. Ward, University of North Carolina; Dayna Johnson, Emory University; Mario Sims, University of Mississippi; James Wilson, Emory University; Susan Redline, Beth Israel Deaconess Medical Center
• Language: English
• Date: 2019-10-16
• Publisher: Oxford University Press (OUP)
• Publication Version: Final Published Version
• Copyright Statement: Published by Oxford University Press on behalf of Sleep Research Society (SRS) 2019.
• Final Published Version (URL): http://dx.doi.org/10.1093/sleep/zsz246
• Title of Journal or Parent Work: SLEEP
• Volume: 43
• Issue: 3
• Grant/Funding Information: The research reported in this publication was supported by the National Heart, Lung, and Blood Institute (NHLBI) (R01HL110068). This work was funded, in part, by the Intramural Program at the NIH, National Institute of Environmental Health Sciences (Z1AES103325-01). Dr. Redline was supported in part by 5R35HL135818, and Dr. Johnson was supported in part by K01HL138211. The Jackson Heart Study (JHS) is supported and conducted in collaboration with Jackson State University (HHSN268201800013I), Tougaloo College (HHSN268201800014I), the Mississippi State Department of Health (HHSN268201800015I/HHSN26800001), and the University of Mississippi Medical Center (HHSN268201800010I, HHSN268201800011I and HHSN268201800012I) contracts from the National Heart, Lung, and Blood Institute (NHLBI) and the National Institute for Minority Health and Health Disparities (NIMHD). The authors also wish to thank the staffs and participants of the JHS. Dr. Wilson is supported by U54GM115428 from the National Institute of General Medical Sciences. The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute; the National Institutes of Health; or the U.S. Department of Health and Human Services.
• Keywords: insomnia; objective; sleep; actigraphy; epidemiology; OSA; sleep duration; subjective; African Americans
• Research Categories: Biology, Neuroscience

Abstract

Study Objectives Most epidemiological studies assess sleep duration using questionnaires. Interpreting this information requires understanding the extent to which self-reported habitual sleep reflects objectively assessed sleep duration, particularly among African Americans, who disproportionately experience poor sleep health. Methods Among African-American participants of the Jackson Heart Sleep Study, we investigated differences in questionnaire-based self-assessed average sleep duration and self-assessed wake-bed time differences compared to actigraphy-based assessments of total sleep time (TST) and average time in bed (TIB). Linear regression models provided estimates of concordance between actigraphy-based and self-reported sleep duration. Results Among 821 adults, self-assessed average sleep duration was lower than self-assessed wake-bed time differences (6.4 ± 1.4 vs. 7.5 ± 1.7 h, p < 0.0001). Mean actigraphy-based TST was 6.6 ± 1.2 h, and actigraphy-based average TIB was 7.6 ± 1.2 h. Self-assessed average sleep duration and actigraphy-based TST were moderately correlated (r = 0.28, p < 0.0001). Self-assessed average sleep duration underestimated actigraphy-based TST by −30.7 min (95% confidence intervals [CI]: −36.5 to −24.9). In contrast, self-assessed wake-bed time differences overestimated actigraphy-based TST by 45.1 min (95% CI: 38.6–51.5). In subgroup analyses, self-assessed average sleep duration underestimated actigraphy-based measures most strongly among participants with insomnia symptoms. Conclusions Among African Americans, self-assessed average sleep duration underestimated objectively measured sleep while self-assessed wake-bed time differences overestimated objectively measured sleep. Sleep measurement property differences should be considered when investigating disparities in sleep and evaluating their associations with health outcomes.