(PS3-56) Multi-method and Multi-informant Youth Sleep Assessment in a Partial Hospitalization Program

Abstract Text:

Background: The American Academy of Sleep Medicine recommends that 6-12-year-old children get 9-12 hours of sleep a night. Unfortunately, approximately half of children in the US experience sleep deficiencies, with this number growing as high as 70% during the transition to adolescence. Children with insufficient sleep are at increased risk for adverse health outcomes, including psychopathology, cardiometabolic health problems, behavior and emotional dysregulation, and delays in cognitive development. As such, assessment of youth sleep health is a vital aspect of clinical care, especially for peripubertal youth at high risk for sleep deficiencies and severe psychopathology. However, short one-time questionnaires often limit sleep assessment in clinical settings, and using daily diaries is often a high-burden method that families may struggle to complete regularly or accurately. Given the noted associations between sleep deficiencies and adverse mental health outcomes, the purpose of this study was to understand 1) the prevalence of insufficient sleep in children in an acute level of care and 2) how accurately youth and their caregivers’ retrospective report of youth sleep duration compares to objectively-assessed duration.

Method: We enrolled 50 peripubertal youth (ages 9-12) admitted to a mental health partial hospitalization program in a sleep research study and compared child and parent self-report total sleep time to FitBit Charge 5-derived objective total sleep time based on activity and heart rate. The participants were 61% Non-Hispanic White, 22% Black, 16% Hispanic, 4% Indigenous American, and 2% Asian. Forty-two percent identified as female, 36% as male, and 22% as non-binary.

Results: We found that 96% of our participants did not meet sleep duration guidelines of 9-12 hours a night based on objective assessment. On average, children slept 7.47 hours a night (SD = .87), but parents reported 10.11 hours (SD = .91) and children reported 9.63 hours (SD = 1.41). Forty percent of parents and 20% of youth overestimated sleep by 3+ hours; 80% of parents and 60% of youth overestimated sleep by 2+ hours. Stronger correlations were observed between Fitbit sleep duration and parent-reported sleep duration for 11-12-year-old youth (r = .46) compared to younger youth (r = -.003). Conversely, the correlation between Fitbit sleep duration and youth-reported sleep duration is higher for 9-10-year-old youth (r = .41) than older youth (r = .17).

Discussion: While youth may be more accurate overall in their estimation of their sleep, these correlations suggest that may be dependent on age. These data highlight the prevalence of insufficient sleep in youth with acute mental health problems, and that single timepoint youth or caregiver-report questionnaires may substantially overestimate total sleep duration. The implementation of wearable sleep measurement in clinical care can provide greater information on sleep health and inform personalization of treatment for transdiagnostic sleep interventions.