Table 1.
Child Sleep Behavior facets: Summary of qualitative item development and review
| Interviewsa | Existing PRO measuresb | Cognitive Interview Itemsc | |||
|---|---|---|---|---|---|
| Experts n=8 | Child n=28 | n=10 | Tested | Retained | |
|
| |||||
| Timing: bedtime, wake time (eliminated “during school breaks”; not universally understood as summers vs. weekends vs. winter holiday) | 7 (88%) | 13 (46%) | 6 (60%) 1,3,5,7,8,10 | 6 | 4 |
| Bedtime | 7 (88%) | 8 (29%) | 2 (20%)3,7 | 3 | 2 |
| Wake time | −7 (88%) | 6 (21%) | 3 (30%)1,7,10 | 3 | 2 |
| Sleep opportunity | 6 (75%) | 4 (14%) | 5 (50%)1,3,5,7,8 | 3d | 2d |
| Routines and consistency : regular bedtime routine, consistent sleep schedule | 6 (75%) | 11 (42%) | 2 (20%) 1,3 | 5 | 3 |
| Bedtime routines | 3 (38%) | 8 (29%) | -- | 3 | 1 |
| Bedtime consistency | 6 (75%) | 4 (14%) | 2 (20%)1,3 | 1 | 1 |
| Wake time consistency | 6 (75%) | 4 (14%) | -- | 1 | 1 |
| Technology : use of technology immediately before bed or upon nighttime waking | 6 (75%) | 12 (43%) | 0 (0%) | 7 | 3 |
| Television/video viewing | 6 (75%) | 2 (7%) | -- | 2 | 1 |
| Computer/tablet/phone use | 5 (63%) | 10 (36%) | -- | 3 | 1 |
| Videogame playing | 4 (50%) | 1 (4%) | -- | 1 | 1 |
| Listened to music (valence unclear) | -- | 4 (14%) | -- | 1 | 0 |
| Sleep environment : noise/quiet, temperature, airflow, light | 5 (63%) | 14 (50%) | 0 (0%) | 5 | 4 |
| Noise/quiet | 3 (38%) | 8 (29%) | -- | 1 | 1 |
| Temperature (too hot and too cold) | 3 (38%) | 5 (19%) | -- | 2 | 2 |
| Light/darkness: different interpretation of dark room (too light) | 3 (38%) | 2 (7%) | -- | 2 | 1 |
| Sleep onset association : need for assistance to fall asleep | 4 (50%) | 0 (0%) | 1 (10%) 1 | 3 | 1 |
| Need someone to fall asleep | 4 (50%) | -- | 1 (10%)1 | 3 | 1 |
Number of experts and children who identified concepts for each facet (percentage within interviewee group);
Existing pediatric sleep PRO measures that include items for each facet (% of the 10 most commonly used measures): 1 = Children’s Sleep Habits Questionnaire (CSHQ);(J A Owens et al., 2000) 2 = Pediatric Sleep Questionnaire (PSQ);(Chervin et al., 2000) 3 = Sleep self-report (SSR);(Judith A Owens et al., 2000) 4 = Obstructive sleep apnea QoL;(Franco et al., 2000) 5 = Sleep Disturbance Scale for Children (SDSC);(Ferreira et al., 2009) 6 = Epworth Sleepiness Scale (ESS);(Johns, 1991) 7 = School Sleep Habits Survey (SSHS);(Wolfson & Carskadon, 1998) 8 = Pediatric Daytime Sleepiness Scale (PDSS);(Drake et al., 2003) 9 = Morningness-Eveningness Scale for Children (MESC);(Carskadon et al., 1993) 10 = Sleep Questionnaire (Simonds & Parraga);(Johnson et al., 2005);
Number of items tested in cognitive interviews and retained after child cognitive interviews;
Sleep opportunity variables were derived from bedtime and waketime.