Cleveland Adolescent Sleepiness Questionnaire Research Articles

Sleep Duration and Daytime Sleepiness in Indian Adolescents: Is There a Gender Difference?

To the Editor: Studies on adolescent sleep show that adolescents are not obtaining optimum hours of sleep recommended for their age group, which is 9.2 h across all pubertal ages [1, 2]. Many adolescents are reported to have sleep problems, which can cause chronic deprived sleep and excessive daytime sleepiness, leading to negative effects on individual performance and health [2, 3]. Almost 45 to 85 % of sixth to 12th grade students obtain less than recommended hours of sleep for their age group and 44 % of students report to have difficulty staying awake in school times [4]. However, only few studies have been done on excessive daytime sleepiness among adolescents in Asia. The daytime sleepiness and the association of gender with sleep duration and daytime sleepiness was assessed among sixth to 12th grade students between 11 and 17 y and studying in various schools in Mangalore, India. The adolescents were randomly selected using stratified random sampling method. Stratification was based on gender. The data was collected in July and August 2013. Sleep duration was assessed in hours using questions like “how much sleep do you get on an average during a school day?”. Daytime sleepiness was assessed using Cleveland Adolescent Sleepiness Questionnaire developed by Spilsbury et al. [5]. A total of 58 adolescents, 29 males and females each, participated in the study. When classified according to groups (adolescent classification by American Academy of Pediatrics) 31 of them were early adolescents (11–14 y) and 27 of them were middle adolescents (15–17 y). The adolescents were not obtaining the recommended hours of sleep for their age group on week days, as shown by a catch up sleep during weekends (7.68 ± 0.99 h vs. 8.70 ± 1.63 h). Early adolescents obtained better sleep than middle adolescents’. The mean daytime sleepiness scores for adolescents were 36.83 ± 8.38, higher in middle adolescents and among female adolescents. Sleep duration and daytime sleepiness by gender however showed no statistically significant differences between male and female adolescents. Negative correlation between sleep duration and daytime sleepiness (r=–0.295 and p value 0.025) shows that as sleep duration increases, daytime sleepiness decreases. This study highlights the importance of adolescent sleep and provides an evidence for the direction of future research. It also provides an implication that adolescents’ suffer significantly with daytime sleepiness and future results could provide more insight into this existing evidence.

The relationships between asthma control, daytime sleepiness, and quality of life among children with asthma: a path analysis

We aimed to examine the relationships between asthma control, daytime sleepiness, and asthma-specific health-related quality of life (HRQOL) among children with asthma. Path analyses were conducted to test if daytime sleepiness can mediate the effect of asthma control status on asthma-specific HRQOL. 160 dyads (pairs) of asthmatic children and their parents were collected for analyses. The Asthma Control and Communication Instrument (ACCI) was used to categorize adequate and poor asthma control status. The Cleveland Adolescent Sleepiness Questionnaire (CASQ) was used to measure children's daytime sleepiness, including sleep in school, awake in school, sleep in evening, and sleep during transport. The Patient-Reported Outcomes Measurement Information System (PROMIS) Asthma Impact Scale was used to measure asthma-specific HRQOL. Poorly controlled asthma was associated with daytime sleepiness and impaired asthma-specific HRQOL. Asthma control status was directly associated with asthma-specific HRQOL (P<.05), whereas sleep in school and sleep in evening domains of daytime sleepiness significantly mediated the relationship between poor asthma control and impaired HRQOL (P<.01). Asthma control status was associated with pediatric asthma-specific HRQOL, and the association was significantly mediated by daytime sleepiness. Healthcare providers need to address pediatric sleep needs related to poor asthma control to reduce the negative impact on HRQOL.

The Cleveland Adolescent Sleepiness Questionnaire

Developed the Cleveland Adolescent Sleepiness Questionnaire (CASQ), a brief, self-completed instrument to measure excessive daytime sleepiness in adolescents. Cross-sectional analysis. A subsample of 411 adolescents 11-17 years of age recruited from area schools, churches, and "control" participants in a sleep disordered breathing cohort study; a second subsample of 62 adolescents with diagnosed sleep disordered breathing also participating in the sleep disordered breathing study. Participants completed the CASQ along with two other available measures of daytime sleepiness and other sleep parameters (sleep duration on school nights, sleep duration on non-school nights, and sleep debt, defined as non-school night sleep duration minus school-night sleep duration). Demographic information was obtained from a caregiver-completed questionnaire. The CASQ was developed using exploratory factor analysis, followed by confirmatory factor analysis using structural equation modeling techniques. Goodness-of-fit measures for the final 16-item scale structure ranged from good to excellent. The CASQ's internal consistency was good (alpha = 0.89). Correlations between the CASQ, two other measures of daytime sleepiness, and sleep parameters gave preliminary evidence of the CASQ's construct validity. The CASQ shows promise as a valid measure of daytime sleepiness in adolescents.