ORIGINAL ARTICLE
Measuring sleep habits using the Sleep Timing
Questionnaire: A validation study for school-age children
Rebecca B TREMAINE, Jillian DORRIAN and Sarah BLUNDEN
Centre for Sleep Research, Adelaide, South Australia, Australia
Abstract
In 2003 Monk and colleagues published a single-administration replacement for a standard sleep
diary, the Sleep Timing Questionnaire (STQ). Reliable and valid for adult participants, it offers
advantages over existing methodologies in cost and convenience. It takes approximately 10 min to
complete but can yield information equivalent to a week of actigraphy, or a 2-week sleep diary. This
study sought to validate the STQ for school-age children. Sixty-five children (20 boys, 45 girls), aged
11–16 years participated in this study. The participants wore wrist actigraphs, completed a 1-week
sleep diary and the STQ. Analyses tested convergent validity between the STQ and actigraphy, and
the STQ and sleep diaries. Correlations between STQ and actigraphy (r = 0.45–0.76, P < 0.001), and
STQ and sleep diaries (r = 0.42–0.86, P < 0.001), were positive and significant for sleep onset
and wake times. Correlations between STQ and actigraphy for sleep latency and wake after sleep
onset (WASO) were very low (r < 0.10). In contrast, sleep latency was moderately and significantly
correlated between STQ and sleep diary (r = 0.42, P < 0.001), and the correlation for WASO was high
and significant (r = 0.74, P < 0.001). Differences between the STQ and sleep diary were within
acceptable limits for all sleep parameters, and the differences between STQ and actigraphy were
acceptable for sleep onset and school day wake time. The STQ may be a valid indicator of sleep onset
and wake time in school-age children. It can also produce measures of sleep latency and WASO with
comparable accuracy to a standard sleep diary.
Key words: actigraphy, children, sleep, sleep diary.
INTRODUCTION
In 2003 Monk and colleagues
1
published a single-
administration self-report instrument to be used in place
of a standard sleep diary, particularly when time or
circumstance does not permit the completion of a multi-
day sleep diary. This instrument, the Sleep Timing
Questionnaire (STQ), was shown to be a reliable and
valid measure of sleep parameters (bed time, wake time,
sleep latency, and wake after sleep onset), correlating
highly and significantly with both a traditional 2-week
Sleep Diary (rho = 0.84–0.86), and wrist actigraphy
(r = 0.59–0.77).
To date, the STQ has been used to measure adult
sleep,
2–4
but has yet to be validated for children or
adolescents. This is surprising, given that the STQ is
able to quantify sleep parameters with accuracy compa-
rable to a sleep diary, yet without the level of adherence
needed to maintain a daily sleep diary for 1–2 weeks.
This is promising, as researchers have noted shortcom-
ings of sleep diaries.
5–8
Commitment and compliance
with the instruction of filling in a diary every day can
prove difficult or unsustainable.
9–11
In addition, several
studies of children’s sleep have relied on parental
Correspondence: Ms Rebecca Tremaine, Centre for Sleep
Research, GPO Box 2471, Adelaide, SA 5001, Australia.
Email: Rebecca.Tremaine@unisa.edu.au
Accepted for publication 12 May 2010.
Sleep and Biological Rhythms 2010; 8: 194–202 doi:10.1111/j.1479-8425.2010.00446.x
194 © 2010 The Authors
Journal compilation © 2010 Japanese Society of Sleep Research