Measuring sleep quality
Abstract
Despite being used commonly in sleep medicine, the term "sleep quality" has not been rigorously defined. The purpose of this article is to consider objective measures of the subjective "sleep quality" experience. In order to do so, it was necessary to choose a definition of "sleep quality" as a basis for discussion. We have chosen to employ the simple Likert-style rating of (the previous night's) sleep quality, commonly included as an item on sleep diaries, as the core sleep quality indicator and focus of this article. The potential objective measures discussed include polysomnography, cyclic alternating pattern and actigraphy. We review the strengths and weaknesses of these measures as well as discuss challenges facing the development of an objective correlate of "sleep quality" ratings, including that such ratings may reflect non-sleep phenomena such as mood or health status and the possibility that "sleep quality" may reflect different aspects of sleep among people. We also discuss new approaches intended to address these challenges, including: (1) combining different types of measures; (2) sub-grouping individuals based on clinical or physiological characteristics and developing different measures in these subgroups; and (3) sub-grouping based on the association of potential measures and quality ratings over nights.
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Subjective sleep measures may capture experiential aspects of sleep quality, such as fatigue and daytime sleepiness, that are more proximally related to learning and school functioning than objective indicators alone.
“This pattern is consistent with prior research suggesting that subjective sleep measures may capture experiential aspects of sleep quality (e.g., fatigue, daytime sleepiness) that are more proximally related to learning and school functioning than objective indicators alone (Adelantado-Renau et al., 2019a; Krystal & Edinger, 2008).”
From The Effect of Sleep Quality on Academic Performance: A Systematic Review and Meta-Analysis Study (2026) · cites this paper as Krystal & Edinger, 2008
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“…research suggesting that subjective sleep measures may capture experiential as‑ pects of sleep quality (e.g., fatigue, daytime sleepiness) that are more proximally related to learning and school functioning than objective indicators alone (Adelantado‑Renau et al., 2019a; Krystal & Edinger, 2008).”
- Authors
- Krystal, A. D., & Edinger, J. D.
- Affiliations
- Duke University (US)
- Corresponding author
- Krystal, Andrew D.
- Venue
- Sleep Medicine
- Publisher
- Elsevier BV
- Published
- 2008-09
- Volume
- 9
- Pages
- S10-S17
- ISSN
- 1389-9457 (ISSN-L)
- OpenAlex
- W2024919601
- Cited by
- 590
- References
- 4
- Citations by year
- 2026: 29 · 2025: 57 · 2024: 65 · 2023: 56 · 2022: 65 · 2021: 49 · 2020: 50 · 2019: 46 · 2018: 33 · 2017: 30 · 2016: 29 · 2015: 12 · 2014: 20 · 2013: 15 · 2012: 13
- FWCI
- 8.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sleep Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs
- Sanofi
- National Heart, Lung, and Blood Institute (R01HL073259, R01-HL-073259-01)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Keywords
- sleep quality, sleep diary, Likert scale, polysomnography, cyclic alternating pattern, actigraphy, subgroup analysis
- MeSH terms
- Electroencephalography, Humans, Sleep, Sleep Wake Disorders, Sleep, REM, Polysomnography
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