An umbrella review summarizing assessment instruments for children in the field of sleep
Which instruments can be used to evaluate behaviors, habits, and routines?
DOI:
https://doi.org/10.59526/soh.14.51388Keywords:
Occupational Therapy, Assessment Instruments, Literature Review, Sleep Hygiene, Sleep Health, Sleep Problems, AdolescentsAbstract
Sleep-related problems and poor sleep hygiene are common among children and adolescents. Sometimes the problems are so severe that healthcare services are contacted. The available assessment instruments for evaluating children’s sleep vary in terms of which domains of sleep health they cover. The aim of this study was to describe assessment instruments for school-aged children and adolescents that include sleep problems related to behaviors, habits, and routines. A systematic literature review in the form of an umbrella review resulted in three review articles, of which four assessment instruments appeared in at least two (a selection made to provide an overview while still limiting
the number). Of the four instruments, two have been translated into Swedish: Children’s Sleep Habits Questionnaire (CSHQ) and Sleep and Lifestyle Questionnaire (SLQ); and two were available only in English: Children’s Report of Sleep Patterns (CRSP) and Adolescent Sleep Hygiene Scale (ASHS). Assessment instruments for children’s and adolescents’ sleep are important for identifying sleep problems and understanding influencing factors. The areas particularly emphasized in the included instruments are sleep habits/lifestyle factors, sleep patterns, and sleep hygiene. Further research is needed, and translation or development of new instruments adapted to the Swedish context is considered highly relevant.
References
Agostini, A., & Centofanti, S. (2021). Normal sleep in children and adolescence. Child and Adolescent Psychiatric Clinics of North America, 30(1), 1–14. https://doi.org/10.1016/j.chc.2020.08.011 DOI: https://doi.org/10.1016/j.chc.2020.08.011
Aromataris E., Fernandez R., Godfrey C., Holly C., Kahlil H., Tungpunkom P. (2015). Summarizing systematic reviews: methodological development, conduct and reporting of an Umbrella review approach. International Journal of Evidence Based Healthcare, 13(3), 132-40. https://doi.org/10.1097/XEB.0000000000000055 DOI: https://doi.org/10.1097/XEB.0000000000000055
Bartel, K., Scheeren, R., & Gradisar, M. (2019). Altering adolescents’ pre-bedtime phone use to achieve better sleep health. Health Communication, 34, 456–462. https://doi.org/10.1080/10410236.2017.1422099 DOI: https://doi.org/10.1080/10410236.2017.1422099
Browning, J., Ludwig, R., Eakman, A., Sanders, M., Faulkner, S., Enam, N., van der Veen, R. D., Latella, D., Poole, C. W., Bendixen, R. M., & Hartman, A. G. (2024). Restful rehabilitation: Sleep’s essential role in occupational therapy education, intervention, and research. American Journal of Occupational Therapy, 78(6), 7806347020. https://doi.org/10.5014/ajot.2024.050915 DOI: https://doi.org/10.5014/ajot.2024.050915
Buysse, D. J. (2014). Sleep health: Can we define it? Does it matter? Sleep, 37(1), 9–17. https://doi.org/10.5665/sleep.3298 DOI: https://doi.org/10.5665/sleep.3298
Carskadon, M. A. (2011). Sleep in adolescents: The perfect storm. Pediatric Clinics of North America, 58(3), 637–647. https://doi.org/10.1016/j.pcl.2011.03.003 DOI: https://doi.org/10.1016/j.pcl.2011.03.003
Ebben, M. R., & Spielman, A. J. (2009). Non-pharmacological treatments for insomnia. Journal of Behavioral Medicine, 32(3), 244–254. https://doi.org/10.1007/s10865-008-9198-8 DOI: https://doi.org/10.1007/s10865-008-9198-8
Epley, E., Wolske, J., Mirza, M., & Fischer, G. (2021). Habits and health promotion in occupational therapy: A scoping review. Annals of International Occupational Therapy, 4. https://doi.org/10.3928/24761222-20210921-04 DOI: https://doi.org/10.3928/24761222-20210921-04
Faulkner, S. (2022). Sleep and occupational performance are inseparable: Why occupational therapy practice and research should consider sleep and circadian rhythm. British Journal of Occupational Therapy, 85(5), 305–307. https://doi.org/10.1177/03080226221089846 DOI: https://doi.org/10.1177/03080226221089846
Fritz, H., Hu, Y. L., Gahman, K., Almacen, C., & Ottolini, J. (2020). Intervention to modify habits: A scoping review. OTJR: Occupation, Participation and Health, 40(2), 99–112. https://doi.org/10.1177/1539449219876877 DOI: https://doi.org/10.1177/1539449219876877
Garmy, P., Nyberg, P., & Jakobsson, U. (2012). Sleep and television and computer habits of Swedish school-age children. Journal of School Nursing, 28(6), 469–476. https://doi.org/10.1177/1059840512444133 DOI: https://doi.org/10.1177/1059840512444133
Hedin, G., Norell-Clarke, A., Hagell, P., Tønnesen, H., Westergren, A., & Garmy, P. (2020). Facilitators and barriers for a good night’s sleep among adolescents. Frontiers in Neuroscience, 14, Article 92. https://doi.org/10.3389/fnins.2020.00092 DOI: https://doi.org/10.3389/fnins.2020.00092
Hena, M., & Garmy, P. (2020). Social jetlag and its association with screen time and nighttime texting among adolescents in Sweden: A cross-sectional study. Frontiers in Neuroscience, 14, Article 122. https://doi.org/10.3389/fnins.2020.00122 DOI: https://doi.org/10.3389/fnins.2020.00122
Inhulsen, M. M. R., van Stralen, M. M., Terwee, C. B., Ujcic-Voortman, J. K., Seidell, J. C., & Busch, V. (2022). Measuring sleep health in primary school-aged children: A systematic review of instruments and their content validity. Sleep, 45(11), zsac215. https://doi.org/10.1093/sleep/zsac215 DOI: https://doi.org/10.1093/sleep/zsac215
Ji, X., & Liu, J. (2016). Subjective sleep measures for adolescents: A systematic review. Child: Care, Health and Development, 42(6), 825–839. https://doi.org/10.1111/cch.12376 DOI: https://doi.org/10.1111/cch.12376
Larsson, I., Svedberg, P., Nygren, J. M., & Malmborg, J. S. (2024). Validity and reliability of the Swedish version of the Children’s Sleep Habits Questionnaire (CSHQ-SWE). BMC Pediatrics, 24(1), Article 378. https://doi.org/10.1186/s12887-024-04859-z DOI: https://doi.org/10.1186/s12887-024-04859-z
LeBourgeois, M. K., Giannotti, F., Cortesi, F., Wolfson, A. R., & Harsh, J. (2005). The relationship between reported sleep quality and sleep hygiene in Italian and American adolescents. Pediatrics, 115(1 Suppl), 257–265. https://doi.org/10.1542/peds.2004-0815H DOI: https://doi.org/10.1542/peds.2004-0815H
Lim, D. C., Najafi, A., Afifi, L., Bassetti, C., Buysse, D. J., Han, F., Högl, B., Melaku, Y. A., Morin, C. M., Pack, A. I., Poyares, D., Somers, V. K., Eastwood, P. R., Zee, P. C., Jackson, C. L., & World Sleep Society Global Sleep Health Taskforce. (2023). The need to promote sleep health in public health agendas across the globe. The Lancet Public Health, 8(10), e820–e826. https://doi.org/10.1016/S2468-2667(23)00182-2 DOI: https://doi.org/10.1016/S2468-2667(23)00182-2
Lollies, F., Schnatschmidt, M., Bihlmeier, I., Genuneit, J., In-Albnon, T., Holtmann, M., Legenbauer, T., & Schlarb, A. A. (2022). Associations of sleep and emotion regulation processes in childhood and adolescence – A systematic review, report of methodological challenges and future directions. Sleep Science, 15(4), 490–514. https://doi.org/10.5935/1984-0063.20220082 DOI: https://doi.org/10.5935/1984-0063.20220082
Liu, J., Ji, X., Rovit, E., Pitt, S., & Lipman, T. (2022). Childhood sleep: Assessments, risk factors, and potential mechanisms. World Journal of Pediatrics, 20(2), 105–112. https://doi.org/10.1007/s12519-022-00628-z DOI: https://doi.org/10.1007/s12519-022-00628-z
Ludwig, R., Eakman, A., Bath-Scheel, C., & Siengsukon, C. (2022). How occupational therapists assess and address the occupational domain of sleep: A survey study. American Journal of Occupational Therapy, 76(6). https://doi.org/10.5014/ajot.2022.049379 DOI: https://doi.org/10.5014/ajot.2022.049379
Lönn, M., & Odéus, E. (2025). Outcome measures in evaluation of weighted blankets: A scoping review. Occupational Therapy International, 19, 3663534. https://doi.org/10.1155/oti/3663534 DOI: https://doi.org/10.1155/oti/3663534
Meltzer, L. J., Williamson, A. A., & Mindell, J. A. (2021). Pediatric sleep health: It matters, and so does how we define it. Sleep Medicine Reviews, 57, 101425. https://doi.org/10.1016/j.smrv.2021.101425 DOI: https://doi.org/10.1016/j.smrv.2021.101425
Meltzer, L. J., Avis, K. T., Biggs, S., Reynolds, A. C., Crabtree, V. M., & Bevans, K. B. (2013). The Children's Report of Sleep Patterns (CRSP): A self-report measure of sleep for school-aged children. Journal of Clinical Sleep Medicine, 9(3), 235–245. https://doi.org/10.5664/jcsm.2486 DOI: https://doi.org/10.5664/jcsm.2486
Meltzer, L. J., & Montgomery-Downs, H. E. (2011). Sleep in the family. Pediatric Clinics of North America, 58(3), 765–774. https://doi.org/10.1016/j.pcl.2011.03.010 DOI: https://doi.org/10.1016/j.pcl.2011.03.010
Noland, H., Price, J. H., Dake, J., & Telljohann, S. K. (2009). Adolescents' sleep behaviors and perceptions of sleep. Journal of School Health, 79(5), 224–230. https://doi.org/10.1111/j.1746-1561.2009.00402.x DOI: https://doi.org/10.1111/j.1746-1561.2009.00402.x
Owens, J. A., Spirito, A., & McGuinn, M. (2000). The Children's Sleep Habits Questionnaire (CSHQ): Psychometric properties of a survey instrument for school-aged children. Sleep, 23(8), 1043–1051. https://doi.org/10.1093/sleep/23.8.1043 DOI: https://doi.org/10.1093/sleep/23.8.1d
Sen, T., & Spruyt, K. (2020). Pediatric sleep tools: An updated literature review. Frontiers in Psychiatry, 11, 317. https://doi.org/10.3389/fpsyt.2020.00317 DOI: https://doi.org/10.3389/fpsyt.2020.00317
Storfer-Isser, A., LeBourgeois, M. K., Harsh, J., Tompsett, C. J., & Redline, S. (2013). Psychometric properties of the Adolescent Sleep Hygiene Scale. Journal of Sleep Research, 22(6), 707–716. https://doi.org/10.1111/jsr.12059 DOI: https://doi.org/10.1111/jsr.12059
Trosman, I., & Ivanenko, A. (2024). Classification and epidemiology of sleep disorders in children and adolescents. Psychiatric Clinics of North America, 47(1), 47–64. https://doi.org/10.1016/j.psc.2023.06.004 DOI: https://doi.org/10.1016/j.psc.2023.06.004
Wright, C. D., Tiani, A. G., Billingsley, A. L., Steinman, S. A., Larkin, K. T., & McNeil, D. W. (2019). A framework for understanding the role of psychological processes in disease development, maintenance, and treatment: The 3P-Disease Model. Frontiers in Psychology, 10, 2498. https://doi.org/10.3389/fpsyg.2019.02498 DOI: https://doi.org/10.3389/fpsyg.2019.02498
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Maria Lönn, Ellen Odéus, Gita Hedin

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright to their work.
