Are sleep quality judgments comparable across individuals, places, and spaces? An interdisciplinary analysis of data from 207,608 individuals across 68 countries

Objectives: Significant research has shown that health is a heterogeneous concept, and one person's poor health may not be comparable with another's. Yet, little consideration has been given to whether sleep qual-ity judgments are also heterogeneous or whether they cohere between individuals. Another possibility is that there are group differences in the ways in which sleep quality is perceived. If this is the case, it is possible known inequalities in sleep are-in part-an artifact of social position influencing how we conceive of sleep problems. The current study explores this possibility.Design: Cross-sectional, using World Health Organization data from 207,608 individuals; aged between 15 and 101 years of age from 68 countries. Alongside a battery of sleep and demographic variables, data con-tained sleep and energy vignettes. Random effect anchoring vignette models were applied to investigate interpersonal incompatibility and whether sleep quality perceptions operate differently depending on social location, context, and function. Results: While sleep quality judgments are largely comparable across individuals, findings also highlight how the relationship between education and self-reported sleep changes following adjustment for reporting het-erogeneity. Estimates of threshold parameters suggest that those with more years of education have a slightly increased threshold for reporting mild sleep problems (B 0.005; s.e. 0.001) but a lower threshold for reporting sleep problems as extreme (B-0.007; s.e. 0.001).Conclusions: Sleep quality judgments occupy a complex position between heterogeneity and coherence. This has implications for both epidemiological methodologies and contemporary debates about social justice, public health and sleep.Crown Copyright (c) 2022 Published by Elsevier Inc. on behalf of National Sleep Foundation. All rights reserved.

Automated summary

Based on a study using data from the World Health Organization, it was found that while sleep quality judgments are largely comparable across individuals, education level may have an impact on the reporting of sleep problems.