Adaptation
and
study
of
the
measurement
properties
of
a
sleep
questionnaire
231
Conclusions:
The
Spanish
adaptation
of
the
BISQ
shows
overall
adequate
validity
and
reliability
for
the
evaluation
of
sleep
in
infants
and
pre-school
children.
Its
use
as
a
clinical
tool,
or
for
clinical-epidemiological
research
studies,
is
feasible.
©
2017
Asociaci
́
on
Espa
̃
nola
de
Pediatr
́
ıa.
Published
by
Elsevier
Espa
̃
na,
S.L.U.
This
is
an
open
access
article
under
the
CC
BY-NC-ND
license
(
http://creativecommons.org/licenses/by-nc-nd/
4.0/
).
PALABRAS
CLAVE
Ni
̃
no;
Preescolar;
Lactante;
Sue
̃
no/fisiología;
Trastornos
del
sue
̃
no/diagnóstico;
Encuestas
y
cuestionarios;
Estudios
de
validación
Adaptación
y
estudio
de
propiedades
métricas
de
un
cuestionario
de
valoración
del
sue
̃
no
para
lactantes
y
preescolares
Resumen
Introducción:
Aunque
las
alteraciones
del
sue
̃
no
en
lactantes
y
preescolares
son
comunes,
no
se
dispone
de
un
instrumento
en
espa
̃
nol
adecuadamente
validado
para
su
estudio.
El
Brief
Infant
Sleep
Questionnaire
(BISQ)
es
un
cuestionario
multidimensional
bien
establecido
con
este
fin
en
el
ámbito
internacional.
Objetivos:
Adaptar
el
BISQ
al
espa
̃
nol
y
analizar
su
fiabilidad
y
validez.
Explorar
su
viabilidad
en
el
contexto
asistencial
y
de
investigación.
Participantes
y
métodos:
Se
incluyeron
ni
̃
nos
de
3
a
30
meses
de
edad.
La
adaptación
al
espa
̃
nol
(BISQ-E)
se
efectuó
mediante
técnica
bilingüe
de
retrotraducción
y
consenso,
siguiendo
las
recomendaciones
internacionales.
Se
evaluó
la
fiabilidad
mediante
análisis
de
los
resultados
del
test---retest
del
BISQ-E
y
de
la
concordancia
de
las
respuestas
a
2
formas
de
administración
(autoadministración
y
entrevista
clínica).
La
validez
de
constructo
se
estableció
analizando
su
correlación
con
un
diario
de
sue
̃
no.
Resultados:
Participaron
un
total
de
87
familias/ni
̃
nos.
La
correlación
global
test---retest
en
60
sujetos
fue
de
r
=
0,848
(p
<
0,001).
El
índice
de
kappa
entre
las
2
formas
de
administración
fue
de
0,939
(IC
95%:
0,858---1,00;
p
<
0,001).La
correlación
BISQ-E-diario
de
sue
̃
no
se
analizó
en
27
familias/ni
̃
nos
y
fue
estadísticamente
significativa
para
las
variables
estudiadas:
hora
de
acostarse
(r
=
0,731),
horas
de
sue
̃
no
nocturno
(r
=
0,726),
horas
de
sue
̃
no
diurno
r
=
0,867)
y
número
de
despertares
nocturnos
(r
=
0,888)
(p
<
0,001).
Conclusiones:
La
adaptación
espa
̃
nola
del
BISQ
presenta
unas
características
de
validez
y
fia-
bilidad
adecuadas
para
la
evaluación
del
sue
̃
no
en
lactantes
y
preescolares.
Su
utilización
como
instrumento
clínico
o
para
estudios
de
investigación
clínico-epidemiológica
resulta
factible.
©
2017
Asociaci
́
on
Espa
̃
nola
de
Pediatr
́
ıa.
Publicado
por
Elsevier
Espa
̃
na,
S.L.U.
Este
es
un
art
́
ıculo
Open
Access
bajo
la
licencia
CC
BY-NC-ND
(
http://creativecommons.org/licenses/by-
nc-nd/4.0/
).
Introduction
Sleep
disturbances
in
children
are
among
the
most
frequent
reasons
for
consultation
in
paediatric
clinical
practice.
1,2
Previous
studies
report
that
between
25%
and
46%
of
the
paediatric
population
may
experience
some
type
of
sleep
disturbance
during
childhood
or
adolescence.
3,4
The
preva-
lence
reported
in
the
literature
for
children
aged
less
than
3
years
ranges
between
11%
and
40%.
5,6
Many
sleep
distur-
bances
are
behavioural
in
nature
(difficulty
falling
asleep,
difficulty
staying
asleep
or
poor
sleep
hygiene),
7
so
their
prevention
and
management
should
start
as
early
as
possible
and
should
be
pursued
from
the
field
of
primary
care.
Current
sleep
recommendations
and
guidelines
are
mainly
based
on
expert
opinion
and
consensus,
as
there
is
little
experimental
evidence
in
this
field.
2,8
Notwithstand-
ing,
the
available
literature
evinces
a
growing
interest
in
the
essential
link
between
sleep
and
adequate
physical,
cognitive
and
psychosocial
development,
including
its
impact
on
family
dynamics.
9---11
The
sleep-onset
time
and
the
total
duration
of
sleep
in
the
first
years
of
life
are
considered
predictors
for
features
of
anxiety
(separation
anxiety,
introversion)
12,13
and
have
been
associated
with
an
adequate
acquisition
of
healthy
eating
habits
14
and
increased
inactivity
and
obesity
in
toddlers.
15
In
light
of
their
importance,
routine
screening
of
sleep
disturbances
would
be
helpful
for
their
early
detec-
tion,
which
would
allow
appropriate
intervention
and
thus
improvement
of
psychosocial
and
cognitive
outcomes
in
the
paediatric
population.
16
The
multidimensional
nature
of
sleep
poses
challenges
to
its
evaluation.
Polysomnography
and
actigraphy
contribute
relevant
data,
11,17
but
their
usefulness
is
limited
due
to
their
low
feasibility
in
large-scale
population-based
studies.
Fur-
thermore,
they
offer
little
towards
the
assessment
of
some
behavioural
factors
that
play
important
roles
in
sleep.
1
This
is
why
it
is
important
to
develop
questionnaires
that
can
assess
subjective
variables
such
as
the
restorative
quality
of
sleep
and
the
potential
impact
on
the
family.
The
Brief
Infant
Sleep
Questionnaire
(BISQ)
is
one
of
the
most
widely
used
questionnaires
currently
available
for
the
assessment
of
sleep
in
early
childhood
(
Table
1
).
18
It
was