Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022:1:935228.
doi: 10.3389/frsle.2022.935228. Epub 2022 Jul 21.

A Nationally Representative Survey Assessing Restorative Sleep in US Adults

Rebecca Robbins  1   2 , Stuart F Quan  1   2 , Daniel Buysse  3 , Matthew D Weaver  1   2 , Matthew P Walker  4 , Christopher L Drake  5 , Kristen Monten  6 , Laura K Barger  1   2 , Shantha M W Rajaratnam  1   2   7   8 , Thomas Roth  5 , Charles A Czeisler  1   2   9
Affiliations

A Nationally Representative Survey Assessing Restorative Sleep in US Adults

Rebecca Robbins et al. Front Sleep. 2022.

Abstract

Restorative sleep is a commonly used term but a poorly defined construct. Few studies have assessed restorative sleep in nationally representative samples. We convened a panel of 7 expert physicians and researchers to evaluate and enhance available measures of restorative sleep. We then developed the revised Restorative Sleep Questionnaire (REST-Q), which comprises 9 items assessing feelings resulting from the prior sleep episode, each with 5-point Likert response scales. Finally, we assessed the prevalence of high, somewhat, and low REST-Q scores in a nationally representative sample of US adults (n= 1,055) and examined the relationship of REST-Q scores with other sleep and demographic characteristics. Pairwise correlations were performed between the REST-Q scores and other self-reported sleep measures. Weighted logistic regression analyses were conducted to compare scores on the REST-Q with demographic variables. The prevalence of higher REST-Q scores (4 or 5 on the Likert scale) was 28.1% in the nationally representative sample. REST-Q scores positively correlated with sleep quality (r=0.61) and sleep duration (r=0.32), and negatively correlated with both difficulty falling asleep (r=-0.40) and falling back asleep after waking (r=-0.41). Higher restorative sleep scores (indicating more feelings of restoration upon waking) were more common among those who were: ≥60 years of age (OR=4.20, 95%CI: 1.92-9.17); widowed (OR=2.35, 95%CI:1.01-5.42), and retired (OR=2.02, 95%CI:1.30-3.14). Higher restorative sleep scores were less frequent among those who were not working (OR=0.36, 95%CI: 0.10-1.00) and living in a household with two or more persons (OR=0.51,95%CI:0.29-0.87). Our findings suggest that the REST-Q may be useful for assessing restorative sleep.

Keywords: Restorative sleep; national sample; sleep; sleep health.

PubMed Disclaimer

Conflict of interest statement

Competing interests Dr. Rebecca Robbins has received consulting fees from Rituals Cosmetics BV, Savoir Beds Ltd, With Deep Inc, Sleep Cycle AB, Oura Ring Ltd, Denihan Hospitality Group, and the Skimm. This work was supported by a grant from the Bryte Foundation. Dr. Walker serves as a consultant for and has equity interest in the companies, Bryte, Shuni, Oura Ring, and StimScience. Dr. Quan reports receiving consulting fees from Whispersom, Bryte Foundation, Best Doctors, DR Capital. Dr. Rajaratnam has unpaid appointments at CRC for Alertness, Safety and Productivity, Australia and the Sleep Health Foundation. Dr. Rajaratnam also is supported on grants from Vanda Pharmaceuticals, Philips Respironics, Cephalon, Rio Tinto, BHP Billiton and Shell. Dr. Rajaratnam also has received other support from Optalert, Compumedics, Teva Pharmaceuticals and Circadian Therapeutics. Dr. Czeisler reports grants and contracts to BWH from Dayzz Live Well, Delta Airlines, Jazz Pharma, Puget Sound Pilots, Regeneron Pharmaceuticals/Sanofi; is/was paid consultant/speaker for Inselspital Bern, Institute of Digital Media and Child Development, Klarman Family Foundation, M. Davis and Co, National Council for Mental Wellbeing, National Sleep Foundation, Physician’s Seal, SRS Foundation, State of Washington Board of Pilotage Commissioners, Tencent, Teva Pharma Australia, With Deep, and Vanda Pharmaceuticals, in which Dr. Czeisler holds an equity interest; received travel support from Aspen Brain Institute, Bloomage International Investment Group, Inc., Dr. Stanley Ho Medical Development Foundation, German National Academy of Sciences, Ludwig-Maximilians-Universität München, National Highway Transportation Safety Administration, National Safety Council, National Sleep Foundation, Salk Institute for Biological Studies/Fondation Ipsen, Society for Research on Biological Rhythms, Stanford Medical School Alumni Association, Tencent Holdings, Ltd, and Vanda Pharmaceuticals; receives research/education gifts through BWH from Arbor Pharmaceuticals, Avadel Pharmaceuticals, Bryte, Alexandra Drane, Cephalon, DR Capital Ltd, Eisai, Harmony Biosciences, Jazz Pharmaceuticals, Johnson & Johnson, Mary Ann & Stanley Snider via Combined Jewish Philanthropies, NeuroCare, Inc., Optum, Philips Respironics, Regeneron, Regional Home Care, ResMed, San Francisco Bar Pilots, Sanofi SA, Schneider, Simmons, Sleep Cycle. Sleep Number, Sysco, Teva Pharmaceuticals, Vanda Pharmaceuticals; is/was an expert witness in legal cases, including those involving Advanced Power Technologies, Aegis Chemical Solutions, Amtrak; Casper Sleep Inc, C&J Energy Services, Catapult Energy Services Group, Covenant Testing Technologies, Dallas Police Association, Enterprise Rent-A-Car, Espinal Trucking/Eagle Transport Group/Steel Warehouse Inc, FedEx, Greyhound, Pomerado Hospital/Palomar Health District, PAR Electrical Contractors, Product & Logistics Services LLC/Schlumberger Technology, Puckett EMS, Puget Sound Pilots, Union Pacific Railroad, UPS, and Vanda Pharmaceuticals; serves as the incumbent of an endowed professorship given to Harvard by Cephalon; and receives royalties from McGraw Hill and Philips Respironics for the Actiwatch-2 and Actiwatch Spectrum devices. Dr. Czeisler’s interests were reviewed and are managed by the Brigham and Women’s Hospital and Mass General Brigham in accordance with their conflict-of-interest policies. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Definition of restorative sleep from the panel of expert sleep medicine physicians and researchers.
Figure 2
Figure 2
Descriptive statistics summarizing responses to the 9 questions which comprise the Restorative Sleep Questionnaire (REST-Q). Each question featured the stem “For each of the following items, please tell me to what degree you felt each of the below when you woke up today, compared to before you went to sleep. Last night's sleep left me feeling…”.
Figure 3
Figure 3
Prevalence of low, somewhat, and high REST-Q scores in a nationally representative sample of US adults.
Figure 4
Figure 4
Pairwise correlation matrix of REST-Q responses (on the 100-point scale) and sleep duration, sleep quality, insomnia, and sleep difficulties (onset and maintenance). The REST-Q scores used in the correlation analyses are the 100-point scores that have not yet been scored to the “low,” “somewhat,” and “high” categories. Color indicates the magnitude and direction of the correlation. Bright green indicates a strong, negative correlation and light green indicates a weak, negative correlation. Bright blue indicates a strong, positive correlation and light blue indicates a weak, positive correlation. The sleep duration variable displayed is the weighted weekly average sleep duration, with 5/7th weight assigned to the reported sleep duration on work/school nights and 2/7th weight assigned to the reported sleep duration on free nights.
Figure 5
Figure 5
Mean responses regarding sleep quality (A), difficulty initiating sleep (B), difficulty maintaining sleep (C), weighted average of week/school and free night sleep duration (D) by REST-Q scores (low, somewhat, high). The sleep duration variable used in the ANOVA displayed in (D) is the weighted weekly average sleep duration, with 5/7th weight assigned to the reported sleep duration on work/school nights and 2/7th weight assigned to the reported sleep duration on free nights.
See this image and copyright information in PMC

References

    1. American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edn. Washington, DC: American Psychiatric Association. 10.1176/appi.books.9780890425596 - DOI
    1. Aschoff J. (1965). Circadian rhythms in man. Science 148, 1427–1432. 10.1126/science.148.3676.1427 - DOI - PubMed
    1. Azad K. A., Alam M. N., Haq S. A., Nahar S., Chowdhury M. A., Ali S. M., et al. (2000). Vegetarian diet in the treatment of fibromyalgia. Bangl. Med. Res. Council Bull. 26, 41–47. - PubMed
    1. Balanzá-Martínez V., Kapczinski F., de Azevedo Cardoso T., Atienza-Carbonell B., Rosa A. R., Mota J. C., et al. (2021). The assessment of lifestyle changes during the COVID-19 pandemic using a multidimensional scale. Rev. Psiquiatr. Salud Ment. 14, 16–26. 10.1016/j.rpsm.2020.07.003 - DOI - PMC - PubMed
    1. Blumen M. B., Quera Salva M. A., Vaugier I., Leroux K., d'Ortho M.-P., Barbot F., et al. (2012). Is snoring intensity responsible for the sleep partner's poor quality of sleep? Sleep Breath. 16, 903–907. 10.1007/s11325-011-0554-5 - DOI - PubMed

LinkOut - more resources