How Do Children Talk About Sleepiness and Fatigue?

Abstract

Sleepiness and fatigue experienced excessively or chronically are associated with numerous negative impacts on childhood development and wellbeing. The overlapping nature and lack of consensus for definitions of these symptoms within childhood may contribute to misdiagnosis, as does the lack of research – which has focused on adult populations and quantitative methodologies to date. Similarly, current measures of child sleepiness and fatigue are typically derived from adult measures, thereby neglecting the child’s perspective and limiting the understanding and measurement of these phenomena in children. The present study is the first qualitative examination of children’s own language around the concepts of sleepiness and fatigue. Semi-structured interviews were conducted with primary school children from Adelaide, South Australia (N = 42) with the sample stratified by gender, school grade (three, five, & seven), and socio-economic status. Interviews presented eight visual and audio scenarios, and participants’ responses to these were recorded, transcribed, and thematically analysed using a realist epistemology. Analysis led to the identification of two overarching themes: 1) language describing ‘objective’ experiences which can be observed by others and 2) language describing ‘subjective’ experiences which cannot be observed by others. Four subthemes exist: ‘causes’ and ‘behavioral responses’ (objective descriptions), and ‘body-based sensations’ and ‘mind-based experiences’ (subjective descriptions). Importantly, across themes, children shared various features which distinguished between sleepiness and fatigue. Based on these findings, there is potential to develop a developmentally sensitive self-report measurement tool designed to accurately identify and distinguish between sleepiness and fatigue in children.