Are sleep quality judgements 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 quality judgements are also heterogenous 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 artefact of social position influencing how we conceive of sleep problems. The current study explores this possibility.Design: Cross-sectional, using World Health Organisation data from 207,608 individuals; aged between 15 to 101 years of age from 68 countries. Alongside a battery of sleep and demographic variables, data contained 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: Whilst sleep quality judgements are largely comparable across individuals, findings also highlight how the relationship between education and self-reported sleep changes following adjustment for reporting heterogeneity. 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 judgements 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