Validation of the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale in older black and white women

Beaudreau, Sherry A.; Spira, Adam P.; Stewart, Anita L.; Kezirian, Eric J.; Lui, Li Yung; Ensrud, Kristine E.; Redline, Susan; Ancoli‐Israel, Sonia; Stone, Katie L.

doi:10.1016/j.sleep.2011.04.005

Cited by 206 publications

(155 citation statements)

References 24 publications

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“…36,37 Our review of the published literature revealed a wide range of reported Cronbach α for the PSQI, with a low of 0.43 (among Japanese healthy participants) to a high of 0.85 (among German patients with insomnia). [8][9][10][11]13,[15][16][17]38 Although the statistic is not interpretable in our study (given the observed three-factor structure), we reported an overall Cronbach's α (0.57) so as to be consistent with the other studies. Several previous studies conducted among pregnant Australian and British women, 1,7 Norwegian postpartum women, 39 Australian adults, 40 and cancer patients in Greece 8 found that the removal of "sleep medication use" component improved the Cronbach's α for the PSQI.…”

Section: Discussionsupporting

confidence: 80%

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Psychometric Properties of the Pittsburgh Sleep Quality Index (PSQI) in a Cohort of Peruvian Pregnant Women

Zhong

Gelaye

Sánchez

et al. 2015

Journal of Clinical Sleep Medicine

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Study Objectives: We sought to evaluate the construct validity and factor structure of the Spanish-language version of the Pittsburgh Sleep Quality Index (PSQI) among pregnant Peruvian women. Methods: A cohort of 642 women were interviewed at ≤ 16 weeks of gestation. During interview, we ascertained information about lifestyles, demographics, sleep characteristics, and mood symptoms. Stress induced sleep disturbance, depressive symptoms, and anxiety symptoms were evaluated using the Ford Insomnia Response to Stress Test (FIRST), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) assessment scales, respectively. Consistency indices, exploratory and confi rmatory factor analyses, correlations, and logistic regressions were used. Results: Both exploratory and confi rmatory factor analyses indicated a three-factor solution: sleep quality, sleep effi ciency, and sleep medication. We observed signifi cantly positive correlations of the PSQI with the FIRST (0.42), the PHQ-9 (0.49), and the GAD-7 (0.46). Poor sleepers (PSQI global score > 5) had signifi cantly increased odds of experiencing stress-induced sleep disturbance (odds ratio, OR = 3.57; 95% CI: 2.40, 5.31), depression (OR = 5.48; 95% CI: 3.58, 8.37), and generalized anxiety disorder (OR = 4.57; 95% CI: 3.08, 6.76). Conclusions:The Spanish-language version of the PSQI instrument was found to have good construct validity among pregnant Peruvian women. Consistent with some other studies, the PSQI was found to have a three-factor structure. Further assessment and validation studies are needed to determine whether the three, factor-specifi c scoring of the PSQI is favored over the PSQI global score in diverse populations. A mong pregnant women, pregnancy-associated physiological and hormonal changes are known to contribute to increased prevalence and severity of sleep complaints and disorders.1,2 Sleep complaints and disorders experienced in early pregnancy have been linked to hyperemesis, cesarean delivery, preterm birth, gestational diabetes mellitus, fetal growth restriction, and preeclampsia.2-5 Of note, an emerging literature has suggested that sleep disorders and poor sleep quality predict an increased risk of mood disorders including depressive symptomatology in late pregnancy.6,7 However, despite these observations and their clinical implications, relatively little has been done to design and implement clinical protocols that may be used to reliably and validly assess sleep effi ciency and night and daytime disturbance among pregnant women.One widely used self-reported measure of sleep quality, the Pittsburgh Sleep Quality Index (PSQI), has been established as a valid scale with acceptable psychometric properties when used among men and non-pregnant women in diverse global settings. [8][9][10][11][12][13][14][15][16][17][18] Though increasingly being used among pregnant women, 1,7,19 the psychometric properties of the PSQI has not been adequately assessed in this population. We are aware of only two published studies have eva...

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Section: Discussionsupporting

confidence: 80%

“…[8][9][10][11][12][13][14][15][16][17][18] Though increasingly being used among pregnant women, 1,7,19 the psychometric properties of the PSQI has not been adequately assessed in this population. We are aware of only two published studies have evaluated the psychometric properties of the PSQI among pregnant women.…”

mentioning

confidence: 99%

Psychometric Properties of the Pittsburgh Sleep Quality Index (PSQI) in a Cohort of Peruvian Pregnant Women

Zhong

Gelaye

Sánchez

et al. 2015

Journal of Clinical Sleep Medicine

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“…The association between self-rated health and EDS in our study is noteworthy, since self-rated health is considered a significant and powerful indication of overall health 19 and is related to increased mortality and poorer quality of life among older adults 15 . The results of this study allow healthcare professionals, especially those who are primary health care practitioners, to identify older adult profiles with higher odds of presenting excessive daytime sleepiness.…”

Section: Discussionmentioning

confidence: 56%

“…The scale has been validated for older American women and has an adequate internal consistency (α = 0.76) 19 , In Brazil it has been validated for adults 18 and its feasibility was tested in institutionalized older people 20 , demonstrating that is possible use this instrument. Despite the limitations, this is a widely used scale for EDS assessment in older population 8,9,11,21,22 .…”

Section: Methodsmentioning

confidence: 99%

Correlates of excessive daytime sleepiness in community-dwelling older adults: an exploratory study

Lima

Soares

Bilton

et al. 2015

Rev. bras. epidemiol.

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Excessive daytime sleepiness (EDS) imposes a wide range of adverse health-related outcomes in older people, such as disability, which impair everyday activities and may increase the risk of fall. Few studies have explored EDS in Brazilian older people living in the community who are typically cared in primary health services. This study aims to investigate the prevalence of EDS and its sociodemographic, physical and mental health correlates among community-dwelling older adults. This is an exploratory, population-based study derived from Frailty in Brazilian Older Adults (FIBRA) study including adults aged 65 years and older. Participants with a score ≥ 11 points on the Epworth Sleepiness Scale were considered as having excessive daytime sleepiness. A structured, multidimensional questionnaire was used to investigate sociodemographic, physical and mental health, and self-rated health variables. The sample was composed of 776 older adults, of whom 21% (n = 162) presented excessive daytime sleepiness. Multivariate regression analysis revealed that EDS is associated with obesity (OR = 1.50; 95%CI 1.02 -2.20), urinary incontinence (OR = 1.53; 95%CI 1.01 -2.31), poor self-rated health (OR = 1.54; 95%CI 1.06 -2.24), and depression symptoms (OR = 1.49; 95%CI 1.00 -2.20). Our results suggest that healthcare professionals should identify older adults with EDS and implement intervention strategies to minimize the negative impact of the co-occurrence of this condition with obesity, depression and urinary incontinence over health and quality of life.

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“…Almost 40% suffer from a sleep disorder such as sleep apnea, and 32%-45% report difficulties falling or staying asleep. 1,2,3 The hallmark sleep complaint in old age is insomnia, with prevalence rates ranging from 15%-65%. 4,5 Empirical studies support that aging is associated with shorter sleep times, decreased time in deep sleep, increased arousals, and diminished sleep efficiency.…”

Section: Introductionmentioning

confidence: 99%

Self-Reported Sleep in Older African Americans and White Americans

et al. 2016

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Objective: Assess the relationship of self-reported sleep quality and possible sleep disorders with disability in a racially diverse sample of community-dwelling older adults.Methods: Participants included 943 non-demented older African Americans (n=452) and Whites (n=491) from two cohort studies, the Minority Aging Research Study (MARS) and the Rush Memory and Aging Project (MAP). Participants completed a 32-item questionnaire assessing sleep quality and the possible presence of three sleep disorders (sleep apnea, restless leg syndrome [RLS] and REM behavior disorder [RBD]). Disability was assessed with scales that quantified the ability to perform instrumental activities of daily living (IADL), basic activities of daily living (ADL), and physical mobility activities.Results: More than half of the participants reported impaired sleep quality (51%), or the possible presence of at least one sleep disorder (57%; sleep apnea 44%, RLS 25% and RBD 7%). Sleep quality was rated poorer in African Americans, those with advancing age and fewer years of education (all P<.05). Only sleep apnea risk was associated with age (P<.02). In logistic regression models adjusted for age, sex, years of education, and race, both sleep quality and disorders were associated with disability (sleep quality with mobility disability (P<.001), sleep apnea risk with mobility disability and IADL disability (all P<.001) and RLS symptoms with mobility disability (P<.01).Conclusions: Results indicate that self-assessed impaired sleep is common in old age and is associated with disability. Ethn Dis.2016;26(4):521-528; doi:10.18865/ ed.26.4.521

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Validation of the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale in older black and white women

Cited by 206 publications

References 24 publications

Psychometric Properties of the Pittsburgh Sleep Quality Index (PSQI) in a Cohort of Peruvian Pregnant Women

Psychometric Properties of the Pittsburgh Sleep Quality Index (PSQI) in a Cohort of Peruvian Pregnant Women

Correlates of excessive daytime sleepiness in community-dwelling older adults: an exploratory study

Self-Reported Sleep in Older African Americans and White Americans

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