PSQI, a Psychological Screening Tool for Sleep Disturbance - Health Education - DesiMD Healthcare - India

PSQI, a Psychological Screening Tool for Sleep Disturbance

Authored by DesiMD Doctor on 4 Mar 2016 - 14:19


Pittsburgh Sleep Quality Index (PSQI) is one of the most effective tools in measuring subjective sleep quality. It is a freely available tool and also includes a free scoring program for which you might require Microsoft Access. Developed by Buysse et al., this standardized questionnaire assesses seven clinical domains.

The Need to Measure Sleep:

Though frequent, sleep-related disorders (SRDs) are often under-reported, their implications are neglected. This can have a profound effect on one’s work performance, family, school and social relationships, resulting in increased risk for accidents. It is when the quality of life is affected by their symptoms, that people start seeking medical attention.

Sleep related problems are very common in university students, who report a prevalence lying in the range of 19.2% to 57.5%. In general, sleep disturbance is most common and results from many conditions, some arising from casual factors. Some of these conditions include insomnia, narcolepsy, hypersomnia, delayed sleep phase syndrome, daytime sleepiness, parasomnias, sleepwalking, nightmares, etc.  There are various research tools to assess and investigate these disorders.

Did you know SRDs could be deadly?

Dr. Sagar Mundada, a senior resident doctor, Mumbai's JJ Hospital, says, “A timely intervention, treatment, counseling and care can save people from depression and anxiety," Sleep apnea, for instance, is the sole main cause of conditions such as hypertension, congestive heart failure, angina and stroke.

According to National Dementia Report, conditions such as dementia, sleep disorders and other such psychiatric problems are often dismissed as problems related to old age by more than 25%. Majority of them never bother to seek treatment and if they choose to get treated, they would have realized at an advanced stage. The World Alzheimer Report 2015 accounts 4.1 million Indians amongst a total of 47 million people suffering from dementia. Latest statistics also reveal that approximately 9% Indians, mostly over 50 years of age and above, suffer from SRDs and most of them suffer psychiatric conditions such as depression and anxiety.

How does PSQI Work?

This self-rated questionnaire measures the quality of sleep over a one-month period. There are about 19 questions grouped into seven categories: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medications, and daytime dysfunction.

Psychometrics of PSQI

The first four questions request detailed respondent information that needs to be duly filled in – this includes routine bed time and length of time taken to fall asleep. Questions 5-8 are measured on a scale of 0 – 3, where 0 represents zero symptoms and 3 represents presence of symptoms thrice or more in the past week. The 9th question is also measured on a 0-3 scale, where 0 represents “very good” and 3 represents “very bad”. A Global PSQI Score is produced by combining all scores based on specific scoring criteria.  Poor sleepers and good sleepers are distinguished by a global score of > 5, while a poor sleep pattern is reflected by higher scores.

In psychiatric patients, a decent internal consistency and overall test-retest reliability was demonstrated by the PSQI - Cronbach's-alpha: 0.83 & Pearson's correlation coefficient: 0.85 respectively. Similar measures were also noticed in subjects suffering from insomnia and extreme daytime sleepiness.



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