Abstract
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. 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 confirmatory factor analyses, correlations, and logistic regressions were used. Both exploratory and confirmatory factor analyses indicated a three-factor solution: sleep quality, sleep efficiency, and sleep medication. We observed significantly 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 significantly 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). 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-specific scoring of the PSQI is favored over the PSQI global score in diverse populations.
Highlights
BRIEF SUMMARY Current Knowledge/Study Rationale: The Pittsburgh Sleep Quality Index (PSQI) has been established as a valid scale with acceptable psychometric properties when used in men and non-pregnant women in diverse global settings
Given the scarcity of studies concerning the psychometric properties of the PSQI when used among pregnant women, and given that prior studies have shown that sleep, mood, and anxiety disorders are highly prevalent among low-income pregnant women in Lima, Peru,[20,21] we sought to evaluate the psychometric properties of the Spanish-language version of the PSQI among pregnant Peruvian women during early pregnancy
Based on the PSQI global score, 28.5% of study participants were classified as poor sleepers (PSQI global score > 5) and 71.5% were classified as good sleepers (PSQI global score ≤ 5)
Summary
BRIEF SUMMARY Current Knowledge/Study Rationale: The Pittsburgh Sleep Quality Index (PSQI) has been established as a valid scale with acceptable psychometric properties when used in men and non-pregnant women in diverse global settings. Few studies have assessed the reliability and validity of this scale in pregnant women, among whom disturbed sleep and poor sleep quality are common complaints; even fewer have assessed the psychometric properties of the scale when used among women from low- and middle-income countries, where sleep, mood, and anxiety disorders are highly prevalent and comorbid. Study Impact: This is the first study that evaluates the construct validity and factor structure of the Spanish-language version of the PSQI among low-income, pregnant Peruvian women. Given the scarcity of studies concerning the psychometric properties of the PSQI when used among pregnant women, and given that prior studies have shown that sleep, mood, and anxiety disorders are highly prevalent among low-income pregnant women in Lima, Peru,[20,21] we sought to evaluate the psychometric properties of the Spanish-language version of the PSQI among pregnant Peruvian women during early pregnancy. We assessed the relation of maternal early pregnancy sleep quality with measures of stress-induced sleep disturbance, and depressive and anxiety symptoms
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