Abstract
Objectives Psychometric properties of the Czech version of the Pittsburgh Sleep Quality Index (PSQI-CZ) have been evaluated only in patients with chronic insomnia, and thus, it is unclear whether PSQI-CZ is suitable for use in other clinical and nonclinical populations. This study was aimed at examining the validity and reliability of the PSQI-CZ and at assessing whether the unidimensional or multidimensional scoring of the instrument would be recommended. Methods A total of 524 adult subjects from the Czech population participated in the study. The internal consistency of PSQI was evaluated using Cronbach's alpha. The known-group validity was tested using the Kruskal-Wallis H test to verify the difference between patients with sleep disorders and healthy control sample. For testing the structural validity, a cross-validation approach was used with both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). For EFA, the maximum likelihood method with direct oblimin rotation and parallel analysis was used. Results The internal consistency of PSQI-CZ items was moderate (α = 0.75). Receiver operating characteristic (ROC) curve analysis showed high specificity (0.79) and moderate sensitivity (0.64) using an optimal cut-off score of 10. The EFA revealed a 3-factor structure with factors labelled as “sleep duration and efficiency,” “sleep disturbances and quality,” and “sleep latency.” The CFA showed that the emerged 3-factor model had a partly acceptable fit, which was better than other previously supported models. Conclusions A high cut-off score of 10 is recommended to define poor sleep quality. Given the inconsistency of structural analyses, alternative scoring was not recommended. However, the individual components in addition to a total score should be interpreted when assessing sleep quality. We recommend editing and verifying the PSQI-CZ translation.
Highlights
Disturbed sleep represents one of the most frequent health issues
Participants were recruited as part of 3 studies: a longitudinal study on aging and memory, the insomnia treatment programme at the National Institute of Mental Health (Czechia, NIMH-CZ), and a study directly focused on validation of the Pittsburgh sleep quality index (PSQI)-CZ
The healthy controls (HC) group consisted of volunteers from the Czech population who responded to the invitation to participate in the research and stated that they do not suffer from any sleep and psychiatric disorder while other somatic disorders were not monitored
Summary
Disturbed sleep represents one of the most frequent health issues. It has been shown that more than half of the adult population of economically developed countries experience unpleasant sleep disturbance [1]. The functioning of the sleep cycle can be verified by objective methods such as polysomnography or actigraphy. Disruption, BioMed Research International abnormality, or irregularity of some of these measures leads to a decrease in sleep quality. The prevalence of symptoms of difficulty in initiating or maintaining sleep ranges from 10% to 48% in the general population [3]. Poor sleep quality can contribute to absence from work, accidents at the workplace, and increased risk of negative health consequences such as sleep and neuropsychiatric disorders [4]
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