Pittsburgh Questionnaire Research Articles

Detecting insomnia in patients with low back pain: accuracy of four self-report sleep measures

BackgroundAlthough insomnia is common in patients with low back pain (LBP), it is unknown whether commonly used self-report sleep measures are sufficiently accurate to screen for insomnia in the LBP population. This study investigated the discriminatory properties of the Pittsburgh Sleep Quality Index (Pittsburgh questionnaire), Insomnia Severity Index (Insomnia index), Epworth Sleepiness Scale (Epworth scale) and the sleep item of the Roland and Morris Disability Questionnaire (Roland item) to detect insomnia in patients with LBP by comparing their accuracy to detect insomnia to a sleep diary. The study also aimed to determine the clinical optimal cut-off scores of the questionnaires to detect insomnia in the LBP population.MethodsSeventy nine patients with LBP completed the four self-reported questionnaires and a sleep diary for 7 consecutive nights. The accuracy of the questionnaires was evaluated using Receiver Operator Characteristic (ROC) curves with the Area Under the Curve (AUC) used to examine each test’s accuracy to discriminate participants with insomnia from those without insomnia.ResultsThe Pittsburgh questionnaire and Insomnia index had moderate accuracy to detect insomnia (AUC = 0.79, 95% CI = 0.68 to 0.87 and AUC = 0.78, 95% CI = 0.67 to 0.86 respectively), whereas the Epworth scale and the Roland item were not found to be accurate discriminators (AUC = 0.53, 95% CI = 0. 41 to 0.64 and AUC = 0.64, 95% CI = 0.53 to 0.75 respectively). The cut-off score of > 6 for the Pittsburgh questionnaire and the cut-off point of > 14 for the Insomnia index provided optimal sensitivity and specificity for the detection of insomnia.ConclusionsThe Pittsburgh questionnaire and Insomnia index had similar ability to screen for insomnia in patients with low back pain.

Efectividad de la biodanza acuática sobre la calidad del sueño, la ansiedad y otros síntomas en pacientes con fibromialgia

Background and objectiveTo analyze the effects of an aquatic biodance based therapy on sleep quality, anxiety, depression, pain and quality of life in fibromyalgia patients. Patients and methodRandomized controlled trial with 2 groups. Fifty-nine patients were assigned to 2 groups: experimental group (aquatic biodance) and control group (stretching). The outcome measures were quality of sleep (Pittsburgh questionnaire), anxiety (State Anxiety Inventory), depression (Center for Epidemiologic Studies Depression Scale), pain (visual analogue scale, pressure algometry and McGill) and quality of life (Fibromyalgia Impact Questionnaire) before and after a 12-week therapy. ResultsAfter treatment, we observed significant differences in the experimental group (P<.05) on sleep quality (49.7%), anxiety (14.1%), impact of fibromyalgia (18.3%), pain (27.9%), McGill (23.7%) and tender points (34.4%). ConclusionsAquatic biodance contributed to improvements in sleep quality, anxiety, pain and other fibromyalgia symptoms.

Puntos gatillo miofasciales, dolor, discapacidad y calidad del sueño en pacientes con cefalea de tensión crónica: estudio piloto

INTRODUCTION. The referred pain induced by myofascial trigger points (MTP) and sleep disorders can be factors that contribute to chronic tension-type headache. AIM. To determine the relationship between MTP, intensity of pain, disability and quality of sleep in people with chronic tension-type headache. SUBJECTS AND METHODS. Participants in the study consisted of 16 patients with chronic tension-type headache and 15 healthy controls. A visual analogue scale was used to measure the intensity of the pain, and the neck disability questionnaire and the Pittsburgh (quality of sleep) questionnaire were also employed. MTP were explored in the temporal, masseter, upper trapezius, suboccipital, sternocleidomastoid, splenius capitis, semispinalis capitis and anterior digastric muscles by a blind evaluator. RESULTS. The subjects with chronic tension-type headache had greater cervical disability (p < 0.001) than the controls, whereas the quality of sleep showed a tendency (p = 0.092). A positive correlation was found between the worst pain last week with the Pittsburgh questionnaire (r = 0.631; p = 0.009) and disability (r = 0.521; p = 0.046), as well as a positive correlation between disability and quality of sleep (r = 0.815; p < 0.001). The patients with headache displayed a higher number of MTP than the healthy controls (p < 0.001), the presence of active MTP being found exclusively in the patients. No association was found between the number of MTP and intensity of pain, disability or quality of sleep. CONCLUSIONS. Quality of sleep and active MTP can be different factors contributing to chronic tension-type headache. Nevertheless, the presence of MTP could also be an epiphenomenon of the pain.

Acupuncture improves sleep in postmenopause in a randomized, double-blind, placebo-controlled study

ABSTRACTBackground Insomnia increases in frequency as women approach and pass through menopause. Studies have not shown acupuncture efficacy for insomnia in postmenopausal women.Objectives The aim of this study was to evaluate the effectiveness of acupuncture therapy on sleep parameters, depression symptoms and quality of life in postmenopausal women with insomnia.Methods This study included 18 postmenopausal women aged 50–67 years old. Participants had a body mass index ≤ 30 kg/m2, presented a diagnosis of insomnia according to the DSM-IV criteria, had experienced at least 1 year of amenorrhea and had a follicle stimulating hormone level ≥ 30 mIU/ml. Participants were not using antidepressants, hypnotics or hormonal therapy. This study was randomized, double-blind and placebo-controlled. The sample was divided into two groups: acupuncture and ‘sham’ acupuncture. We performed ten sessions of acupuncture and ‘sham’ acupuncture during a period of 5 weeks. A polysomnography exam (PSG) and questionnaires (WHOQOL-BREF, Beck Depression Inventory and Pittsburgh Sleep Quality Index) were completed by all patients before and after the treatment period.Results Anthropometric, polysomnographic, and questionnaire data were similar among the groups at baseline. Comparison of baseline and post-treatment data of the acupuncture group showed that treatment resulted in significantly lower scores on the Pittsburgh Questionnaire and an improvement in psychological WHOQOL. The acupuncture group had a higher percentage of the N3 + 4 stage than the sham group in PSG findings.Conclusion Acupuncture was effective in improving reported sleep quality and quality of life in postmenopausal women with insomnia.

Profile Level Of Physical Activity And Quality Of Sleep In Patients With Fibromyalgia

The fibromyalgia is a chronic non-inflammatory pain syndrome, characterized by the presence of diffuse pain in the body for a period of three months, and as a consequence of the reduction in physical activity level, but also reported complaints of sleep disturbances. PURPOSE: To describe and correlate the level of physical activity and quality of sleep in patients with fibromyalgia. METHODS: We evaluated 15 female patients, mean age of 58.47±7.0 with a diagnosis of fibromyalgia. This is a cross-sectional study with application of questionnaires, self-administered. The assessment of the level of physical activity was made by the International Physical Activity Questionnaire - IPAQ, the chronotype by questionnaire chronotype morning-afternoon and the quality of sleep using the Pittsburgh Questionnaire, to assess sleepiness using the Sleepiness Scale of Epworth. All data were analyzed by statistical program SPSS Statistics Version 17. The tests used were the "student t" for testing the homogeneity of the sample. Test for equality of variance and Levene X2 Fischer to establish the relationship between the IPAQ questionnaires/Pittsburgh and IPAQ/Epworth. RESULTS: The level of physical activity of patients revealed that 67% were minimally active, while 33% were inactive with regard to the quality of sleep 94% had complaints of sleep, 53% have daytime sleepiness. CONCLUSIONS: Given that the practice of physical exercise is now considered a form of treatment for complaints related to sleep, it is believed that one of the alternative treatment for patients with fibromyalgia would be implementing a routine of physical exercise on a gradual and progressive. Since these women have in addition to all the pain of fibromyalgia, a low level of physical activity and sleep disorders. Supported by AFIP and FAPESP (CEPID #98/14303-3 to S.T. and #07/56620-6 to A.S. and #09/05442-6 to R.M.S.C.). Sergio Tufik and Marco Túlio de Mello are recipients of fellowships from CNPq, FADA - UNIFESP, CEPE.

Zaleplon Improves Sleep Quality in Maintenance Hemodialysis Patients

Background/Aim: A recent survey has shown that insomnia is still a very common problem in maintenance hemodialysis (MHD) patients. The aim of the present study was to test the effects of zaleplon (ZAL), a new nonbenzodiazepine hypnotic drug, on the sleep quality of MHD patients with insomnia. Methods: The sleep quality was assessed by the Pittsburgh questionnaire in 10 patients (6 males/4 females) with insomnia on MHD; these patients underwent a randomized double-blind crossover study versus placebo (PLA). The main exclusion criterion was the presence of any possible cause of insomnia related to other concurrent diseases. Results: Treatment with ZAL significantly improved the total score of sleep quality (p < 0.03 vs. PLA). The analysis of the single components revealed that treatment with ZAL was associated with a higher subjective sleep quality (p < 0.01 vs. PLA) and a reduced sleep latency (p < 0.01 vs. PLA). The duration of sleep was not modified by ZAL, whereas a significant improvement was detected in habitual sleep efficacy (p < 0.05 vs. PLA). No peculiar side effect was recorded on ZAL. Blood parameters did not change, nor were differences recorded in the dialysis parameters (body weight gain, blood pressure) throughout the study. Conclusions: This study suggests that ZAL has a positive effect on the sleep quality in MHD patients. The absence of side effects and its pharmacodynamic properties make ZAL a useful drug in uremic patients.