Global PSQI Score Research Articles

Sleep Quality and Correlates of Sleep Among Medical Students

Sleep is an important indicator of physical and mental health. Little is known about the quality, pattern and correlates of sleep among Indian adults. This study was aimed to analyze the quality of sleep in medical students using the Pittsburgh Sleep Quality Index and to relate sleep with blood pressure, body mass index and academic performance. The sample consisted of 67 medical students in the age group of 18–22 years. 28(42%) medical students had ‘poor sleep’. 57% reported inadequate sleep and 54% had sleep disturbances. ‘Poor sleepers’ had higher blood pressure, body mass index and lowered academic performance compared with good sleepers. Global PSQI score showed significant positive correlation with blood pressure and body mass index but not with academic performance. This study shows the high prevalence of poor sleep quality and underline the close relationship of sleep with BP, BMI and academic performance among medical students.

Sleep and quality of life in long-term lung cancer survivors

Sleep problems are common in lung cancer survivors, yet little is known about the prevalence, determinants, and effects on quality of life (QoL) of these sleep problems in long-term lung cancer survivors. A case-control study design comparing 76 elderly lung cancer survivors (LCS, >5 years post diagnosis with mean survival time of 8 years+/-2.1 years) and 78 elderly non-cancer controls (NCC). Measurements included a standardized questionnaire for sleep (Pittsburgh Sleep Quality Index-PSQI), and analogue scales for dyspnea, pain, and other comorbid symptoms, as well as demographic factors and cancer history. Overall, 56.6% of LCS had poor sleep (PSQI global score >5) as compared to only 29.5% of NCC (p<0.001), and 49.2% of LCS who did not have sleep difficulties prior to their lung cancer diagnosis ultimately developed them. There was also evidence of significant impairments in sleep efficiency in LCS (78.3%) relative to NCC (89.6%, p<0.001), predominantly due to increased nocturnal awakenings. A single-item analogue scale for sleep quality was not as effective in identifying sleep problems as more specific questions about sleep duration and sleep efficiency. Poor sleep quality was significantly correlated with impairments in quality of life, even when controlling for other factors, such as dyspnea. Even 8 years after diagnosis, LCS continue to have significant sleep difficulties. By asking specific questions about sleep medication use, nocturnal awakenings and sleep efficiency, health care providers can identify sleep problems that could be treated and potentially improve the quality of life of their patients.

The Relationship of Subjective Sleep Quality, Pain, and Quality of Life in Advanced Cancer Patients

Cancer patients have been reported to complain about poor quality of sleep. This study evaluated the quality of sleep in this group, utilizing demographic data and clinical features of the cancers as assessment criteria. A secondary aim was to evaluate the correlation between the self-rated questionnaire for the quality of sleep with other instruments used in measuring pain and quality of life. A total of 102 patients with stage IV cancer completed the study and were subsequently followed for up to 10 months. Self-rated questionnaires were administered for the evaluation of quality of sleep (PSQI), quality of life Medical Outcomes Study 12-item short-form (SF-12) questionnaire, the Mental Component Summary (MSC) and the Physical Component Summary (PCS), and pain (VAS Pain). The mediation analysis model was also used to evaluate how quality of life can influence the quality of sleep through its relation to pain, the performance status of patients and analgesics (Opioids). The mean age of the study participants was 62.8 (range: 26.0-87.0) years old. The majority (70.6%) of the patients presented with ECOG score between 2 and 3 and with metastasis (58.8%). Mean Global Sleep Quality score was 12.0+/-4.6. The use of the PSQI questionnaire in cancer patients demonstrated that these subjects were prone to sleep poor quality. However, the various demographic variables and clinical features of the cancers did not affect quality of sleep. Global Sleep Quality scores from the PSQI correlated with the scores obtained from the SF-12 questionnaire and with the VAS Pain results, indicating a relationship between quality of sleep, quality of life and pain. However, only the SF-12 questionnaire had predictive value on quality of sleep. Mediation analysis showed that quality of life influences quality of sleep both directly and indirectly by its effect on pain. In addition, some of the effect of quality of life on sleep quality was mediated by the use of opioids. Quality of sleep in patients suffering from stage IV cancer was significantly decreased. Demographic data and clinical variables of cancers did not affect the PSQI Global Sleep Quality score. The use of the mediation model also provides evidence that quality of sleep, quality of life, pain, and opioids are strictly correlated each other.

Influencing Factors of Subjective Sleep Quality among Middle-aged Women

Purpose: The purposes of this study were to (a) explore the prevalence of sleep patterns of middle-aged women; (b) identify the relationship between subjective sleep quality and its related variables; and (c) predict the possible explanations of how the related factors affect subjective sleep quality of middle-aged women. Methods: A total of 256 women aged 40-60 years were purposely sampled and given self-administered questionnaires in a cross-sectional, correlation coefficient design. The data was analysed using t-test, one-way ANOVA, Pearson's correlation coefficients, and stepwise multiple regression. Results: The results were as follows; (a) a total of 40% of the women were poor sleepers as defined by a global PSQI score >5; (b) there were significant differences in quality of sleep related to type of family, number of present illnesses, and use of medication; (c) health promoting behaviors, family functioning, depression, and climacteric symptoms were significantly related to subjective sleep quality; and (d) 34% of variance in subjective sleep quality can be explained by climacteric symptoms, depression, type of family, and spouse. Conclusions: Our findings suggested a high proportion of poor sleeping in middle-aged women. Poor sleeping appeared to have poor health promoting behaviors, lower family functioning, worse depression, and higher climacteric symptoms. Climacteric symptoms, depression, type of family, and spouse were independent risk factors for poor sleeping. Nurse professionals should screen for sleep problems in middle-aged women with a biopsychosocial and behavioral aspect.

A brief Sleep Scale for Posttraumatic Stress Disorder: Pittsburgh Sleep Quality Index Addendum for PTSD

Sleep disturbances reflect a core dysfunction underlying Posttraumatic Stress Disorder (PTSD). Specifically, disruptive nocturnal behaviors (DNB) may represent PTSD-specific sleep disturbances. The Pittsburgh Sleep Quality Index Addendum for PTSD (PSQI-A) is self-report instrument designed to assess the frequency of seven DNB. The goal of this study was to examine the psychometric properties of the PSQI-A to characterize DNB in a group of participants with and without PTSD. Results indicate that the PSQI-A has satisfactory internal consistency and good convergent validity with two standard PTSD measures even when excluding their sleep-related items. A global PSQI score of 4 yielded a sensitivity of 94%, a specificity of 82%, and a positive predictive value of 93% for discriminating participants with PTSD from those without PTSD. The PSQI-A is a valid instrument for PTSD applicable to both clinical and research settings.

Skin picking and sleep disturbances: Relationship to anxiety and need for research

Pathological excoriation (PE) or skin picking is seen in nearly 2% of patients attending dermatology clinics and is often associated with anxiety, stress and frequent help-seeking behaviors. While anxiety and stress are thought to cause poor sleep in the general population, not all anxious people, even those with disabling anxiety disorders, necessarily suffer from insomnia or other sleep problems. The relationship between anxiety symptoms and poor sleep, therefore, remains unclear and sleep quality in PE is unknown. We examined the sleep quality and levels of anxiety in dermatological patients with PE. Dermatological patients with (n = 10) and without (n = 10) PE and healthy controls (n = 10) were assessed on standardized and validated measures of subjective sleep quality [Pittsburgh Sleep Quality Index (PSQI)], anxiety (Spielberger State and Trait Anxiety Inventory; modified Zung Anxiety Scale), stress (Perceived Stress Scale) and work and social disability [Sheehan Disability Inventory subscale (SDI-4)]. Patients with dermatological complaints as a group reported poorer sleep quality, higher scores on Spielberger State and Zung anxiety, perceived stress, and SDI-4. Among both groups of dermatological patients, only the PE group had significantly poor sleep, high anxiety, and perceived stress compared to healthy controls. In the dermatological patients with PE, PSQI-global scores were significantly positively correlated to Spielberger State and Zung Anxiety scores. Dermatological patients with PE are more anxious and have poorer subjective sleep compared to dermatological patients without PE and healthy. Future research is needed to elucidate these relationship factors and to develop new behavioral and drug treatments for the management of PE.