PSQI Estimation in the Sample of Russian Students

Abstract

Sleep-related problems are common for young people like students and schoolchildren. The Pittsburgh Sleep Quality Index (PSQI) is a widely used measure of sleep quality in adolescents, but information regarding its psychometric strengths and weaknesses in Russian population is limited. Study goal was to evaluate sleep quality in the sample of Karelian students and compare with previous studies from other countries. A total number of 333 students from Petrozavodsk University and High Pedagogic School participated in this study (234 girls, 96 boys). Mean age was 17.75 ± 1.9 years. The mean global PSQI score was 6.16 ± 2.8 (median 6, range 0-17) with 56% of the participants experiencing poor sleep quality (> 5), and 19,5% reporting extremely poor sleep quality (≥ 8). Women had higher PSQI scores (6.59±2.89) compared to men (4.89±2.80).This is the first study in students from Russian Karelia, and it shows that sleep quality in our sample is affected by sex and not age.

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International Online Journal of Educational Sciences, 2016, 8 (5), 79-84
© 2016 International Online Journal of Educational Sciences (IOJES) is a publication of Educational Researches and Publications Association (ERPA)
www.iojes.net
International Online Journal of Educational Sciences
ISSN: 1309-2707
PSQI Estimation in the Sample of Russian Students
Sergey N. Kolomeichuk1, Christoph Randler2, Alexey V. Churov1 and Mikhail F.
Borisenkov3
1 Institute of Biology of Karelian Research Centre Russian Academy of Sciences, Petrozavodsk Russia
2University of Tübingen, Department of Biology, Tübingen, Germany
3Institute of Physiology, Komi Science Centre, Ural Branch of Russian Academy of Sciences, Syktyvkar, Russia
ART I CL E IN F O
ABS T RAC T
Article History:
Received 05.10.2016
Received in revised form
12.10.2016
Accepted 02.11.2016
Available online
25.11.2016
Sleep-related problems are common for young people like students and schoolchildren. The
Pittsburgh Sleep Quality Index (PSQI) is a widely used measure of sleep quality in adolescents, but
information regarding its psychometric strengths and weaknesses in Russian population is limited.
Study goal was to evaluate sleep quality in the sample of Karelian students and compare with
previous studies from other countries. A total number of 333 students from Petrozavodsk University
and High Pedagogic School participated in this study (234 girls, 96 boys). Mean age was 17.75 ± 1.9
years. The mean global PSQI score was 6.16 ± 2.8 (median 6, range 0-17) with 56% of the participants
experiencing poor sleep quality (> 5), and 19,5% reporting extremely poor sleep quality (≥ 8). Women
had higher PSQI scores (6.59±2.89) compared to men (4.89±2.80).This is the first study in students
from Russian Karelia, and it shows that sleep quality in our sample is affected by sex and not age.
© 2016 IOJES. All rights reserved
Keywords: 1
Sleep quality; sleep disturbance; adolescence; stress; college students
Introduction
Sleep-related pathologies also called disorders are among major health issues in the world. The
estimated prevalence of sleep problems in the general population range between 16% and 24%, and
prevalence as high as 60% has been reported in the elderly population (Mellinger, Balter, & Uhlenhuth,
1985). Low sleep quality has been associated with increased anxiety, irritability, depression, confusion and
generally lower life satisfaction (Pilcher, Ginter, & Sadowsky, 1997). Students have been identified as a
population group particularly affected by problems with sleep (Bulboltz, Franklin, & Barlow, 2001; Pallos,
Yamada, Doi, & Okawa, 2004; Carney, Edinger, Meyer, Lindman, & Istre, 2006). A majority of university
students are in late adolescence transition to adult life and, due to the stress of education and the academic
workload, their sleep patterns and related problems could differ from non-students of their age (Fukuda &
Ishihara, 2001). Most of the studies examining sleep patterns among college students have focused on the
relationship between sleep habits and academic performance (Trockel, Barnes, & Egget, 2000; Gaultney,
2010; Buboltz, Brown, & Soper, 2001) and mental health problems (i.e., stress, depression and suicidal
ideation) (Sing & Wong, 2010; Kenney, LaBrie, Hummer, & Pham, 2012; Nyer et al., 2013; Nadorff, Nazem, &
Fiske, 2011; Carskadon & Davis, 1989). All the studies concede that college students experience frequent and
sometimes severe sleep problems that negatively impact their health and well-being (Trockel, Barnes, &
Egget, 2000; Gaultney, 2010; Buboltz, Brown, & Soper, 2001; Sing & Wong, 2010). Overall, estimates of
sleeping problems/disturbances among college students ranged between 13.8% and 68.6% depending on the
definition and measurement used (Sing & Wong, 2010; Kenney, LaBrie, Hummer, & Pham, 2012). In a 2012
1
Corresponding author’s address:185910 Russia Petrozavodsk Ul. A.Nevskogo, 50 Institute of Biology Karelian research Center RAS
Telephone:+79114292043
Fax:+7142769810
e-mail:sergey_kolomeychuk@rambler.ru
DOI: http://dx.doi.org/10.15345/iojes.2016.05.009

International Online Journal of Educational Sciences, 2016, 8 (5), 79-84
80
US survey of college students (n = 99,066), 26.4% reported sleep difficulties during the previous 12 months as
being “traumatic or very difficult to handle”, and 57.1% of the sample reported having enough sleep to feel
rested on fewer than four days a week. In a study examining sleep/wake patterns over the transition from
high school to college, Carskadon and Davis found a significant reduction in the number of hours of sleep,
as well as delay in onset of night time sleep, as students transition to college. In addition to the amount of
sleep, the quality of sleep seems to be changing and impacting the well-being of college students (Trockel,
Barnes, & Egget, 2000; Buboltz, Brown, & Soper, 2001; Megdal & Schernhammer, 2007). Using the Pittsburgh
Sleep Quality Index (PSQI), Lund identified 63.9% of college students in her sample (N=1,125) as poor-
quality sleepers, those who experience restricted total sleep, erratic sleep schedules, and/or sleep
disturbances (Lund, Reider, Whiting, & Prichard, 2010). Along the same line, Gaultney found that 27% of
college students (N = 1,845) were at risk for sleep disorders likely to disturb sleep (Gaultney, 2010). When
Pilcher and co-investigators looked at the impact of sleep quantity and quality on the health of college
students, they found sleep quality to be a better predictor than sleep quantity of several measures of health
including health complaints, depression, fatigue and sleepiness. Results from these studies reveal an
unquestionable problem of insufficient and poor quality sleep among adolescents and young adults, as well
as growing levels of sleep dissatisfaction (Hicks, Fernandez, & Pellegrini, 2001). The extent of sleep-related
problems among Russian university students is unknown. In a country like Russia, where there are many
different time zones and nationalities, a rating scale would be an invaluable and versatile tool to estimate
sleep-related problems in this subpopulation. The most widely used sleep instrument is the Pittsburgh Sleep
Quality Index (PSQI). The PSQI (Buysee, Reynolds, Monk, Berman, & Kupfer, 1989), introduced in 1989, has
acquired extensive acceptance as a useful instrument in measuring sleep quality in diverse groups of
patients. The questionnaire is easy to understand and can be completed in 5 min or less. It has been shown to
have good validity for patients with psychiatric and sleep disorders (Doi, Minowa, Uchiyama, Okawa, Kim,
Shibui, & Kamei, 2002) and for patients with other somatic diseases (Carpenter, & Andrykowski, 1998). It
has also been used among student populations in Japan (Pallos, Gergely, Yamada, Miyazaki, & Okawa,
2005), Korea (Lee et al., 2016), US (Lund, Reider, Whiting, & Prichard, 2010) and other countries. PSQI
measures sleep disturbance and usual sleep habits during the prior month. It is self-administered
questionnaire, score of >5 having a diagnostic sensitivity of 89.6% and specificity of 86.5% to distinguish
“poor” sleepers (depressed patients) from “good” sleepers (healthy subjects). Our goal was to evaluate sleep
quality in the sample of Karelian students and compare it with previous studies from other countries.
Methods
Participants
The study was carried out anonymously and voluntarily throughout the winter months from 2013 to
2014 in the city of Petrozavodsk (61.78° N, 34.33° E), which is located in northwest Russia.
A total number of 333 students from University and High Pedagogic school participated in this study
(234 girls, 96 boys). Mean age was 17.75 ± 1.9 years with a range between 15 and 26 years.
Questionnaires were distributed to the University students by lecturers or school psychologists to the
High School students. Students filled out the questionnaires in the classroom. At the time when the survey
was carried out, approximately 90% of respondents had lived in the places of residence that they indicated in
the questionnaire for more than 5 years. On average, classes start at 8:30 in the morning in Karelia.
Instruments
Pittsburg sleep quality index. Sleep quality was assessed via a translated version into Russian of the
Pittsburgh Sleep Quality Index (PSQI), which evaluates the quality of sleep over the past month [25]. This
measure consists of ten questions that include seven components: subjective quality of sleep, sleep latency,
sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, daytime sleepiness,
and disturbances during the day. The maximum PSQI score is 21 points, determined by the sum of the seven
components. Each component is given a score between zero and three points. These scores are then
combined to generate an overall PSQI score; the higher the score, the worse the quality of sleep. An overall
PSQI score > 5 points indicates that the individual has difficulties in at least two components or moderate

Sergey N. Kolomeichuk, Christoph Randler, Alexey V. Churov, & Mikhail F. Borisenkov
81
difficulties in more than three components. In the end, it is common to classify subjects into two groups:
good (PSQI<5) and poor sleepers (PSQI>5).
Demographic data. In addition, each participant had to indicate the date when the form was completed
as well as residence / place of study, residence in the local area and personal data: gender, and age. Table 1
presents descriptive characteristics for the respondents. Lecturers or school psychologists distributed the
questionnaires to the students. The respondents in classrooms completed all the questionnaires.
Statistical Analyses
Only full datasets were analysed. We present descriptive scores and calculated t-test for differences and
Pearsons correlations for relationships. This study was approved by the ethics committee at the
Petrozavodsk Center for Education Control approval # 21/20/187 from 26.02.14. The research has been
conducted in an ethical and responsible manner, in full compliance with all relevant codes of
experimentation and legislation. All the work was done at Common Core Facility of Institute of Biology
Karelian Research Center Russian Academy of Sciences.
Results
Socio-demographic and sleep-related data were presented in Table 1.
Table 1. Sociodemographic characteristics of university students by gender - Petrozavodsk, RUSSlA, 2016
Characteristics
Total n (%)
Gender
p-value b
Men
Women
96 (29.7)
234 (70.3)
n
(%)
n
(%)
Age group (years) (n=333)
0.52
15 to 17
210 (63.1)
70
33.3
140
66.7
18 to 22
117 (35.1)
23
19.6
94
80.4
23to 26
6(3.8)
3
50.0
3
50.0
Marital status (n=330)
Married/Partnership
20 (6.0)
3
3.2
17
5.0
Single
306 (91.9)
93
96.8
214
91.4
Separated
4 (2.1)
0
0.0
4
3.6
Who the student lives with (n=333)
0.723
Alone
9 (2.7)
19
20.3
51
21.6
Parents
266 (79.8)
65
67.3
143
66.8
Relatives (siblings, uncles/aunts, cousins)
53 (15.9)
3
4.2
34
14.6
Partner
15 (4.5)
9
9.4
6
2.5
Out of the 400 participants contacted, 57 refused participation and 10 had incomplete data, so only a
total of 333 questionnaires were analyzed. The mean age of the participants in years was 17.75 ± 1.9. There
were 234 (70.3%) females. The average wake-up time on working days was 7.08 (SD 1.00), and the average
wake-up time on weekend was 11.44 (SD 2.60). The average number of minutes to fall asleep was 27.42 (SD
15.54), and the average hours of sleep per night was 6.95 (SD 1.20).
Results of the PSQI are presented in Figure 1. The mean global PSQI score was 6.16 ± 2.8 (median 6,
range 0-17) with 56% of the participants experiencing poor sleep quality (> 5), and 19,5% reporting extremely
poor sleep quality (≥ 8).

International Online Journal of Educational Sciences, 2016, 8 (5), 79-84
82
Figure 1. PSQI score distribution in the sample of Karelian students.
PSQI scores differed between males and females (T-Test: T=4.917, df= 328, p<0.001). Women had higher PSQI
scores (6.59±2.89) and therefore more sleep problems compared to men (4.89±2.80).
Figure 2. Sex difference in PSQI scores.
It was found that age was uncorrelated with PSQI scores (r=0.021, p=0.703) in our sample.
Discussion
The current study consisted of a 333-student sample with a mean age of 17.75 years. This sample
allowed for the assessment of relationships with individuals who were full-time students. Our work was
aimed at evaluating sleep quality in the sample of Karelian students. To our knowledge, this study is the
first to examine the usefulness of a sleep screening instrument among university students in Russian North-
West. Researchers say that puberty is a crucial period for the development of cardiovascular risk factors
while recommending interventions to avoid unfavorable outcomes in adulthood (Pallos et al, 2004). The
detection of sleep problems among university students becomes especially important due to the lifestyle led
by this population. These individuals often live alone or with colleagues, begin unhealthy food habits, do not
eat during scheduled times, and work or study at night.

Sergey N. Kolomeichuk, Christoph Randler, Alexey V. Churov, & Mikhail F. Borisenkov
83
Values of PSQI. In agreement with the authors of the instrument and studies done worldwide, we
found the best cut-off score for the PSQI among our university students to be 5 and above. 56% of the
participants experienced poor sleep quality and 19.5% extremely poor sleep quality. This is among the range
of the other previous studies (Lund et al., 2010; Aloba, Adewuya, Ola, & Mapayi, 2007) and shows that
students in Russian Karelia also have sleep difficulties. Meanwhile, our sample is younger than age ranges
that have been observed among university samples from other studies (Lund et al., 2010; Megdal, &
Schernhammer, 2007). That explains contradiction in data received from another groups (Ban & Lee, 2001;
Kang & Chen, 2009). The physiological processes that occur during sleep are necessary for the maintenance
of physical and cognitive activity. Disorders associated with poor sleep quality can impair performance in
school, work, and social relationships. Sleep disorders are also associated with an increased risk of accidents
(Carney et al., 2006). Therefore, university students who lack adequate sleep quality might see learning and
academic performance worsening as a result. This can predispose this population to cognitive and
psychosomatic problems (Fukuda, & Ishihara, 2001; Lund et al., 2010). In addition to the damage caused by
sleep disorders alone, additional risks exist due to the association between these disorders and poor sleep
quality with obesity, central obesity, and other anthropometric data.
Sex differences. According to our data, statistically significant differences were found between sexes.
This complies with other studies on this topic, for example with Lund et al. (Lund et al., 2010; Megdal &
Schernhammer, 2007). On the other hand, other works found no statistically significant association between
gender and sleep quality among students (Ban & Lee, 2001; Kang & Chen, 2009) Also, it should be noted
prevalence of female subjects in our sample. It could be explained by the fact that our study held at faculties
more popular among girls.
Age. We found no correlation between age and PSQI values. This could be explained by relatively
small and homogenous by age sample in our study.
Limitations. Our study has several limitations. First, small sample size in our study. Second, the PSQI
is a subjective measure of sleep. Thus, our analysis was based on self-reported data rather than on direct
measurements. Since this is a relatively new area of study, another limitation of this research is the lack of
relevant literature on the subject, preventing a more detailed analysis of the results. Therefore, new studies
are needed to clarify the real influence of parameters on sleep quality in students.
Conclusion
The present study showed that cognitive performance of Tunisian children are time-of-day dependent,
with the best values observed in the morning for CA and best one in the afternoon for choice RT. These
cognitive performances are also day of test dependent, with the best values observed in the middle of week
and worst one in the beginning and the end of week. Nevertheless, these rhythms of cognitive performance
are desynchronized from the rhythm of core temperature.
Acknowledgements
This work was supported by the grant # 15-16-10001 a(p) from Russian Foundation for Humanities. We
appreciate great effort from Derzhavinsky Lyceum, Petrozavodsk State University and High Pedagogical
School (especially Galina A. Reksha) for help with our study.
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