Psychometric Evaluation of the Chinese Version of the Pittsburgh Sleep Quality Index (CPSQI) in Primary Insomnia and Control Subjects

College of Nursing, Taipei Medical University, 250 Wu Hsing Street, Taipei 110, Taiwan.
Quality of Life Research (Impact Factor: 2.49). 11/2005; 14(8):1943-52. DOI: 10.1007/s11136-005-4346-x
Source: PubMed


In order to effectively study the population experiencing insomnia, it is important to identify reliable and valid tools to measure sleep that can be administered in the home setting. The purpose of this study was to assess psychometric properties for the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) in community-dwelling adults with primary insomnia. The CPSQI had an overall reliability coefficient of 0.82 -0.83 for all subjects. "Subjective sleep quality" was the component most highly correlated with the global score. Overall, the CPSQI showed acceptable test-retest reliability over a 14- to 21-day interval with a coefficient of 0.85 for all subjects and 0.77 for primary insomniacs. The two contrasting groups had significantly different global and component scores. A CPSQI of greater than 5 yielded a sensitivity and specificity of 98 and 55% in primary insomniacs vs. controls. A CPSQI of greater than 6 resulted in a sensitivity and specificity of 90 and 67%. Results suggest that the CPSQI is a psychometrically sound measure of sleep quality and disturbance for patients with primary insomnia. It may not be an effective screening tool because of its low specificity, but it can be a sensitive, reliable, and valid outcome assessment tool for use in community-based studies of primary insomnia.

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    • "The Chinese version has good internal consistency (Cronbach's α = .82~.83). When comparing subjects with primary insomnia with healthy controls, a score of greater than 5 yields a sensitivity of 98% and specificity of 55%, and a score of greater than 6 yields a sensitivity of 90% and specificity of 67% (Tsai et al., 2005). In this sample, the PSQI achieved a Cronbach's alpha of .91. "
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    ABSTRACT: The purpose of this research was to examine the relationship between rumination, worry, pre-sleep arousal, and sleep quality. The participants were 202 young adults who completed questionnaires on sleep quality, trait rumination, and worry. After factor analysis of rumination and worry scales, three factors were found and which were positively correlated with pre-sleep cognitive arousal and sleep quality. The results of structural equation model analysis suggested that pre-sleep arousal is a mediator of the effects of repetitive thought on sleep quality. Dwelling on the negative and worry engagement can predict higher pre-sleep arousal which can predict poor sleep quality. Pre-sleep arousal is the key factor in the relationship between repetitive thought and sleep quality.
    Full-text · Article · Mar 2015 · International Journal of Cognitive Therapy
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    • "A multi-dimensional measure of sleep difficulty was administered using a Chinese validated version (Tsai et al. 2005) of the Pittsburgh Sleep Quality Index along with the original English version (Buysse et al. 1989). This instrument includes 19 items relating to the past 2 weeks and spanning seven dimensions involving: sleep quality, hours of sleep, length of sleep onset, sleep efficiency, sleep disturbances, medication use and daytime dysfunction. "
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    ABSTRACT: Problem gambling and sleep difficulty threaten health. Using the basis of self-regulatory theory, potential mechanisms for these problems were investigated. Fifty-nine treatment-seeking gamblers completed the Pittsburgh Sleep Quality Index (sleep difficulty), the Sleep Hygiene Index (negative sleep habits), the Problem Gambling Severity Index and measures of self-regulatory capacity and arousability with data entered into regression analyses. Results supported the relationship between problem gambling and greater sleep difficulty (β = .18, t = 3.22, p < .01). Self-regulatory capacity mediated the relationship between problem gambling and sleep difficulty (R 2 change = .15, F(2, 57) = 12.14, β = −.45, t = −3.45, p < .001) as well as between problem gambling and negative sleep habits; R 2 change = .17, F(2, 57) = 13.57, β = −.28, t = −3.76, p < .001. Arousability predicted sleep difficulty (β = .15, t = 3.07, p < .01) and negative sleep habits (β = .40, t = 5.40, p < .01) but showed no relationship with problem gambling (r = .09, ns). Self-regulatory capacity represents an important mediator of the relationship between problem gambling and sleep-related behaviour and if targeted could reduce behavioural threats to health.
    Full-text · Article · Nov 2014 · Journal of Gambling Studies
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    • "According to Buysse et al., patients with a PSQI score > 5 are conventionally defined as “poor sleepers”, whereas those with a score ≤ 5 are considered “good sleepers”. A previous study of primary insomniacs and healthy controls in community-dwelling adults reported that the cutoff score of 5 in the Chinese version PSQI has a sensitivity and specificity of 98% and 55%, respectively [12]. "
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    ABSTRACT: Background Poor sleep quality, a novel risk factor of cardiovascular diseases (CVD), is highly prevalent in patients with chronic kidney disease (CKD). The association between poor sleep quality and cardiovascular damage in patients with CKD is unclear. This study is aimed to assess the prevalence and related risk factors of sleep disturbance and determine the relationship between sleep quality and cardiovascular damage in Chinese patients with pre-dialysis CKD. Methods A total of 427 pre-dialysis CKD patients (mean age = 39 ± 15 years, 260 male/167 female) were recruited in this study. The demographics and clinical correlates were collected. The sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI), whereas the cardiovascular damage indicators (the Early/late diastolic peak flow velocity (E/A) ratio and left ventricular mass index (LVMI)) were determined by an echocardiographic examination. Results Of the CKD patients, 77.8% were poor sleepers as defined by a PSQI score > 5. Median estimated glomerular filtration rate (eGFR) was 69.4(15.8-110.9) ml/min/1.73 m2. Logistic regression analysis revealed that left ventricular hypertrophy (LVH) was independently associated with the PSQI score (OR = 1.092, 95% CI = 1.011-1.179, p = 0.025), after adjustment for age, sex and clinical systolic blood pressure, diastolic blood pressure, Phosphate, Intact parathyroid hormone (iPTH), Hemoglobin and eGFR. The linear regression analysis showed that the E/A ratios were independently associated with the PSQI score (β = -0.115, P = 0.028) after adjustment for a series of potential confounding factors. Conclusions Poor sleep quality, which is commonly found in pre-dialysis CKD patients, is an independent factor associated with cardiovascular damage in CKD patients. Our finding implies that the association between poor sleep and CVD might be mediated by cardiac remodeling.
    Full-text · Article · Aug 2014 · BMC Nephrology
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