Sleep Health Assessments
Pittsburgh Sleep Quality Index (PSQI)
What is the Pittsburgh Sleep Quality Index (PSQI)?
The Pittsburgh Sleep Quality Index (PSQI) is a standardized, self-rated questionnaire used by researchers and clinicians to measure sleep quality and disturbances over a one-month period. It assesses seven different components of sleep to generate a single global score.
Important: A high PSQI score indicates poor sleep quality and suggests that a consultation with a healthcare professional may be beneficial. This tool does not provide a medical diagnosis.
PSQI Score Interpretation
| Score Range | Interpretation |
|---|---|
| 0 - 5 | Good sleep quality |
| 6 - 10 | Poor sleep quality, mild disturbance |
| 11 - 15 | Poor sleep quality, moderate disturbance |
| 16 - 21 | Poor sleep quality, severe disturbance |
A global PSQI score > 5 indicates poor sleep quality and may suggest the presence of a sleep disorder. Consultation with a healthcare professional is recommended.
Understanding the 7 Components of Your PSQI Score
The global PSQI score is the sum of scores from seven key areas related to your sleep. Each component is scored from 0 (no difficulty) to 3 (severe difficulty).
References
- Buysse, D.J., Reynolds III, C.F., Monk, T.H., Berman, S.R., & Kupfer, D.J. (1989). The Pittsburgh Sleep Quality Index (PSQI): A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193-213.
- Mollayeva, T., Thurairajah, P., Burton, K., Mollayeva, S., Shapiro, C.M., & Colantonio, A. (2016). The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: A systematic review and meta-analysis. Sleep Medicine Reviews, 25, 52-73.
- Backhaus, J., Junghanns, K., Broocks, A., Riemann, D., & Hohagen, F. (2002). Test-retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia. Journal of Psychosomatic Research, 53(3), 737-740.
Interpreting Your PSQI Score
Understanding what your global PSQI score means for your sleep health
Score 0-5: Good Sleep Quality
A global PSQI score of 5 or less indicates good sleep quality. You're likely getting adequate, restful sleep and your sleep habits are supporting your overall health. Continue maintaining your healthy sleep routines.
Score 6-10: Moderate Sleep Difficulty
A score in this range suggests some sleep difficulties. Review your sleep hygiene habits, reduce caffeine and screen time before bed, and establish a consistent sleep schedule. If problems persist, consider consulting a healthcare provider.
Score 11-21: Poor Sleep Quality
A score above 10 indicates significant sleep problems that may be affecting your daily functioning, health, and quality of life. We strongly recommend consulting with a sleep specialist or healthcare provider to identify underlying causes and develop an appropriate treatment plan.
Clinical Threshold: In research and clinical practice, a PSQI global score greater than 5 is widely used as the cut-off point distinguishing "good" from "poor" sleepers, with a diagnostic sensitivity of 89.6% and specificity of 86.5%.
Who Should Take the PSQI Test?
Consider taking the PSQI if you:
- • Have trouble falling asleep or staying asleep
- • Wake up feeling unrefreshed despite adequate sleep time
- • Experience daytime fatigue or sleepiness
- • Want to track changes in your sleep quality over time
- • Are working with a healthcare provider on sleep issues
The PSQI is commonly used for:
- • Initial sleep quality screening
- • Monitoring treatment effectiveness
- • Research studies on sleep
- • Identifying sleep disorder symptoms
- • Personal sleep health tracking
Frequently Asked Questions About the PSQI
What is the Pittsburgh Sleep Quality Index (PSQI)?
The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire developed in 1989 by Dr. Daniel J. Buysse at the University of Pittsburgh. It assesses sleep quality and disturbances over a one-month period through 19 questions that generate seven component scores and one global score.
What is a good PSQI score?
A global PSQI score of 5 or less is considered "good" sleep quality. Scores above 5 indicate increasingly poor sleep quality. The maximum possible score is 21, with higher scores representing worse sleep quality.
How is the PSQI scored?
The PSQI generates seven component scores (subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction), each scored from 0 to 3. These are summed to produce a global score ranging from 0 to 21.
Is the PSQI clinically validated?
Yes, the PSQI is one of the most widely validated and used sleep quality instruments in clinical research and practice. It has been translated into over 50 languages and validated across diverse populations with high reliability and validity.
How often should I take the PSQI?
Since the PSQI assesses sleep over the previous month, taking it monthly can help track changes in your sleep quality. If you're undergoing treatment for sleep problems, your healthcare provider may recommend more frequent assessments.
Can the PSQI diagnose sleep disorders?
The PSQI is a screening tool, not a diagnostic instrument. While it can identify poor sleep quality and suggest potential problems, a definitive diagnosis of sleep disorders like insomnia, sleep apnea, or narcolepsy requires evaluation by a qualified healthcare professional, often including sleep studies.
The Science Behind the PSQI
Understanding the validation and reliability of this clinical tool.
Validation and Reliability
The PSQI is a robust and scientifically validated instrument. The original 1989 study demonstrated its high internal consistency (Cronbach's alpha of 0.83), meaning its seven components reliably measure the same underlying construct of sleep quality. It has high test-retest reliability and effectively distinguishes between clinical groups with sleep disorders and healthy controls.
Limitations to Be Aware Of
While highly useful, the PSQI has some limitations. It relies on self-reported data, which can be subject to recall bias. It is a screening tool, not a diagnostic instrument; a formal diagnosis requires clinical evaluation and often a sleep study (polysomnography).
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