Relationships between the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and clinical/polysomnographic measures in a community sample.
OBJECTIVE
1) To characterize PSQI and ESS scores, and their relationship to each other, in an adult community sample; 2) To determine whether PSQI and ESS scores, in combination with each other, were associated with distinct demographic, clinical, and sleep characteristics.


METHODS
The PSQI, ESS, clinical rating scales, sleep diaries, actigraphy, and home polysomnography were collected from 187 community-dwelling adults (mean age 59.5 years, 47.1% women, 41.2% African Americans) as part of a study investigating novel cardiovascular risk factors. Correlations, cluster analysis, principal components analysis, MANOVA, ANOVA, and regressions were used to characterize the relationships between the PSQI, ESS, and other study variables


RESULTS
Mean PSQI score was 6.3 (3.4), and mean ESS score was 8.2 (3.9). PSQI and ESS correlated weakly with each other (r = 0.16, p = 0.03), but segregated from each other on principal components analysis. Groups of participants categorized by either cluster analysis of PSQI and ESS scores, or by scores above or below traditional cut-off values, differed from each other on psychological/stress symptoms and quantitative and qualitative sleep diary measures, but not on actigraphic or polysomnographic measures. Specifically, higher PSQI scores were associated with female sex, greater psychological distress, and greater sleep disturbance on sleep diaries.


CONCLUSIONS
The PSQI and ESS measure orthogonal dimensions of sleep-wake symptoms, but neither is related to objective sleep measures. The PSQI is more closely related to psychological symptom ratings and sleep diary measures than the ESS. These instruments are not likely to be useful as screening measures for polysomnographic sleep abnormalities.
Buysse
Daniel J
DJ
Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA. buyssedj@upmc.edu
Hall
Martica L
ML
Strollo
Patrick J
PJ
Kamarck
Thomas W
TW
Owens
Jane
J
Lee
Laisze
L
Reis
Steven E
SE
Matthews
Karen A
KA
D000368:Aged; D000704:Analysis of Variance; D044383:Black People / Q000523:psychology; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000379:methods / Q000706:statistics & numerical data; D011594:Psychometrics; D012044:Regression Analysis; D015203:Reproducibility of Results; D012111:Residence Characteristics; D012894:Sleep Stages / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000145:classification / Q000175:diagnosis / Q000523:psychology*; D011795:Surveys and Questionnaires; D044465:White People / Q000523:psychology; D001741:Black or African American