title: Psychometric Properties of the Pittsburgh Sleep Quality Index (PSQI) in a Cohort of Peruvian Pregnant Women.
abstract: OBJECTIVE
  We sought to evaluate the construct validity and factor structure of the Spanish-language version of the Pittsburgh Sleep Quality Index (PSQI) among pregnant Peruvian women.
  
  
  METHODS
  A cohort of 642 women were interviewed at ≤ 16 weeks of gestation. During interview, we ascertained information about lifestyles, demographics, sleep characteristics, and mood symptoms. Stress induced sleep disturbance, depressive symptoms, and anxiety symptoms were evaluated using the Ford Insomnia Response to Stress Test (FIRST), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) assessment scales, respectively. Consistency indices, exploratory and confirmatory factor analyses, correlations, and logistic regressions were used.
  
  
  RESULTS
  Both exploratory and confirmatory factor analyses indicated a three-factor solution: sleep quality, sleep efficiency, and sleep medication. We observed significantly positive correlations of the PSQI with the FIRST (0.42), the PHQ-9 (0.49), and the GAD-7 (0.46). Poor sleepers (PSQI global score > 5) had significantly increased odds of experiencing stress-induced sleep disturbance (odds ratio, OR = 3.57; 95% CI: 2.40, 5.31), depression (OR = 5.48; 95% CI: 3.58, 8.37), and generalized anxiety disorder (OR = 4.57; 95% CI: 3.08, 6.76).
  
  
  CONCLUSIONS
  The Spanish-language version of the PSQI instrument was found to have good construct validity among pregnant Peruvian women. Consistent with some other studies, the PSQI was found to have a three-factor structure. Further assessment and validation studies are needed to determine whether the three, factor-specific scoring of the PSQI is favored over the PSQI global score in diverse populations.
authors.affiliation: Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA.
authors.forename: Qiu-Yue
authors.initials: QY
authors.lastname: Zhong
authors.affiliation: Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA.
authors.forename: Bizu
authors.initials: B
authors.lastname: Gelaye
authors.affiliation: Universidad Peruana de Ciencias Aplicadas, Lima, Peru.|Asociación Civil PROESA, Lima, Peru.
authors.forename: Sixto E
authors.initials: SE
authors.lastname: Sánchez
authors.affiliation: Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D010568:Peru / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011594:Psychometrics; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Peru; Pittsburgh Sleep Quality Index; pregnant women; psychometric properties; sleep
references.citation: JAMA. 1999 Nov 10;282(18):1737-44
references.pmid: 10568646
references.citation: Psychiatry Res. 2000 Dec 27;97(2-3):165-72
references.pmid: 11166088
references.citation: J Gen Intern Med. 2001 Sep;16(9):606-13
references.pmid: 11556941
references.citation: Sleep. 2004 Mar 15;27(2):285-91
references.pmid: 15124724
references.citation: J Pain Symptom Manage. 2004 Feb;27(2):140-8
references.pmid: 15157038
references.citation: Sleep Med Rev. 1998 Nov;2(4):231-42
references.pmid: 15310494
references.citation: J Nurs Res. 2004 Dec;12(4):287-96
references.pmid: 15619179
references.citation: Med Care. 1992 Jun;30(6):473-83
references.pmid: 1593914
references.citation: Sleep. 2006 Jan;29(1):112-6
references.pmid: 16453989
references.citation: Arch Intern Med. 2006 May 22;166(10):1092-7
references.pmid: 16717171
references.citation: Sleep Med. 2007 Apr;8(3):266-70
references.pmid: 17368977
references.citation: J Sleep Res. 2008 Jun;17(2):217-20
references.pmid: 18482110
references.citation: J Clin Sleep Med. 2008 Dec 15;4(6):563-71
references.pmid: 19110886
references.citation: Womens Health Issues. 2009 Jan-Feb;19(1):45-51
references.pmid: 19111787
references.citation: Behav Sleep Med. 2009;7(2):106-17
references.pmid: 19330583
references.citation: Sleep. 2009 Jul;32(7):847-55
references.pmid: 19639747
references.citation: BMC Womens Health. 2010 May 14;10:17
references.pmid: 20470416
references.citation: Support Care Cancer. 2011 Nov;19(11):1831-40
references.pmid: 20972588
references.citation: Epidemiology. 2011 Sep;22(5):738-44
references.pmid: 21734587
references.citation: Am J Obstet Gynecol. 2012 Feb;206(2):136.e1-5
references.pmid: 22000892
references.citation: Sleep Med. 2012 Jan;13(1):36-42
references.pmid: 22033120
references.citation: Neurol Sci. 2013 Apr;34(4):511-9
references.pmid: 22526760
references.citation: Sleep Biol Rhythms. 2006 Jun;4(2):129-139
references.pmid: 22822303
references.citation: Sleep Med. 2014 Feb;15(2):196-202
references.pmid: 24380783
references.citation: Rheumatol Int. 2014 Jul;34(7):929-36
references.pmid: 24509897
references.citation: J Affect Disord. 2014 Apr;158:148-53
references.pmid: 24655779
references.citation: J Affect Disord. 2014 Jun;162:1-7
references.pmid: 24766996
references.citation: PLoS One. 2014 Dec 31;9(12):e116383
references.pmid: 25551586
references.citation: PLoS One. 2015 Apr 27;10(4):e0125096
references.pmid: 25915929
references.citation: Psychiatry Res. 1989 May;28(2):193-213
references.pmid: 2748771
references.citation: Int J Med Educ. 2011 Jun 27;2:53-55
references.pmid: 28029643
references.citation: BMJ. 1997 Feb 22;314(7080):572
references.pmid: 9055718
references.citation: J Psychosom Res. 1998 Jul;45(1):5-13
references.pmid: 9720850