title: The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: A systematic review and meta-analysis.
abstract: This review appraises the process of development and the measurement properties of the Pittsburgh sleep quality index (PSQI), gauging its potential as a screening tool for sleep dysfunction in non-clinical and clinical samples; it also compares non-clinical and clinical populations in terms of PSQI scores. MEDLINE, Embase, PsycINFO, and HAPI databases were searched. Critical appraisal of studies of measurement properties was performed using COSMIN. Of 37 reviewed studies, 22 examined construct validity, 19 - known-group validity, 15 - internal consistency, and three - test-retest reliability. Study quality ranged from poor to excellent, with the majority designated fair. Internal consistency, based on Cronbach's alpha, was good. Discrepancies were observed in factor analytic studies. In non-clinical and clinical samples with known differences in sleep quality, the PSQI global scores and all subscale scores, with the exception of sleep disturbance, differed significantly. The best evidence synthesis for the PSQI showed strong reliability and validity, and moderate structural validity in a variety of samples, suggesting the tool fulfills its intended utility. A taxonometric analysis can contribute to better understanding of sleep dysfunction as either a dichotomous or continuous construct.
authors.affiliation: Graduate Department of Rehabilitation Science, Collaborative Program in Neuroscience, University of Toronto, Toronto Rehabilitation Institute-University Health Network, 550 University Avenue, Rm 11120, Toronto, ON M5G 2A2, Canada. Electronic address: tatyana.mollayeva@utoronto.ca.
authors.forename: Tatyana
authors.initials: T
authors.lastname: Mollayeva
authors.affiliation: The Hospital for Sick Children, Canada.
authors.forename: Pravheen
authors.initials: P
authors.lastname: Thurairajah
authors.affiliation: Department of Medical Imaging, Institute of Health Policy, Management & Evaluation, University of Toronto, Canada.
authors.forename: Kirsteen
authors.initials: K
authors.lastname: Burton
authors.affiliation: Department of Cell and Systems Biology, Faculty of Arts & Science, Acquired Brain Injury Research Laboratory, University of Toronto, Youthdale Child & Adolescent Sleep Clinic, Ontario, Canada; Department of Ecology and Evolutionary Biology, Faculty of Arts & Science, Acquired Brain Injury Research Laboratory, University of Toronto, Youthdale Child & Adolescent Sleep Clinic, Ontario, Canada.
authors.forename: Shirin
authors.initials: S
authors.lastname: Mollayeva
authors.affiliation: Department of Psychiatry and Ophthalmology, University of Toronto, Toronto Western Hospital, University Health Network, Ontario, Canada; Youthdale Child & Adolescent Sleep Clinic, Ontario, Canada.
authors.forename: Colin M
authors.initials: CM
authors.lastname: Shapiro
authors.affiliation: Saunderson Family Chair in Acquired Brain Injury Research, Toronto Rehabilitation Institute-University Health Network, CIHR Chair in Gender, Work and Health, Department of Occupational Science and Occupational Therapy, University of Toronto, Canada.
authors.forename: Angela
authors.initials: A
authors.lastname: Colantonio
mesh_terms: D006801:Humans; D011594:Psychometrics; D015203:Reproducibility of Results; D012890:Sleep; D012893:Sleep Wake Disorders / Q000175:diagnosis*; D011795:Surveys and Questionnaires
keywords: Meta-analysis; Psychometric properties; Sensibility; Systematic review; The Pittsburgh sleep quality index