The Pittsburgh Sleep Quality Index (PSQI)

WHY: Sleep is a necessary part of life. However, normal aging changes, medical problems, psychiatric problems, and psychosocial issues can alter the pattern and quality of sleep as one grows older, and thus affect the quality of life in the older adult. Assessment of sleep patterns enables the nurse to intervene immediately by implementing interventions with the client, or by referring the client for further assessment. BEST TOOL: The Pittsburgh Sleep Quality Index (PSQI) is an effective instrument used to measure the quality and patterns of sleep in the older adult. It differentiates “poor” from “good” sleep by measuring seven areas: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction over the last month. The client self-rates each of these seven areas of sleep. Scoring of answers is based on a 0 to 3 scale, whereby 3 reflects the negative extreme on the Likert Scale. A global sum of “5” or greater indicates a “poor” sleeper. Although there are several questions that request the evaluation of the client’s bedmate or roommate, these are not scored (not reflected in attached instrument). Refer to “More on the Topic”, Buysse et al., 1989, for these questions. TARGET POPULATION: The PSQI can be used for both an initial assessment and ongoing comparative measurements with older adults across all health care settings. VALIDITY/RELIABILITY: The PSQI has internal consistency and a reliability coefficient (Cronbach’s alpha) of 0.83 for its seven components. Numerous studies using the PSQI have supported high validity and reliability. STRENGTHS AND LIMITATIONS: The PSQI is a subjective measure of sleep. Self-reporting by clients can empower the client, but can reflect inaccurate information if the client has difficulty understanding what is written, or can not see or physically write out responses. Moreover, the scale is presented in English. The scale can be adapted to enable the client to respond verbally to items on the scale by having the nurse read the statements to the client.