Background <p>Several instruments are available to assess sleep quality, including the 19-item Pittsburgh Sleep Quality Index (PSQI). As shorter measures may be desirable for use in clinical settings or population-based research, we evaluated the validity of a 2-item sleep quality screener, the PSQI-2.</p> Methods <p>The PSQI-2 inquiries about sleep duration and subjective sleep quality over the past 30 days, scoring each from 0 (“very good”; &gt;7&#xa0;h of sleep) to 3 (“very bad”; &lt; 5&#xa0;h of sleep). The sum of the two items generates a score from 0 to 6; the higher the score, the worse the sleep quality. This study was conducted with 1,762 adults in a population-based household survey with stratified sampling between October and December 2020 in Brazil. Concurrent validity was assessed using the full PSQI as the reference test.</p> Results <p>Factor analysis confirmed a two-factor structure, supporting the selection of PSQI items 1 (subjective sleep quality) and 3 (sleep duration). As PSQI-2 scores increased from 0 to 6, a substantial increase has been found in the prevalence of individuals with poor sleep quality (<i>p</i> &lt;.05). The PSQI-2 had excellent internal consistency (α = 0.94 and ω = 0.85) and known-group validity, with higher scale scores found in individuals with symptoms of depression and anxiety. Considering PSQI &gt; 5 (poor sleep quality) as a reference, the best cut-off point of the PSQI-2 score was <i>≥</i> 2, with a sensitivity of 77.9% and specificity of 73.8%. The concurrent validity revealed acceptable performance of the PSQI-2 for the PSQI &gt; 5 and &gt; 7, and exceptional performance for the PSQI &gt; 10 as a reference.</p> Conclusion <p>The PSQI-2 presents good/excellent validity evidence for screening sleep quality in a sample of Brazilian adults.</p>

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The Pittsburgh sleep quality index-2 (PSQI-2): the validity of a two-item sleep quality screener in Brazilian adults

  • Luiz Antônio Alves de Menezes-Júnior,
  • Júlia Cristina Cardoso Carraro,
  • George Luiz Lins Machado-Coelho,
  • Adriana Lúcia Meireles

摘要

Background

Several instruments are available to assess sleep quality, including the 19-item Pittsburgh Sleep Quality Index (PSQI). As shorter measures may be desirable for use in clinical settings or population-based research, we evaluated the validity of a 2-item sleep quality screener, the PSQI-2.

Methods

The PSQI-2 inquiries about sleep duration and subjective sleep quality over the past 30 days, scoring each from 0 (“very good”; >7 h of sleep) to 3 (“very bad”; < 5 h of sleep). The sum of the two items generates a score from 0 to 6; the higher the score, the worse the sleep quality. This study was conducted with 1,762 adults in a population-based household survey with stratified sampling between October and December 2020 in Brazil. Concurrent validity was assessed using the full PSQI as the reference test.

Results

Factor analysis confirmed a two-factor structure, supporting the selection of PSQI items 1 (subjective sleep quality) and 3 (sleep duration). As PSQI-2 scores increased from 0 to 6, a substantial increase has been found in the prevalence of individuals with poor sleep quality (p <.05). The PSQI-2 had excellent internal consistency (α = 0.94 and ω = 0.85) and known-group validity, with higher scale scores found in individuals with symptoms of depression and anxiety. Considering PSQI > 5 (poor sleep quality) as a reference, the best cut-off point of the PSQI-2 score was  2, with a sensitivity of 77.9% and specificity of 73.8%. The concurrent validity revealed acceptable performance of the PSQI-2 for the PSQI > 5 and > 7, and exceptional performance for the PSQI > 10 as a reference.

Conclusion

The PSQI-2 presents good/excellent validity evidence for screening sleep quality in a sample of Brazilian adults.