Department of Neuroscience, University of Split School of Medicine, Soltanska 2, 21000, Split, Croatia.
Sleep Medicine Center, University of Split School of Medicine and University Hospital Split, Soltanska 1, Split, Croatia.
Neurol Sci. 2017 Jul;38(7):1299-1306. doi: 10.1007/s10072-017-2978-6. Epub 2017 May 4.
Previous studies aimed to determine if Pittsburgh sleep quality index (PSQI) is a valid screening instrument for obstructive sleep apnea, indicating its disadvantages. However, the rationale of PSQI use in sleep clinics is not the screening, but the assessment of sleep quality itself. Therefore, the aims of this study were to investigate the sleep quality in obstructive sleep apnea patients and to identify the cutoff point for differentiation of "good" and "poor" sleepers among them. We constructed the Croatian version of PSQI and assessed its psychometric properties. The protocol of the study included the assessment of sleep quality in 130 obstructive sleep apnea patients and 75 healthy control subjects. All subjects completed the Croatian version of the PSQI, and the patients underwent overnight polysomnography screening. Obstructive sleep apnea patients had higher values of the global PSQI component score, indicating lower sleep quality, compared to a healthy control group (p < 0.001). The psychometric properties of PSQI scores in the prediction of normal sleep efficiency indicate that the cutoff score of 9.5 differentiates patients in total sleep time (p < 0.001), REM duration (p = 0.014), sleep efficiency (p = 0.001), time spent awake during sleep (p = 0.006), after sleep (p = 0.024), and after sleep onset (p = 0.001). In OSA patients, a PSQI cutoff score of 9.5 differentiated good and poor sleepers significantly in total sleep time, REM duration, time spent awake during sleep, and WASO time. Current findings enhance the interpretability of PSQI results in a population of OSA patients.
先前的研究旨在确定匹兹堡睡眠质量指数（PSQI）是否是阻塞性睡眠呼吸暂停的有效筛查工具，这表明了其存在的局限性。然而，在睡眠诊所中使用 PSQI 的基本原理并不是筛查，而是评估睡眠质量本身。因此，本研究的目的是调查阻塞性睡眠呼吸暂停患者的睡眠质量，并确定区分其中“良好”和“不良”睡眠者的截断值。我们构建了 PSQI 的克罗地亚语版本，并评估了其心理测量学特性。该研究方案包括对 130 名阻塞性睡眠呼吸暂停患者和 75 名健康对照组的睡眠质量评估。所有受试者均完成了 PSQI 的克罗地亚语版本，并接受了夜间多导睡眠图筛查。与健康对照组相比，阻塞性睡眠呼吸暂停患者的 PSQI 总分更高，表明睡眠质量较低（p < 0.001）。PSQI 评分在预测正常睡眠效率方面的心理测量学特性表明，9.5 的截断得分可区分总睡眠时间（p < 0.001）、快速眼动（REM）持续时间（p = 0.014）、睡眠效率（p = 0.001）、睡眠期间清醒时间（p = 0.006）、睡眠后时间（p = 0.024）和睡眠后潜伏期（p = 0.001）。在 OSA 患者中，PSQI 截断值为 9.5 时，可显著区分总睡眠时间、REM 持续时间、睡眠期间清醒时间和睡眠潜伏期的良好和不良睡眠者。当前的发现增强了 PSQI 结果在 OSA 患者人群中的可解释性。
