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Quantification of Subjective Sleep Quality in Healthy Elderly Men and Women Using the Pittsburgh Sleep Quality Index (PSQI)
Abstract
Subjective sleep quality deteriorates with aging, but the extent to which this is a product of age itself, as opposed to the medical or psychiatric problems associated with aging, has not been carefully studied. To investigate this issue, we examined the subjective sleep quality of 44 healthy subjects over 80 years of age (20 men, 24 women), and 35 healthy subjects [corrected] between the ages of 20 and 30 (23 men, 12 women) using the Pittsburgh Sleep Quality Index (PSQI). All subjects underwent rigorous medical and psychiatric evaluations to verify that they were in excellent physical and psychological health. Significant age effects were noted for the global PSQI score and several PSQI component scores, but overall sleep quality for the majority (68.1%) of 80-yr-olds fell within a categorically defined range for "good" sleepers. Measures of habitual sleep quality did not correlate strongly with most polysomnographic sleep measures, number of medications used or circadian measures in elderly subjects. These results show that subjective sleep quality does deteriorate in the healthy elderly, but not to the level seen in patients with sleep disorders. Extremely healthy elderly subjects appear to adapt in their perception of objectively disturbed sleep.
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“PSQI has good reliability and validity in its versions in English (Buysse et al., 1991), Spanish (Jiménez-Genchi et al., 2008), Brazilian Portuguese (Bertolazi et al., 2011) and following Zwart et al. (2018), the Dutch version provided by eProvide® will be used.”
From Internet-based self-administered intervention to reduce anxiety and depression symptomatology and improve well-being in 7 countries: protocol of a randomized control trial (2024) · cites this paper as Buysse et al., 1991
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“In contrast, the cut-off values for ‘poor sleep’ were total PSQI of ≥9, which differed from previous studies that considered 5 or 6 as the optimal cut-off point(Buysse et al., 1991; Moghaddam et al., 2012; Yildirim & Boysan, 2017).”
MethodHeterogeneous Network Approach to Predict Individuals’ Mental Health
Liu, S., Vahedian, F., Hachen, D. S., Ližardo, O., Poellabauer, C., Striegel, A., & Milenković, T. (2021) · ACM Transactions on Knowledge Discovery from Data · doi:10.1145/3429446 · Cited by 16
Chui, D. (2014) · JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH · doi:10.7860/jcdr/2014/10301.5141 · Cited by 10
Good and Bad Sleep in Childhood: A Questionnaire Survey amongst School Children in Southern Italy
Ficca, G., Conte, F., Padova, V. D., & Zilli, I. (2011) · Sleep Disorders · doi:10.1155/2011/825981 · Cited by 9
“In their classical paper on subjective sleep quality in aging, Buysse and colleagues [13] found that almost 70% of people aged more than 80 fell within a categorically defined range for “good” sleepers.”
BackgroundResultTiming, Duration and Quality of Sleep, and Level of Daytime Sleepiness in 1166 Retired Seniors
Monk, T. H., Buysse, D. J., Schlarb, J. E., & Beach, S. R. (2012) · Healthy Aging & Clinical Care in the Elderly · doi:10.4137/hacce.s10596 · Cited by 9
Self-citationSayed, S., & Younis, G. (2016) · Menoufia Nursing Journal · doi:10.21608/menj.2016.120315 · Cited by 9
Subjective and objective quality of sleep
Åkerstedt, T., Kecklund, G., & Axelsson, J. (2008) · Somnologie - Schlafforschung und Schlafmedizin · doi:10.1007/s11818-008-0342-z · Cited by 9
Is sleep quality a moderated mediator between perceived stress and depression among stroke patients?
Guo, L., Wei, M., Namassevayam, G., Zhang, M., Xie, Y., Meng, R., Guo, Y., & Liu, Y. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1284197 · Cited by 8
Lin, G.-J., Xu, J.-J., Peng, X.-R., & Yu, J. (2024) · Sleep Medicine · doi:10.1016/j.sleep.2024.04.025 · Cited by 8
Emamzadeh, N., Abbası, F., Delfan, N., Etemadi, M. H., & Iranmehr, A. (2025) · Neurosurgical Review · doi:10.1007/s10143-025-03522-0 · Cited by 8
Early Life Trauma and Social Processing in HIV: The Role of Neuroendocrine Factors and Inflammation
Rubin, L. H., Bhattacharya, D., Fuchs, J., Matthews, A., Abdellah, S., Veenhuis, R. T., Langenecker, S. A., Weber, K. M., Nazarloo, H. P., Keating, S. M., et al. (2022) · Psychosomatic Medicine · doi:10.1097/psy.0000000000001124 · Cited by 8
Jeon, S., Conley, S., Hollenbeak, C. S., O'Connell, M., Wang, Z., Tocchi, C., & Redeker, N. S. (2023) · Sleep Medicine · doi:10.1016/j.sleep.2023.05.019 · Cited by 10
Mao, T., Chai, Y., Guo, B., Quan, P., & Rao, H. (2023) · Nature and Science of Sleep · doi:10.2147/nss.s420650 · Cited by 10
Yanez-Regonesi, F., Sangalli, L., Robinson, C. M., & de Leeuw, R. (2023) · Journal of Sleep Research · doi:10.1111/jsr.14114 · Cited by 9
Hanai, A., Ishikawa, T., Sugao, S., Fujii, M., Hirai, K., Watanabe, H., Matsuzaki, M., Nakamoto, G., Takeda, T., Kitabatake, Y., et al. (2023) · JMIR Formative Research · doi:10.2196/47372 · Cited by 8
“The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality, where a high score ( ≥ 5.5) indicates poor sleep quality [23,24].”
MethodInfluentialFactors Associated with Poor Sleep Quality in Postpartum Women: A Crossectional Study
Motta, A. J. P., Lucchese, R., Leão, G. C. S., Rosa, D. E., Júnior, V. D. A. G., & de Mendonça, R. S. (2024) · Sleep Science · doi:10.1055/s-0044-1782174 · Cited by 7
“The data obtained through the PSQI total score showed that281 women had poor sleep quality (PSQI > 5, 70.25%, 95% CI: 65.8 Based on the bivariate analysis, the signi fi cant variables were selected for the multiple analysis.”
MethodInfluential
Metadata
- Authors
- Buysse, D. J., Reynolds, C. F., Monk, T. H., Hoch, C. C., Yeager, A. L., & Kupfer, D. J.
- Affiliations
- University of Pittsburgh (US)
- Corresponding author
- Daniel J. Buysse
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 1991-07-01
- Volume
- 14
- Issue
- 4
- Pages
- 331-8
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- OpenAlex
- W1704280769
- Cited by
- 874
- References
- 0
- Citations by year
- 2026: 7 · 2025: 34 · 2024: 61 · 2023: 53 · 2022: 62 · 2021: 61 · 2020: 63 · 2019: 36 · 2018: 50 · 2017: 32 · 2016: 27 · 2015: 31 · 2014: 42 · 2013: 32 · 2012: 33
- FWCI
- 4.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- SLEEP (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5p01ag006836-04)
- National Institute on Aging (AG 06836)
- National Institute of Mental Health (MH-00295, MH-37869, R01MH037869)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- subjective sleep quality, aging, older adults, Pittsburgh Sleep Quality Index, healthy older adults, sleep perception, sleep disorders, circadian rhythm, medication use, sex differences
- MeSH terms
- Aged, Aged, 80 and over, Aging, Arousal, Attitude to Health, Circadian Rhythm, Female, Humans, Male, Personality Inventory, Psychometrics, Sleep Stages, Sleep, REM
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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