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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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InfluentialOzkutlu, O., & İnal, Ö. (2025) · Psychiatric Quarterly · doi:10.1007/s11126-025-10135-9 · Cited by 2
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BackgroundFactors Associated With Sleep Disturbance Amongst Youth With Bipolar Disorder.
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“Since subjective and objective sleep reflect different aspects of sleep (Buysse et al., 1991; Lauderdale et al., 2016), the two may show heterogeneities in their associations with social function in later life.”
Minz, S., Mohapatra, M., Pati, U. C., Sahu, P., Satpathy, R., Kumari, R. B., Acharya, P. K., Sahoo, N., & Jally, S. K. (2024) · PLoS ONE · doi:10.1371/journal.pone.0314770 · Cited by 1
“%) from different countries [30–38].”
Tang, J. Y. ‐., Luo, H., Tse, M. A., Kwan, J. S. K., Leung, A. Y. M., Wong, T. B.-K. T., Lum, T. Y. S., & Wong, G. H. Y. (2025) · JMIR Aging · doi:10.2196/65636 · Cited by 1
“…activity) [19], sleep quality as measured using the Pittsburgh Sleep Quality Index (PSQI; higher scores indicate worse overall sleep quality) [20], social functioning as measured using the Lubben Social Network Scale (LSNS; higher scores indicate a greater level of social support) [21], and…”
Sugimoto, H., Tanioka, T., Yasuhara, Y., Kurokawa, A., Sato, M., Ozawa, K., Locsin, R. C., & Honda, S. (2017) · Open Journal of Psychiatry · doi:10.4236/ojpsych.2018.81002 · Cited by 1
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“A total score of 5 and above is defined as “poor” sleep quality (Ağargün et al., 1996; Buysse et al., 1991).”
BackgroundAssociation of Sleep paralysis with Insomnia and Sleep Quality
Ikhlaq, A. (2021) · Annals of Reviews & Research · doi:10.19080/arr.2021.06.555689 · Cited by 1
A Comparison of the Pittsburgh Sleep Quality Index, a New Sleep Questionnaire, and Sleep Diaries
Sethi, K. (2012) · doi:10.12794/metadc177254 · Cited by 1
“Consistent with the findings of Buysse et al. (1989), other studies have found that the PSQI has insignificant or low correlations with PSG measurement of sleep parameters, and overestimates sleep duration and sleep efficiency (Backhaus et al., 2002; Buysse et al., 1991).”
ResultPrause, W., Saletu, B., Anderer, P., Grätzhofer, E., Freidl, M., Bach, M., & Aigner, M. (2006) · Journal für Kardiologie (Krause & Pachernegg GmbH) · Cited by 1
Evaluación de las perturbaciones extrínsecas del sueño en la población de Valladolid
Ares, J. L. C., García, V. M. V., Hurtado, A. A. Á., Romero, G. D. T., Teso, F. A. D., & Fernández, J. A. (2000) · Atención Primaria · doi:10.1016/s0212-6567(00)78747-6 · Cited by 1
Cognitive-Affective Processing, Sleep Quality, and Mood in Obstructive Sleep Apnea
Considine, C. M. (2015) · Cited by 1
Therapeutic benefits of napping in the elderly
Murphy, P., & Campbell, S. S. (2009) · Cambridge University Press eBooks · doi:10.1017/cbo9780511770661.042 · Cited by 1
Berry, R. B., & Wagner, M. H. (2014) · Elsevier eBooks · doi:10.1016/b978-1-4557-7051-9.00037-1 · Cited by 1
Jonsson, K. (2018) · KTH Publication Database DiVA (KTH Royal Institute of Technology) · Cited by 1
Auswirkungen chronischer Schlafrestriktion auf Leistungs-fähigkeit, Stimmung und Müdigkeit
Müller, T. H., Paterok, B., Hoffmann, M., & Becker‐Carus, C. (1997) · Somnologie - Schlafforschung und Schlafmedizin · doi:10.1007/s11818-997-0013-5 · Cited by 1
Panayiotis Panayides, A., Gavrielides, M. A., Galatopoulos, C., & Gavriilidou, M. (2013) · PsycEXTRA Dataset · doi:10.1037/e528452013-011 · Cited by 1
The association between sleep and obesity and its impact on health and wellbeing
Araghi, M. (2014) · University of Birmingham Institutional Research Archive (University of Birmingham) · Cited by 1
Circadian rhythm sleep disorders related to an abnormal escape of the sleep-wake cycle
Boivin, D. B., & Santo, J. B. (2003) · Springer eBooks · doi:10.1007/978-1-4615-0217-3_40
Sekercioglu, N. (2014) · Memorial University Research Repository (Memorial University)
Sick and tired: understanding and managing sleep difficulties in Fibromyalgia Syndrome
Theadom, A. (2011) · Tuwhera (Auckland University of Technology)
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
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