Cited by 875Sleep and related disordersObstructive Sleep Apnea ResearchSleep and Work-Related Fatigue

The DOI matches its Crossref record.

Quantification of Subjective Sleep Quality in Healthy Elderly Men and Women Using the Pittsburgh Sleep Quality Index (PSQI)

Daniel J. Buysse, Charles F. Reynolds, Timothy H. Monk, Carolyn C. Hoch, Amy L. Yeager, David J. Kupfer·1991·Sleep

Open this paper in CoChat — free account

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.

Integrity signals

Registry

Crossref · 10.1093/sleep/14.4.331

Cites

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Sorted by citations

Items 801–875 of 875

Genetic and environmental influences on sleep quality : quantitative and molecular genetic approaches to an understanding of individual differences
Barclay, N. L. (2011) · Goldsmiths (University of London)
Insuffisance respiratoire chronique
Patout, M., Artaud-Macari, É., Lamia, B., Muir, J., & Cuvelier, A. (2015) · Revue des Maladies Respiratoires Actualités · doi:10.1016/s1877-1203(15)30075-6
Factors Associated with Sleep Wake Disturbances in Adult Survivors of Childhood Brain Tumors
Gapstur, R. (2010) · University of Minnesota Digital Conservancy (University of Minnesota)
Elderly Sleep Disorders and Alzheimer's Disease: Part One
Groulx, B. (1998)
Subjektive und objektive Schlafqualität : Vergleich von Insomniepatienten und Kontrollprobanden in ambulanten und stationären Polysomnographien
Assmus, A., & Töpper, R. (2002) · RWTH Publications (RWTH Aachen)
An investigation of the subjective sleep of elderly women : what is good sleep and how is it achieved
Davis, B. M. (2009) · Victoria University Research Repository (Victoria University)
Compte rendu de congrès
Vincent, D. (2006) · Annales Médico-psychologiques revue psychiatrique · doi:10.1016/j.amp.2005.11.008
Disorders of the Sleep-Wake Cycle in Blindness Troubles du cycle veille-sommeil dans la cécité
Adeoti, C. O. (2010)
TRADUÇÃO, ADAPTAÇÃO CULTURAL E VALIDAÇÃO DE DOIS INSTRUMENTOS DE AVALIAÇÃO DO SONO: ESCALA DE SONOLÊNCIA DE EPWORTH E ÍNDICE DE QUALIDADE DE SONO DE PITTSBURGH
Médicas, C. (2008)
Parasomnias in the Elderly
Youn, T., & Jeong, D. (2001) · Sleep Medicine and Psychophysiology
Burnout among Turkish Teachers: The Influence of Sleep Quality and Job Satisfaction Türk Öğretmenlerde Tükenmişlik: Uyku Kalitesi ve Mesleki Doyumun Etkisi
Merey, Z., Pişkin, M., Boysan, M., et al. (2013)
Obstructive Sleep Apnea Epidemiology and Patient-Centered Measures
Kezirian, E. J., & Weaver, E. M. (2006) · CRC Press eBooks · doi:10.3109/9780849374487-43
The Effect of Culture and Advisor Characteristics on Treatment Outcomes
Brown, J. A. (2015) · OhioLink ETD Center (Ohio Library and Information Network)
Effects of the Nursing Home System on Subjective Sleep Quality and Bed Climate of Residents
Okamoto-Mizuno, K., Yokoya, T., & Kudoh, Y. (2000) · Journal of home economics · doi:10.11428/jhej1987.51.223
The impact of sleep on cognition in older adults: does depression matter?
Mellor, A. (2014) · UWA Profiles and Research Repository (University of Western Australia)
Aus der Klinik für Endokrinologie, Diabetologie und Rheumatologie
Fakultät, M. (2010)
The prevalence and related factors of depressive symptoms among junior college nursing students: a cross-sectional study
Chi, T. (2015)
Resources for GPs
Burch, E. (2017)
Assessing the quality of sleep among nurses working at educational hospitals of Zanjan University of Medical Sciences and its related factors
Hamid, ُ., Amini, A., Feizzy-Amiry, B., et al. (2017) · DOAJ (DOAJ: Directory of Open Access Journals)
Sleep to be an All-Star!
Hoedlmoser, K. (2018) · Sportphysio · doi:10.1055/s-0043-123864
Schlaf-Wach-Störungen
Hermann, E., Hermann, R., & Gassmann, D. (2018) · Springer eBooks · doi:10.1007/978-3-662-54909-4_10
Healthy Smoker: An Oxymoron? Maybe, But It Is More Complicated Than That
Bennett, J. M., Roos, L. G., Marino, J. S., Rohleder, N., & Coffman, M. J. (2018) · Springer eBooks · doi:10.1007/978-3-319-73636-5_2
“Sleep quality was assessed via the Pittsburgh Sleep Quality Index (PSQI), a well-validated and reliable measure of sleep with a cutoff suggesting clinical sleep disturbances [35].”
Method
Do You Know How You Sleep? Correlates of Subjective-Objective Sleep Discrepancies Among Emerging Adults at University
Conte, L. (2019) · doi:10.14418/wes01.2.253
The Impact of Ambient Scent Environment on Residents’ Wellness and Their Perception of Interior Environments in Long-Term Care Facilities
Bae, S. (2019) · University of Minnesota Digital Conservancy (University of Minnesota)
Monitoring Circadian Rhythm and Sleep Patterns Using Wrist-worn Temperature and 3-axis Accelerometer Sensors: A Study with Healthy Younger Adults, Healthy Older Adults, and People Living with Dementia
Wei, J. (2019) · UWSpace (University of Waterloo)
Sleep Disorders, Daytime Sleepiness and Depression in Metabolic Syndrome
Parıldar, H., Ciğerli, Ö., Ergen, N., Ünal, A. D., Tarçın, Ö., Erdal, R., & Demirağ, N. G. (2014)
Improving sleep and cognition in young adults and the elderly
Cordi, M. J. (2014) · Zurich Open Repository and Archive (University of Zurich) · doi:10.5167/uzh-111343
The Relation Between the Bladder Drainage Types and Sleep Quality on Patients with Spinal Cord Injury
Karataş, G. (2020) · Eurasian Journal of Medical Investigation · doi:10.14744/ejmi.2020.00477
“Total score equal to or greater than 5 shows poor sleep quality (≥5; poor SQ).[11] The Satisfaction with Life Scale (SWLS) was carried out to evaluate the life satisfaction levels of patients.”
Method
Insomnia
Berry, R. B. (2011) · Elsevier eBooks · doi:10.1016/b978-1-4377-0326-9.00025-7
Epidemiology of naps:association with sleep, ethnicity, and age
Soeffing, J. P. (2010)
An Investigation of Positive and Negative Sleep Appraisals along the Mood Continuum
Pearson, L. (2020) · Research Explorer (The University of Manchester)
ROTATOR MANSET LEZYONU OLAN HASTALARDA ZIHINSEL SAGLIK YUKUNUN AĞRI, KİNEZYOFOBİ, UYKU VE YAŞAM KALİTESİ ÜZERİNE ETKİSİNİN İNCELENMESİ
Yavuzdemir, M. A., Ağce, Z. B., & Torpil, B. (2021) · Gazi Sağlık Bilimleri Dergisi · doi:10.52881/gsbdergi.975485
A novel neuroelectrophysiological age index implicates brain health and sleep disordersPreprint
Yook, S., Park, H. R., Park, C. J., Park, G., Lim, D. C., Kim, J., Joo, E. Y., & Kim, H. (2022) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2022.01.24.477464
A Randomized Double-Blind Placebo-Controlled Evaluation of the Safety and Efficacy of Wild Sage Metabolites in Preventing Snoring, Improving Sleep, and Activating Alpha Wave Brain Frequencies in Healthy Adults
Ikeda, Y., & Nasu, M. (2022) · Cureus · doi:10.7759/cureus.22714
“Accordingly, with the improvement of sleep quality by PSQI score and mate assessment, participants within the WSM group also presented higher levels of alpha waves when compared with placebo.”
MethodInfluential
Sleep Disorders
Schutte, N. S., & Malouff, J. M. (1995) · Springer eBooks · doi:10.1007/978-1-4899-1277-0_11
An investigation of the relationship between sleep and fatigue in those with and without insomnia
Harris, A. L. (2021) · doi:10.32920/ryerson.14645433
An investigation of the relationship between sleep and fatigue in those with and without insomnia
Harris, A. L. (2021) · doi:10.32920/ryerson.14645433.v1
Relationships between pain severity and sleep quality in people with neck pain
(2022) · The Annals of Clinical and Analytical Medicine · doi:10.4328/acam.21191
Poorer Sleep Health is Associated With Altered Brain Activation During Cognitive Control Processing in Healthy AdultsPreprint
Smevik, H., Habli, S., Saksvik, S. B., Kliem, E., Evensmoen, H. R., Conde, V., Petroni, A., Asarnow, R. F., Dennis, E. L., Eikenes, L., et al. (2022) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2022.10.28.512671
Interrelation of Blood in Urine with Use of Sleeping Pills
Arshad, A., Sohail, S., Hussain, S. B., et al. (2022) · Mediterranean Journal of Basic and Applied Sciences · doi:10.46382/mjbas.2022.6302
Machine learning of cerebello-cerebral functional networks for mild cognitive impairment detectionPreprint
Yao, Q., Qu, L., Song, B., Wang, X., Wang, T., Ma, W., Tian, M., Shen, B., Qi, X., Zhu, D., et al. (2023) · Research Square · doi:10.21203/rs.3.rs-2663342/v1
A Pilot Study of the Pittsburgh Sleep Quality Index Scale among Chinese University Student Population
Yingjie, Z., Qunniao, H., & Tingting, D. (2023) · MEDS Public Health and Preventive Medicine · doi:10.23977/phpm.2023.030106
Assessment of sleep quality and sleep disordered breathing among post-hospitalized patients with COVID-19
Castellanos, P. L., SATASHIA, P., Punj, M., et al. (2023) · Frontiers in Sleep · doi:10.3389/frsle.2023.1214036
ความสมพนธระหวางการปฏบตตามคำแนะนำการเคลอนไหว 24 ชวโมง และองคประกอบของรางกายของนกเรยนมธยมศกษาตอนตน
รื่นอารมย์, ฐ. (2022) · doi:10.58837/chula.the.2022.986
คณภาพการนอนหลบในผปวยโรคหลอดเลอดสมองในโรงพยาบาลพระมงกฎเกลา
โลทะกะ, จ., & ตันวีระชัยสกุล, ช. (2019) · doi:10.58837/chula.the.2019.1402
Subjective-objective sleep discrepancy in older adults : examining the roles of cognition and arousal
Musich, M. L. (2023) · MOspace Institutional Repository (University of Missouri) · doi:10.32469/10355/97091
YKL-40 level and telomere length as potential biomarkers of insomnia disorder—A Case-Control StudyPreprint
Li, J., Liu, P., Wang, Y., Ren, C., & Zhang, M. (2023) · Research Square · doi:10.21203/rs.3.rs-3723950/v1
The Impact of Melatonin on Inflammatory Status and Quality of Life
Chae, B., Park, Y., Lee, S.-J., Lee, J.-S., Kang, S., Na, K., Kim, E.-J., & Yoon, H. (2023) · Chronobiology in Medicine · doi:10.33069/cim.2023.0028
“We assessed sleep quality via the Pittsburgh Sleep Quality Index (PSQI) at the baseline, week 4, and week 8 after treatment with 2 mg PRM. Higher scores indicate a worse sleep quality, while values >5 indicate poor quality of sleep [13].”
Method
Quality of sleep in stroke patients at Phramongkutklao Hospital
Lothaka, J. (2022) · Chulalongkorn Medical Journal · doi:10.58837/chula.cmj.66.1.6
Association between depression and sleep disorder and the mediating role of smartphone addiction: a longitudinal study of Chinese college freshmen during the COVID-19 pandemic
Yuan, G., Zhu, Z., Yang, H., Guo, H., Zhang, J., Zhang, K., Zhang, X., Lu, X., Du, J., Shi, H., et al. (2024) · Current Psychology · doi:10.1007/s12144-024-06054-w
“The total possible score on the scale is 0–21, the higher the score, the more severe the SD. Participants with a total PSQI score greater than 6 can be considered SD (Zheng et al., 2016).”
Design and Rationale of a Two-Armed Randomized Controlled Trial on Yoga/Brisk Walking-Based Lifestyle Modification on Dementia Risk Reduction, and Influence of ApoE Genotypes on the Intervention
Singh, M., & Majumdar, V. (2024) · Journal of Aging Research and Lifestyle · doi:10.14283/jarlife.2024.5
“The scale assesses seven domains: sleep quality, sleep duration, sleep latency, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction (33).”
BackgroundMethod
A Case–Control Study to Compare Sleep Quality between Edentulous and Dentulous Elderly Patients
Kumar, A., Chand, P., Singh, S., et al. (2024) · International Journal of Prosthodontics and Restorative Dentistry · doi:10.5005/jp-journals-10019-1451
“–20 Nevertheless, in otherwise healthy elderly, the prevalence of sleep disturbances is low, 18 thus implying that with factors modifying the health status assessment, dental status and age were noted to be predictors of sleep quality scores.”
Sleep and mental health in athletes
Kim, K. N., Emert, S. E., Huskey, A., Athey, A. B., & Taylor, D. J. (2024) · Elsevier eBooks · doi:10.1016/b978-0-12-822969-9.00008-0
Poor sleep quality is predictive for higher pain levels in patients with chronic scrotal pain, regardless of body perception, biological rhythm, anxiety, and depression
Demirci, A., Hızlı, F., Hamurcu, H. D., et al. (2024) · The French Journal of Urology · doi:10.1016/j.fjurol.2024.102707
Psychometric evaluation of an Arabic language version of the Geriatric Sleep Questionnaire- 6 items (GSQ-6) in Community-dwelling Older AdultsPreprint
Khalil, M. I. M., Shaala, R. S., Elnakeeb, M. E., et al. (2024) · Research Square · doi:10.21203/rs.3.rs-4763603/v1
Effects of brown rice supplementation on physical, cognitive and mental health among adults: Study protocol for a longitudinal, double-blind, randomized, placebo-controlled trialPreprint
Takahashi, M., Kokubun, K., Yoda, M., Kawaoka, S., Nakase, T., Ohara, T., & Taki, Y. (2024) · Research Square · doi:10.21203/rs.3.rs-4719225/v1
Artificial Light at Night Accompanied by Noise Leads to Poor Educational Achievements of SchoolchildrenPreprint
Shama, H., & Portnov, B. A. (2024) · Research Square · doi:10.21203/rs.3.rs-4802176/v1
Sleep Disorders, Electronic Device Use, and Family Support: Looking for a Link in Type 1 Diabetic Adolescents Regarding Their Glycemic Control
Tafti, M. F., Talebian, N., Shokri, P., Shabani-Derakhshan, S., Hadeiy, S. K., Jafari, A., Pirdehghan, A., & Razavi, Z. (2026) · Shiraz E-Medical Journal · doi:10.5812/semj-163662
Longitudinal Digital Phenotyping of Multiple Sclerosis Severity Using Passively Sensed Behaviors and Ecological Momentary AssessmentsPreprint
Xia, Z., Chikersal, P., Venkatesh, S., Walker, E., Dey, A. K., & Goel, M. (2024) · medRxiv · doi:10.1101/2024.11.02.24316647
“To measure the severity of sleep disturbances, participants completed the Pittsburgh Sleep Quality Index (PSQI) once every four weeks [30].”
Method
Couples, Infertility, and the Cost of Her Failure
Longhi, E. V. (2024) · Springer eBooks · doi:10.1007/978-3-031-76726-5_11
To Analyse the Effect of Surya Namaskar on Cognitive Function and Quality of Life among Older Population
Uppal, R., Kaur, S., & Gupta, G. (2025) · Journal of Applied Consciousness Studies · doi:10.4103/jacs.jacs_179_24
Anxiety and sleep quality in the undergraduate stress–depression link: A moderated mediation studyPreprint
Koebeli, C., Koebeli, M., Morgan, K., Edginton, T. L., & Boubert, L. (2025) · medRxiv · doi:10.1101/2025.08.01.25332606
Sleep Health During Pregnancy: A Focus on Prevention
Meneo, D., Baldi, E., Cascone, R., & Baglioni, C. (2025) · Springer eBooks · doi:10.1007/978-3-031-95948-6_11
Territorial reformations in regions: legal aspects
Миронова, Н. И. (2008) · Public Administration Issues · doi:10.17323/1999-5431-2008-0-3-82-105
Sleep quality and the self
Butterworth, J. W., Sedikides, C., Wildschut, T., & Kelley, N. J. (2025) · Self and Identity · doi:10.1080/15298868.2025.2550615 · Cited by 1
“Although actigraphy is a reliable and valid method for assessing behavioral sleep quality (Acebo & LeBourgeois, 2006; Rosipal et al., 2013), sleep quality is multifaceted and difficult to distil into one single variable (Buysse et al., 1991).”
Translation, Adaptation, and Validation of the Athlete Sleep Behavior Questionnaire for Persian-Speaking Athletes
Norouzi‬, E., Zandi, K., & Hossieni, S. A. (2025) · Orthopaedic Journal of Sports Medicine · doi:10.1177/23259671251374311
Comparative Effectiveness of Tibolone and Combined Hormone Therapy in Relieving Menopausal Insomnia
Song, Z., Li, C., Jin, F. J., et al. (2025) · Women s Health Reports · doi:10.1177/26884844251387909
Effects of Melanopic Equivalent Daylight Illuminance on Sleep Regulation and Chronotype-Specific Responses in Young AdultsPreprint
Hwang, E., Kim, H., Lee, H., Nam, H., & Lee, J. (2025) · medRxiv · doi:10.1101/2025.10.21.25338466
“In addition to device-based measures, sleep quality was further evaluated using the Pittsburgh Sleep Quality Index (PSQI) [42].”
Untersuchung des Schlaf-Wachverhaltens und der Tagesbefindlichkeit berufstätiger Männer und Frauen jenseits des 50. Lebensjahres
Brummund, T. (2008)
Investigating the Combined Effect of Artificial Light at Night and Noise on Sleep Quality of High School Students
Shama, H., Tzischinsky, O., & Portnov, B. A. (2026) · Journal of Sleep Research · doi:10.1111/jsr.70301
Investigating the combined effect of artificial light at night and noise on educational achievements of schoolchildren
Shama, H., & Portnov, B. A. (2026) · Chronobiology International · doi:10.1080/07420528.2026.2650829
Modifiable Predictors of Sleep Quality in Multiple Sclerosis: A Prospective Cohort StudyPreprint
DelSignore, M., Venkatesh, S., Zhu, W., Goodman, M., & Xia, Z. (2026) · medRxiv · doi:10.64898/2026.05.29.26354460
A community-based model for multimodal brain-health screening and Alzheimer’s disease and related dementia risk prediction in mid-sized cities and surrounding rural communities: a mixed-methods evaluation
Kemp, A. M. (2026) · Innovation in Aging · doi:10.1093/geroni/igag060
“Physical endurance, as measured by the Six-Minute Walk Test, fell below recommended targets (Enright, 2003), while global sleep scores suggested clinically meaningful sleep disturbance at the population level (Buysse et al., 1991).”
Preserved Medial Temporal Lobe Flexibility Predicts Memory Generalization Only in the Context of Good Sleep Quality among Older African AmericansPreprint
White, P. G., Budak, M., Moallemian, S., Fausto, B. A., & Gluck, M. A. (2026) · medRxiv · doi:10.64898/2026.06.15.26355704
Impact des comorbidités, de la qualité du sommeil et de la fragilité psycho-sociale sur la qualité de vie des personnes âgées
Timotin, L. (2012) · OpenGrey (Institut de l'Information Scientifique et Technique)

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
ORCID: Daniel J. Buysse
Charles F. Reynolds
Amy L. Yeager
David J. Kupfer
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
DOI: 10.1093/sleep/14.4.331
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.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Quantification of Subjective Sleep Quality in Healthy Elderly Men and Women Using the Pittsburgh Sleep Quality Index (PSQI)

Abstract

Overview

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Citations

Cited by

Related

Metadata

Record

About these checks