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General Cancer Diagnosis

• Taiwanese version (Tzeng, Fu and Lin, 2012; n = 205; mean age = 58.39 (14.87) years; inpatient and outpatient; 43% metastatic)
  • PSQI global sleep score of 8 was found to generate the best sensitivity (0.90) and specificity (0.83) for measuring sleep disturbance in patients with cancer.
  • Excellent validity with ROC curve analysis area 0.94 (SE 0.015, asymptotic significance < 0.001)
• Greek version (Kotronoulas, Papadopoulou, Papapetrou and Patiraki, 2011; n = 209; mean age = 54.85 (12.91) years; mean global sleep score= 8.88 (4.51); undergoing active phase chemotherapy treatment; 37.3% on sleep medications)
  • Global sleep scores higher than 8 indicated poor sleepers among patients with cancer.

Multiple cancer diagnoses: (Carpenter and Andrykowksi, 1998; Breast Cancer: n =102, mean age = 56.5 (10.8) years; Bone Marrow Transplant: n = 155, mean age 38.7 (10.0); Renal Transplant: n = 56, mean age 39.8 (10.3); Benign Breast Problems: n = 159, mean age 48.3 (11.1))

Adolescents with Osteosarcoma: (Chinese version: Ju et al. 2019; n = 31; mean age = 15.2 (1.7) years)

• Mean global PSQI score = 8.3 ¡À 3.9 among participants who reported sleep disturbance

General Cancer Diagnosis: (Taiwanese version: Tzeng, Fu and Lin, 2012; n = 16; inpatient; test-retest 20 to 28 days apart)

• Mean global PSQI score = 8.75 ¡À 4.65

Adolescents with Osteosarcoma (Chinese version: Ju et al. 2019; n = 54; mean age = 15.2 (1.7) years; mean PSQI score = 8.3 (3.9))

• Excellent internal consistency (Cronbach¡¯s alpha = 0.87)

General Cancer Diagnosis: (Taiwanese version: Tzeng, Fu and Lin, 2012; n = 205; mean age = 58 (14.87) years; inpatient and outpatient; 43% metastatic)

General Cancer Diagnosis: (Beck, Shwartz, Towsley, Dudley and Barsevick, 2004; Study 1 cross-sectional: n = 214, mean age = 53 years, 49% female, mean global PSQI score = 8.15 (4.70); Study 2 longitudinal: n = 259, mean age = 56.6 years, 89.2% female, mean global PSQI score = 7.31 (4.03))

• Excellent internal consistency (Cronbach¡¯s alpha = 0.80 in Study 1 and 0.77 in Study 2)

Mixed Cancer Diagnoses: (Carpenter and Andrykowksi, 1998; Breast Cancer: n =102, mean age = 56.5 (10.8) years; Bone Marrow Transplant: n = 155, mean age 38.7 (10.3); Renal Transplant: n = 56, mean age 39.8 (10.3); Benign Breast Problems: n = 159, mean age 48.3 (11.1))

Adolescents with Osteosarcoma (Chinese version: Ju et al. 2019; n = 54; mean age = 15.2 (1.7) years; mean PSQI global score = 8.3 (3.9))

• Excellent correlation between Multidimensional Assessment of Fatigue scale and PSQI sleep quality factor (r = 0.71), subject sleep quality (r = 0.61), daytime dysfunction (r = 0.72)
• Adequate correlation between Multidimensional Assessment of Fatigue scale and PSQI sleep efficiency factor (r = 0.57), sleep duration (r = 0.34), habitual sleep efficiency (r = 0.45), and sleep disturbances (r = 0.51)
• Poor correlation between Multidimensional Assessment of Fatigue scale and PSQI sleep latency (r = 0.26), use of sleep medications (r = 0.15).
• PSQI can discriminate between subgroups. Significantly high sleep global score (poor sleep quality) in those with metastasis compared to those without metastasis (p = 0.02) and in those receiving more than 2 cycles of chemotherapy compared to those receiving less than 2 (p = 0.04). No difference based on gender, tumor size, or tumor location.

General Cancer Diagnosis

• Taiwanese version (Tzeng, Fu and Lin, 2012; n = 205; mean age = 59 (14.87) years; inpatient and outpatient; 43% metastatic) 
  • Adequate correlation with symptom distress items of the M.D. Anderson Symptom Inventory (r = 0.54)
  • Adequate correlation with fatigue severity items of the Brief Fatigue Inventory (r = 0.55)
  • Excellent correlation between PSQI global sleep score and sleep disturbance item of the M. D. Anderson Symptom Inventory (r = 0.72)
  • Excellent correlation between Sleep Log and PSQI subscale scores of sleep latency (r = 0.57), sleep duration (r = 0.82), sleep efficiency (r = - 0.63), sleep quality (r = - 0.68)
  • Significant difference between known groups: Patients with low fatigue severity (Brief Fatigue Inventory Score < 4) reported significantly better (p < 0.001) sleep quality than patients with high fatigue severity (Brief Fatigue Inventory Score > 7) 
• Greek version (Kotronoulas, Papadopoulou, Papapetrou and Patiraki, 2011; n = 209; mean age = 54.85 (12.91) years; mean global sleep score = 8.88 (4.51);undergoing active chemotherapy)
  • Excellent correlation between PSQI global sleep score and  Sleep Quality-Visual Analogue Scale (r = - 0.75)
  • Excellent correlation between  PSQI global sleep score and Insomnia Severity Index (r = 0.81)
  • No correlation with Epworth Sleepiness Scale Greek version (no values provided)
  • Excellent correlation of Factor 1 (quality of nocturnal sleep: subscales of sleep quality, latency, duration, efficiency, and disturbances) with Sleep Quality-Visual Analogue Scale (r = - 0.73) and Insomnia Severity Index (r = 0.80)
  • Poor correlation of Factor 2 (daily disturbances and management of sleep problems: subscales of sleep medication and daytime dysfunction) with Epworth Sleepiness Scale Greek version (r = 0.30) and daytime functioning item of Insomnia Severity Index (r = 0.31)
  • Significant difference between known groups: Patients with high anxiety or depression and poor performance status had significantly (p < 0.05)  high global PSQI scores (indicating poorer sleep quality).

Different cancer populations: (Carpenter and Andrykowksi, 1998)

• Known Groups Validity
  • Significant difference (p < 0.05) between known groups for the scores in all populations for the following groups:
    • With and without sleep problems based on Symptom Experience Report
    • Good and poor sleep quality based on Sleep, Energy, Appetite Scale
    • With and without sleep restlessness based on subscale of Center for Epidemiological Studies Depression Scale 

• Breast Cancer (women n=102; mean age= 56.5 (10.8) years; mean global PSQI score = 7 (4.4)):
  • Convergent Validity
    • Excellent correlation between PSQI global PSQI score and sleep problems (r = 0.65) measured by Symptom Experience Report and sleep restlessness (r = 0.69) measured by Centers for Epidemiological Studies Depression Scale
    • Adequate correlation between PSQI global score and feeling tired (r = 0.44), weakness (r = 0.43) measured by Symptom Experience Report, and all subscales of the Profile of Mood states (r = 0.45 to 0.53)
    • Adequate negative correlation between PSQI global score and vigor/activity (r = - 0.39) subscale of Profile of Mood states where higher scores indicate better activity, and Medical Outcomes Survey SF-36 (r = - 0.53) where higher scores indicate better quality of life
  • Divergent Validity
    • Adequate correlation between PSQI global score and nausea (r = 0.36) measured by Symptom Experience Report
    • Poor correlation between global PSQI score and vomiting (r = 0.26) measured by Symptom Experience Report
• Bone Marrow Transplant (n = 155, mean age 38.7 (10.3); mean global PSQI score = women 6.0(4.3), men 5.4 (3.6);
  • Convergent Validity
    • Excellent correlation between PSQI global score and sleep problems (r = 0.72) measured by Symptom Experience Report
    • Excellent negative correlation between PSQI global score and Functional Living Index for Cancer Patients (r = - 0.63) where higher scores indicate better quality of life, and sleep quality (r = - 0.75) measured by Sleep, Energy and Appetite Scale where higher scores indicate better sleep quality
    • Adequate correlation between PSQI global score and feeling tired (r = 0.54), weakness (r = 0.52) measured by Symptom Experience Report, all subscales of Profile of Mood states (r = - 0.36 to 0.60)
    • Adequate negative correlation between PSQI global score and energy (r = - 0.54) and appetite (r = - 0.37) measured by Sleep, Energy and Appetite Scale where higher scores indicate better sleep quality
  • Divergent Validity
    • Poor correlation between global PSQI score and nausea (r= 0.17), vomiting (r = 0.12), and taste (r= 0.13) measured by Symptom Experience Report
• Renal Transplant (n = 56, mean age 39.8 (10.3), mean global PSQI score = women 7.9 (4.5), men 7.3 (4.3))
  • Convergent Validity
    • Excellent correlation between PSQI global score and sleep problems (r = 0.74), feeling tired (r = 0.67) measured by Symptom Experience Report
    • Excellent negative correlation between PSQI global score and sleep quality (r = - 0.76) measured by Sleep, Energy and Appetite Scale where higher scores indicate better sleep quality.
    • Adequate negative correlation between PSQI global score and Functional Living Index for Cancer Patients (r = - 0.57) where higher scores indicate better quality of life, and energy (r = - 0.52) measured by Sleep, Energy and Appetite Scale where higher scores indicate better sleep quality and vigor/activity (r = - 0.56) subscale of Profile of Mood states where higher score indicates better activity.
    • Adequate correlation between PSQI global score and weakness (r = 0.43) measured by Symptom Experience Report, and between the total score (r = 0.47), tension/anxiety (r = 0.36), fatigue/inertia (r = 0.54), depression/dejection (r = 0.42), confusion bewilderment (r = 0.32) subscales of Profile of Mood states
    • Poor negative correlation between PSQI global score and appetite (r = - 0.27) subscale of Sleep, Energy, and Appetite Scale where higher score indicates better appetite.
    • Poor correlation between PSQI global score and anger/hostility (r = 0.22) subscale of Profile of Mood states
  • Divergent Validity
    • Adequate correlation between PSQI global score and nausea (r = 0.37) measured by Symptom Experience Report
    • Poor correlation between PSQI global score and vomiting (r = 0.08), change in taste (r = 0.03) measured by Symptom Experience Report
• Benign Breast Problems (women n = 159, mean age 48.3 (11.1), mean global PSQI score = 6.4 (4.2))
  • Convergent Validity
    • Excellent correlation between PSQI global score and sleep problems (r = 0.77) measured by Symptom Experience Report, total score (r = 0.62) and tension/anxiety (r = 0.62) subscale of Profile of Mood states, sleep restlessness (r = 0.75), and total score (r = 0.65) measured by Centers for Epidemiological Studies Depression Scale
    • Adequate correlation between PSQI global score and feeling tired (r = 0.49), weakness (r = 0.52) measured by Symptom Experience Report, fatigue/inertia (r = 0.53), depression/dejection (r = 0.58), confusion/bewilderment (0.46), anger/hostility (r = 0.45) subscale of Profile of Mood states
    • Adequate negative correlation between PSQI global score and vigor/activity (r = - 0.45) subscale of Profile of Mood states where higher score indicates better activity.
  • Divergent Validity
    • Poor correlation between PSQI global score and nausea (r = 0.27), vomiting (r = 0.04), change in taste (r = 0.28) measured by Symptom Experience Report

General Cancer Diagnosis (Beck, Shwartz, Towsley, Dudley and Barsevick, 2004; Study 1 cross-sectional: n = 214, mean age = 53 years, 49% female, mean global PSQI score = 8.15 (4.70); Study 2 longitudinal: n = 259, mean age = 56.6 years, 89.2% female, mean global PSQI score = 7.31 (4.03))

• Known Groups Validity
  • Significant difference in global PSQI scores when the study sample was split into two groups of low and high fatigue, defined using the Schwartz Cancer Fatigue Scale. These significant differences were seen in both, Study 1 and Study 2 samples.

General Cancer Diagnosis: (Greek version: Kotronoulas, Papadopoulou, Papapetrou and Patiraki, 2011; n = 209; mean age = 54.85 (12.91) years; mean global PSQI score = 8.88 (4.51); undergoing active phase chemotherapy treatment)

• Two-factor structure identified using exploratory factor analysis: quality of nocturnal sleep, and daily disturbances and management of sleep problems

Adolescents with Osteosarcoma: (Chinese version: Ju et al. 2019; n = 54; mean age = 15.2 (1.7) years; mean PSQI score = 8.3 (3.9))

• Excellent with a fit index of 0.97 for the two-factor structure: perceived sleep quality and sleep efficiency

General Cancer Diagnosis (Beck, Shwartz, Towsley, Dudley and Barsevick, 2004; Study 1 cross-sectional: n = 214, mean age = 53 years, 49% female, mean global PSQI score = 8.15 (4.70); Study 2 longitudinal: n = 259, mean age = 56.6 years, 89.2% female, mean global PSQI score = 7.31 (4.03))

• No redundancy in the 7 subscales: Item to total correlations less than 0.70 in Study 1 and Study 2
• Distinct factors are likely within the subscales: Sleep medications and Daytime dysfunction with low item to total correlations less than 0.3 in Study 1 and 2, additionally Sleep disturbances with less than 0.3 in Study 2

Older Women: (Beaudreau et al. 2012; n = 2968; mean age = 83.4 (3.7) years; mean global sleep score = 6.3 (3.6); 10.3% black women participants, 89.7% white women participants)

• Standard cut-point for clinical significance was >5 for PSQI global score

Older Men: (Spira et al., 2012; n = 3059; mean age= 76.4 (5.5) years; mean global sleep score = 5.6 (3.2))

Older Women: (Beaudreau et al. 2012; n = 2968; mean age = 83.4 (3.7) years; 10.3% black women participants, 89.7% white women participants)

• Mean global PSQI score = 6.3 ¡À 3.6

Older Men: (Spira et al., 2012; n = 3059; mean age = 76.4 (5.5) years; mean global sleep score = 5.6 (3.2))

• Poor correlation between PSQI global score and sleepiness items of the Epworth Sleepiness Scale (r = 0.13)
• Poor  correlation between PSQI global score and wake after sleep onset measured by actigraphy (r = 0.18)
• Poor correlation between greater disturbance on PSQI and greater depressive symptoms on Geriatric Depression Scale (r = 0.34)
• Poor correlation between greater disturbance on PSQI and lower mental health-related quality of life on SF-12 mental component (r = - 0.30)
• Poor correlation between PSQI score and lower SF-12 physical component summaries (r = -0.31)
• Known groups validity. Men reporting insomnia or periodic leg movements had significantly (p <0.001) worse scores than those reporting no sleep disorder history.  

General Anxiety disorder: (Bush et al. 2012; n = 134; mean age = 66.9 (5.8) years; mean global sleep score = 8.74 (4.05))

• Convergent validity 
  • Adequate correlation between PSQI global sleep score and the Beck Depression Inventory-II (r = 0.50)
    • • Adequate correlation between component scores of PSQI to the Beck Depression Inventory-II for subjective sleep quality (r = 0.44), sleep duration (r = 0.38), and daytime dysfunction (r = 0.53)
      • Poor correlation between component scores of PSQI to the Beck Depression Inventory-II for sleep latency (r = 0.17), sleep efficiency (r = 0.28), and sleep disturbances (r = 0.28), sleep medications (r =0.22).  
  • Poor correlation between PSQI global sleep score and the Pennsylvania State Worry Questionnaire (r = 0.25). All component scores were poorly correlated as well (r = 0.02 to 0.28)
  • Poor correlation between PSQI global sleep score and anti-anxiety medication use (r = 0.20), anti-depressant use (r = -0.08), and sedative medication use (r = 0.22)
• Discriminant validity 
  • Poor correlation between PSQI global sleep score and Multidimensional Scale of Perceived Support (r = -0.24) and Life Orientation Test (r = -0.26)
• Known groups validity
  • Mean global PSQI scores were significantly different between those with Generalized anxiety disorder and other diagnosis or no anxiety.

Older Women: (Beaudreau et al. 2012; n = 2968; mean age = 83.4 (3.7) years; mean global sleep score = 6.3 (3.6))

• Poor correlation between PSQI global score and daytime sleepiness measured by Epworth Sleepiness Scale (r = 0.11)
• Poor correlation between PSQI global score and actigraphic wake after sleep onset (r = 0.14)
• Poor correlation between PSQI global score and actigraphic daytime inactivity (r = 0.05)
• Poor correlation between PSQI global score and depressive symptoms measured by Geriatric Depression Scale (r = 0.31)

• Mean global PSQI score = 7.25 ¡À 2.50

Adolescents with Osteosarcoma (Chinese version): (Ju et al. 2019; n = 54; mean age = 15.2 (1.7))

• Mean global PSQI score = 8.3 ¡À 3.9

Adolescents (Brazilian version): (Passos et al., 2016; n = 209; mean age = 14.38 (1.94) years)

• Adequate test-retest reliability (ICC = 0.65; 95% CI: 0.21---0.85) for PSQI global sleep score
• Adequate  test-rest reliability for factor 1 (ICC = 0.59; 95% CI: 0.09-0.82)
• Adequate  test-rest reliability for factor 2 (ICC = 0.71; 95% CI: 0.35-0.87)
• Excellent test-rest reliability for factor 3 (ICC = 0.81; 95% CI: 0.56-0.91)

Adolescents and Young Adults (Spanish Version): (De La Vega et al., 2015; n = 216; mean age = 17.12 (3.05) years; test-retest 6 weeks apart)

Adolescents with Osteosarcoma (Chinese version): Ju et al. 2019; n = 54; mean age = 15.2 (1.7) years; mean PSQI score = 8.3 (3.9))

• Excellent with a fit index of 0.97 for the two-factor structure: perceived sleep quality and sleep efficiency

Adolescents (Brazilian version): (Passos et al., 2016; n = 100; mean age = 13.66 (2.35) years)

• Two factors identified using factor analysis explained 60.41% of the total variance: Daytime dysfunction and sleep disorders

Adolescents and Young Adults (Spanish Version): (De La Vega et al., 2015; n = 216; mean age = 17.12 (3.05) years)

• Excellent with a comparative fit index of 0.91 for a one factor model without the sleep medication component/subscale.

Adolescents: (Raniti, et al., 2018; n = 889; mean age = 15.71 (1.57) years; mean global sleep score = 6.36 (3.22))

• Excellent with a comparative fit index of 0.96 for a single factor model  

Adolescents (Indonesian version): (Setyowati & Chung, 2020; n= 528; age range 13 to 16 years; PSQI global score = 7.25 (2.50))

Mixed Population: (Buysse et al., 1989; n = 91; test-retest average: 28.2 days apart)

• PSQI global sleep score of 5 was found to identify 88.5 % of all patients and controls, and generate the sensitivity (89.6%) and specificity (86.5%)
  • PSQI global score of 5 was found to identify 84.4% of patients with disorders of initiating and maintain sleep
  • PSQI global score of 5 was found to identify 88% of patients with disorders of excessive somnolence
  • PSQI global score of 5 was found to identify 97% of patients with depression

Primary insomnia: (Backhaus et al., 2002; n = 80; mean age = 46.3 (15) years)

• PSQI mean global sleep score >5 indicates relevant sleep disturbances with a higher sensitivity (sensitivity 98.7%; specificity 84.4%)
• PSQI mean global sleep score >6 indicates relevant sleep disturbances with a lower sensitivity (sensitivity 93.4%; specificity 100%)

Chinese version (Primary insomnia and healthy controls): (Tsai et al., 2005; Primary insomnia n = 87: PSQI and sleep scales data for n = 51, mean age = 41 (10) years; mean global sleep score = 10.2 (3.2); Controls n = 157: mean age (37 (14) years)

• PSQI global scores >5 discriminated poor from good sleepers (sensitivity 98%; specificity 55%)
• PSQI global sleep score >6 discriminated poor from good sleepers (sensitivity 90%; specificity 67%)

Psychiatric disorders (Japanese Version):  (Doi et al., 2000; n = 92)

• Primary insomnia (n= 14; mean age = 50.4 (14.6) years; mean global sleep score = 8.93 (4.1))
  • Estimations were based on a 5.5 cut-off points (sensitivity 85.7%; specificity 86.6%)
• Major depression (n = 30; mean age = 47 (16.3) years; mean global sleep score = 9.33 (4.58))
  • Estimations were based on a 5.5 cut-off points (sensitivity 80%; specificity 86.6%)
• Generalized anxiety disorder (n = 24; mean age = 40.9 (15.8) years; mean global sleep score = 9.63 (3.42))
  • Estimations were based on a 5.5 cut-off points (sensitivity 83.3%; specificity 86.6%)
• Schizophrenia (n = 24; mean age = 29.3 (9.4) years; mean global sleep score = 9.13 (4.2))
  • Estimations were based on a 5.5 cut-off points (sensitivity 83.3%; specificity 86.6%)