Insomnia screening in postacute traumatic brain injury - Utility and validity of the Pittsburgh Sleep Quality Index

Objective: To assess insomnia in a rehabilitation population, the authors e xamined the utility and validity of the Pittsburgh Sleep Quality Index (PSQ I). The assessment of insomnia is relevant to the treatment of traumatic br ain injury at the postacute level and routine screening for insomnia may be enhanced by the availability of a standardized, conveniently used, self-re port sleep questionnaire. Design: The authors prospectively studied 91 consecutive patients with trau matic brain injury who were admitted to an outpatient neurorehabilitation p rogram. Besides administering the PSQI, Beck Depression Inventory, Epworth Sleepiness Scale, and Multidimensional Pain Inventory, sleep diary and inte rview data were obtained and used to divide subjects into insomnia and noni nsomnia groups according to the criteria established by the Diagnostic and Statistical Manual of Mental Disorders, ed 4. Results: Sensitivity and specificity rates to the clinical diagnosis of ins omnia were 93% and 100%, respectively,for a PSQI Global Score of >8, and 83 % and 100% for a diagnosis of insomnia based exclusively on PSQI-derived sl eep variable data. Sleep diary data provided concurrent validity for PSQI e stimates of sleep-onset latency, sleep duration, and sleep efficiency. The Beck Depression Inventory, Epworth Sleepiness Scale, and Multidimensional P ain Inventory established concurrent validity for individual PSQI items per taining to mood, hypersomnia, and pain disturbance. Conclusion: The PSQI was demonstrated to be a valid and useful screening to ol for assessing insomnia among postacute patients with traumatic brain inj ury.