PITTSBURGH SLEEP QUALITY INDEX
INSTRUCTIONS: The following questions relate to your usual sleep habits during the past month only. Your answers should indicate the most accurate reply for the majority of days and nights in the past month. Please answer all questions.
During the past month, how often have you had trouble sleeping because you . . .
5.
Cannot get to sleep within 30 minutes
6.
Wake up in the middle of the night or early morning
7.
Have to get up to use the bathroom
8.
Cannot breathe comfortably
15.
How often during the past month have you had trouble sleeping because of the problem above?
16.
During the past month, how would you rate your sleep quality overall?
17.
During the past month, how often have you taken medicine to help you sleep (prescribed or "over the counter")?
18.
During the past month, how often have you had trouble staying awake while driving, eating meals, or engaging in social activity?
19.
During the past month, how much of a problem has it been for you to keep up enough enthusiasm to get things done?
20.
Do you have a bed partner or room mate?
If you have a room mate or bed partner, ask him/her how often in the past month you have had . . .
22.
Long pauses between breaths while asleep
23.
Legs twitching or jerking while you sleep
24.
Episodes of disorientation or confusion during sleep
26.
How often during the past month have you had trouble sleeping because of the problem above?
