Name:__________________________________________ Date: ________________
Pittsburgh Sleep Quality Index (PSQI)
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.
1. During the past month, what time have you usually gone to bed at night? ___________________
2. During the past month, how long (in minutes) has it usually taken you to fall asleep each night? __________
3. During the past month, what time have you usually gotten up in the morning? ___________________
4. During the past month, how many hours of actual sleep did you get at night? (This may be different than the
number of hours you spent in bed.) ___________________
5. During the past month, how often have you had Not during Less than Once or Three or more
trouble sleeping because you… the past once a twice a times a week
month week week
a. Cannot get to sleep within 30 minutes
b. Wake up in the middle of the night or early
morning
c. Have to get up to use the bathroom
d. Cannot breathe comfortably
e. Cough or snore loudly
f. Feel too cold
g. Feel too hot
h. Have bad dreams
i. Have pain
j. Other reason(s), please describe:
6. During the past month, how often have you
taken medicine to help you sleep (prescribed or
“over the counter”)?
7. During the past month, how often have you had
trouble staying awake while driving, eating meals,
or engaging in social activity?
No Only a Somewhat A very big
problem very slight of a problem
at all problem problem
8. During the past month, how much of a problem
has it been for you to keep up enough enthusiasm
to get things done?
Very Fairly Fairly Very
good good bad bad
9. During the past month, how would you rate
your sleep quality overall?
No bed Partner/room Partner in Partner in
partner or mate in same room but same bed
room mate other room not same bed
10. Do you have a bed partner or room
mate?
Not during Less than Once or twice Three or
the past once a week a week more times
month a week
If you have a room mate or bed partner, ask
him/her how often in the past month you have
had:
a. Loud snoring
b. Long pauses between breaths while asleep
c. Legs twitching or jerking while you sleep
d. Episodes of disorientation or confusion
during sleep
e. Other restlessness while you sleep, please
describe:
Copyright notice: The Pittsburgh Sleep Quality Index (PSQI) is copyrighted by Daniel J.
Buysse, M.D. Permission has been granted to reproduce the scale for researchers to
use in non-industry studies. For other uses of the scale, the owner of the copyright
should be contacted.
Citation: Buysse, DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ: The Pittsburgh
Sleep Quality Index (PSQI): A new instrument for psychiatric research and practice.
Psychiatry Research 28:193-213, 1989