Exploration of dimensionality and psychometric properties of the Pittsburgh Sleep Quality Index in cases with temporomandibular disorders

Ksenija Rener-Sitar, Mike T. John, Dipankar Bandyopadhyay, Michael J. Howell, Eric L. Schiffman

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51 Scopus citations


Background: This study assessed the dimensional structure of sleep quality with the Pittsburgh Sleep Quality Index (PSQI) and investigated its psychometric properties in cases with temporomandibular disorders (TMD).Methods: A convenience sample of 609 TMD cases (age: 37.1 ± 13.1 yrs, 18-67 yrs, 85% female) of the multi-center Validation Project meeting Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and with sufficient PSQI data were included in this study. To investigate PSQI scores' dimensionality, exploratory factor analysis was used. Factors were identified using the Scree plot. To investigate internal consistency, Cronbach's alpha was calculated. Analyses were separately performed for TMD cases with (N = 496) and TMD cases withouta pain-related diagnosis (N = 113).Results: The mean PSQI score for all TMD cases was 7.1 ± 4.0 units, range: 0-19. The exploratory factor analysis identified one factor for cases with at least one pain-related TMD diagnosis as well as one factor for cases with a pain-free TMD diagnosis that explained 41% of the variance in cases with pain-related TMD and 37% in cases with pain-free TMD. Internal consistency for PSQI scores was alpha of 0.75 in cases with pain-related TMD, alpha of 0.66 in cases with pain-free TMD and alpha = 0.75 for all TMD cases.Conclusions: Sleep quality in TMD patients is a unidimensional construct and can therefore be represented by one summary score; a finding that is in line with previous reports in TMD patients.

Original languageEnglish (US)
Article number10
JournalHealth and Quality of Life Outcomes
Issue number1
StatePublished - Jan 21 2014

Bibliographical note

Funding Information:
This study was supported by the USA national medical research agency The National Institutes of Health (grant U01-DE013331). KRS is supported by the Clinical Research Grant Nr. 20110361 funded by the University Medical Center of Ljubljana, Slovenia. The study was performed at Division of TMD and Orofacial Pain, School of Dentistry, University of Minnesota, Minneapolis, MN, USA.


  • Chronic pain
  • Factor analysis
  • Orofacial pain
  • Psychometrics
  • Quality of life
  • Questionnaires
  • Reliability and validity
  • Self-assessment
  • Sleep disorders
  • Temporomandibular disorders


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