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"Insomnia"

Original Articles
Testing the reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index using Fitbit devices: a cross-sectional analysis
Si-Yeon Lee, Ja-Eun Choi, Ji-Won Lee, Yaeji Lee, Jae-Min Park, Kyung-Won Hong
Korean J Fam Med 2025;46(1):42-47.   Published online April 22, 2024
DOI: https://doi.org/10.4082/kjfm.23.0166
Background
Sleep disorders and insomnia are prevalent worldwide, with negative health outcomes. The Pittsburgh Sleep Quality Index (PSQI) is a widely used self-report assessment tool for evaluating sleep quality, comprising seven subdomains. The Korean version of the PSQI (PSQI-K) has been tested for reliability and validity in small sample sizes but lacks large-scale validation using objective measures.
Methods
This study was conducted with 268 Korean adults attending health check programs. Participants completed the PSQI-K questionnaire and wore Fitbit devices (Fitbit Inc., USA) to ascertain sleep parameters. Reliability was analyzed using the Cronbach’s α coefficient, and construct validity was determined through factor analysis. Criteria validity was assessed by correlating their index scores with Fitbit sleep parameters. We identified the optimal cutoff for detecting sleep disorders.
Results
The Cronbach’s α coefficient was 0.61, indicating adequate internal consistency. Factor analysis revealed three factors, explaining 48.2% of sleep quality variance. The index scores were negatively correlated with Fitbit sleep efficiency, total sleep time, and number of awakenings (P<0.05). The optimal cutoff point for identifying sleep disorder groups was ≥6.
Conclusion
The PSQI-K demonstrated good reliability and validity when correlated with Fitbit sleep parameters, offering a practical screening tool for identifying sleep disorders among Korean adults. Cutoff scores can help identify patients for sleep interventions. However, further large-scale studies are required to validate these findings.

Citations

Citations to this article as recorded by  
  • Association of work ability with job burnout and sleep quality among biosafety laboratory personnel in Xinjiang, China: a cross-sectional study
    Keke Ju, Ruikai Wu, Jing Yu, Lei Ding, Mengjie Xia, Jiwen Liu, Yaoqin Lu
    Frontiers in Public Health.2025;[Epub]     CrossRef
  • Validation of the Korean version of the Sleep Hygiene Practice Scale in a Non-Clinical Population
    Dongyeop Kim, Ji Young Yun, Hye Ah Lee, Pamela Song, Heeyoung Ahn, Chien-Ming Yang, Jee Hyun Kim
    Behavioral Sleep Medicine.2024; 22(6): 791.     CrossRef
  • The relationship between sleep quality and happiness among preclinical students in a medical school
    Rusdiah Ruzanna Jusoh, Kavimitha G Krishnasamy, Saila Dharishinee Alagu, Pretha Mohan, Jeslyn Tan Guan Qian, Elayevenee Elanthevan, Muhammad Zulfiqah Sadikan, Haryati Ahmad Hairi
    Journal of Education Technology in Health Sciences.2024; 11(3): 92.     CrossRef
  • 2,439 View
  • 93 Download
  • 2 Web of Science
  • 3 Crossref
The Relationship of Caffeine Intake with Depression, Anxiety, Stress, and Sleep in Korean Adolescents
Mi-Joo Jin, Chang-Ho Yoon, Hae-Jin Ko, Hyo-Min Kim, A-Sol Kim, Ha-Na Moon, Seung-Pi Jung
Korean J Fam Med 2016;37(2):111-116.   Published online March 25, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.2.111
Background

In various studies in adults, caffeine may increase wakefulness and relieve pain, but caffeine overdose can cause many adverse serious effects on health. Caffeine intake has recently been increasing in adolescents. In spite of importance of caffeine effects on Korean adolescents, there are lack of scientific and systematic studies. The purpose of our study was to identify the relationship between caffeine consumption and effects on adolescents.

Methods

We performed study on 234 middle school students at one middle school in Daegu using a self-report questionnaire. We divided students to quartiles according to amount of caffeine intake. We used Beck Depression Inventory (BDI) to evaluate the degree of depression and Beck Anxiety Inventory (BAI) to evaluate the degree of anxiety. We also used Insomnia Severity Scale (ISI) to evaluate the degree of insomnia and Global Assessment of Recent Stress (GARS) to evaluate the stress in students. We used logistic regression analysis to identify the relationship between caffeine consumption and effects.

Results

Higher caffeine intake was associated with higher weight, height, lower academic achievement, and higher score in BDI, BAI, ISI, and GARS (P for trend <0.005). Higher caffeine intake quartile was associated with greater odds of having significant depression (BDI ≥10, P for trend=0.011), and insomnia (ISI ≥8, P for trend=0.015) after adjustment for factors that can affect the psychological status.

Conclusion

We found that caffeine intake is associated weight, height, academic achievement, and higher score in BDI, BAI, ISI, and GARS. Caffeine intake was positively associated with the severity of depression and the severity of insomnia among adolescents in Korean.

Citations

Citations to this article as recorded by  
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    Mohammadreza Davoudi, Fatemeh Abdoli, Fereshte Momeni, Mojtaba Habibi Asgarabad
    BMC Psychiatry.2025;[Epub]     CrossRef
  • Mental Health, Sleep, and Caffeine Intake Among Shift Workers in a Nationally Representative Sample of the Korean Adult Population
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    Nutrients.2025; 17(7): 1155.     CrossRef
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    Filomena Carvalho, Sofia Tavares, Radhia Lahlou, Alexandra Varges, André Araújo, Cecília Fonseca, Luís Silva
    Nutrients.2025; 17(7): 1153.     CrossRef
  • Comparative Study of Middle and High School Students on the Relationship between High-Caffeine Drinks and Mental Health
    Jeeyeon PARK, Haesun YUN
    Korean Journal of Health Promotion.2025; 25(1): 29.     CrossRef
  • Energy drinks, depression, insomnia and stress among Palestinians: The mediating role of cigarettes smoking, electronic cigarettes and waterpipe
    Fayez Mahamid, Dana Bdier, Basma Damiri
    Journal of Ethnicity in Substance Abuse.2024; 23(4): 823.     CrossRef
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    Mashta Ikram, Hafiz Muhammad Shahbaz, Waqas Ahmed, Zahra Khan, Sajid Khan Tahir, Kashif Akram
    Topics in Clinical Nutrition.2024; 39(1): 33.     CrossRef
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    MoezAlIslam E. Faris, Eman Rashid Saif, Eman Ali Turki, Dana N. Abdelrahim, Salma Abu-Qiyas, Katia Abi Shihab, Falak Zeb, Haydar Hasan, Mona S. Hashim, Hadia M. Radwan, Farah Naja, Leila Cheikh Ismail, Tareq M. Osaili, Hanin Kassem, Radhiya Al Rajaby, Kha
    European Journal of Nutrition.2024; 63(2): 549.     CrossRef
  • Caffeine intake and anxiety: a meta-analysis
    Chen Liu, Licheng Wang, Chi Zhang, Ziyi Hu, Jiayi Tang, Junxian Xue, Wenchun Lu
    Frontiers in Psychology.2024;[Epub]     CrossRef
  • The caffeine dilemma: unraveling the intricate relationship between caffeine use disorder, caffeine withdrawal symptoms and mental well-being in adults
    Mahmut Bodur, Seda Kaya, Merve Ilhan-Esgin, Funda Pınar Çakiroğlu, Ayşe Özfer Özçelik
    Public Health Nutrition.2024;[Epub]     CrossRef
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    Renata Lira de Assis, Caroline Severo de Assis, Tainá Gomes Diniz, Bruno Rafael Virginio de Sousa, Carla Alexandra da Silva Moita Minervino, Matheus Lima de Paiva, Vinícius José Baccin Martins, Enéas Ricardo de Morais Gomes, Marcelo Felipe Rodrigues da Si
    Journal of Functional Foods.2024; 115: 106101.     CrossRef
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    Naciye Çınar, Mustafa Topkafa
    Fullerenes, Nanotubes and Carbon Nanostructures.2024; 32(10): 953.     CrossRef
  • Excessive caffeine use and its consequence on mental illness: a cross-sectional study in Indonesia
    M Marthoenis, M Jannah
    IOP Conference Series: Earth and Environmental Science.2024; 1356(1): 012046.     CrossRef
  • Intersections of perceived stress, burnout, dispositional hope, intellectual humility, locus of control, and lifestyle factors in undergraduate medical education
    Ashten R. Duncan, Sarah Beth Bell, Chan M. Hellman
    Current Psychology.2023; 42(26): 22301.     CrossRef
  • Trigger Factors of Consuming Tea and Coffee in University Students
    Hafiza Madiha Jaffar, Bahisht Rizwan, Al Noor Naseem, Umm e Habiba Asghar, Zabreen Ghalib, Iram Tariq, Gull e Raana Najeeb, Tania Arshad, Aisha Ahmed, Maryam Munir, Anum Azhar
    Pakistan BioMedical Journal.2023; : 22.     CrossRef
  • Association Between Comorbid Anxiety and Depression and Health Risk Behaviors Among Chinese Adolescents: Cross-Sectional Questionnaire Study
    Meng Wang, Xingyue Mou, Tingting Li, Yi Zhang, Yang Xie, Shuman Tao, Yuhui Wan, Fangbiao Tao, Xiaoyan Wu
    JMIR Public Health and Surveillance.2023; 9: e46289.     CrossRef
  • The effects of tea polyphenols on emotional homeostasis: Understanding dementia risk through stress, mood, attention & sleep
    Donné Minné, Juliet Stromin, Taskeen Docrat, Penelope Engel-Hills, Jeanine L. Marnewick
    Clinical Nutrition ESPEN.2023; 57: 77.     CrossRef
  • Caffeine intake is associated with less severe depressive symptoms in noncancer populations: an analysis based on NHANES 2007-2016
    Long-Shan Yang, Ze-Yi Zhang, Lun-Jie Yan, Yu-Chuan Yan, Si-Yu Tan, Dong-Xu Wang, Zhao-Ru Dong, Tao Li
    Nutrition Research.2023; 118: 1.     CrossRef
  • Caffeine Intake and Its Association with Mental Health Status among Pharmacy Students at UiTM Puncak Alam
    Nurul Atikah Annuar, Kwong Siew Shia John, Noor Jannah Yob, Yuslina Zakaria, Siti Nooraishah Hussin
    Malaysian Journal of Medicine and Health Sciences.2023; 19(3): 36.     CrossRef
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    Revista Colombiana de Psiquiatría.2022; 51(1): 25.     CrossRef
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    Hatice Çolak, Emel Erdeniz, Esra Tansu Sarıyer, Ekin Çevik, Didem Yangın
    Mediterranean Journal of Nutrition and Metabolism.2022; 15(2): 253.     CrossRef
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    Jennifer M. Meigs, Victoria R. Bartolomeo, Amy R. Wolfson
    Sleep Medicine Reviews.2022; 62: 101587.     CrossRef
  • Comparative validated chromatographic methods for the simultaneous determination of caffeine, codeine, paracetamol along with the related compound "p-aminophenol" in tablets
    Reham A. Fekry, Khadiga M. Kelani, Yasmin M. Fayez, Mahmoud A. Tantawy
    JPC – Journal of Planar Chromatography – Modern TLC.2022; 35(1): 51.     CrossRef
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    Public Health Nutrition.2022; 25(12): 3509.     CrossRef
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    International Journal of Environmental Research and Public Health.2022; 19(8): 4751.     CrossRef
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    Journal of Rural Medicine.2022; 17(3): 137.     CrossRef
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  • Association between energy drink intake, sleep, stress, and suicidality in Korean adolescents: energy drink use in isolation or in combination with junk food consumption
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  • 43 Web of Science
  • 47 Crossref
The Effect of Laughter Therapy on Sleep in the Community-dwelling Elderly.
Hyun Wook Jung, Chang Ho Youn, Nu Ri Cho, Mi Kyung Lee, Jung Bum Lee
Korean J Fam Med 2009;30(7):511-518.   Published online July 20, 2009
DOI: https://doi.org/10.4082/kjfm.2009.30.7.511
Background
Aging process causes several changes in the typical sleep patterns. Elderly people complain frequently about sleep duration, changes of sleep/wake rhythm and day time sleepiness. This study was performed to evaluate improvement of sleep quality after laughter therapy. Methods: On July 2007, the study participants aged over 65 were recruited through a community center in Daegu. There were 48 subjects in the experimental group and 61 in the control group. The laughter therapy program was applied to the experimental group. We compared Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) before and after laughter therapy. Data were analyzed by independent t-test, chi-square test, paired t-test, and ANCOVA using SPSS windows ver. 14.0. Results: At initial study, there were no signifi cant differences in baseline characteristics. The ISI scores were 8.00 ± 6.29 and 8.36 ± 6.38; the PSQI scores were 6.98 ± 3.41 and 7.38 ± 3.70; The Geriatric Depression Seals (GDS) scores were 7.98 ± 3.58 and 8.08 ± 3.95 in experimental and control groups, respectively. After laughter therapy, the ISI scores were 7.58 ± 5.38 (P = 0.327) and 9.31 ± 6.35 (P = 0.019), PSQI scores were 6.04 ± 2.35 (P = 0.019) and 7.30 ± 3.74 (P = 0.847), GDS scores were 6.94 ± 3.19 (P = 0.027), 8.43 ± 3.44 (P = 0.422) in experimental and control groups, respectively. Conclusion: The laughter therapy is considered to be useful for the elderly people in a community that improves insomnia and sleep quality.

Citations

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  • Laughter-inducing therapies: Systematic review and meta-analysis
    C. Natalie van der Wal, Robin N. Kok
    Social Science & Medicine.2019; 232: 473.     CrossRef
  • The preliminary effects of laughter therapy on loneliness and death anxiety among older adults living in nursing homes: A nonrandomised pilot study
    Nilgün Kuru Alıcı, Pınar Zorba Bahceli, Oya Nuran Emiroğlu
    International Journal of Older People Nursing.2018;[Epub]     CrossRef
  • Effects of Laughter Therapy on Depression and Sleep among Patients at Long-term Care Hospitals
    Ji Hyoung Han, Kyung Min Park, Heeok Park
    Korean Journal of Adult Nursing.2017; 29(5): 560.     CrossRef
  • The Effect of Laughter Therapy on Arthralgia, Ankylosis, Depression, and Sleep of Elderly Housebound Women with Osteoarthritis
    Chung Soon Kim, Sook Hi Jang, You Young Cho
    Journal of Korean Biological Nursing Science.2015; 17(2): 123.     CrossRef
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    Kyeong-Im Lee, Young Eun
    Journal of muscle and joint health.2011; 18(1): 28.     CrossRef
  • For the Sleep-Related Study
    Nam-Seok Joo
    Korean Journal of Family Medicine.2010; 31(10): 745.     CrossRef
  • Sleep Quality of Breast Cancer Patients Receiving Chemotherapy in the Outpatients Setting
    Joo-Hyun Park, Sun Jin Lee, Jung Im Gwak, Jae-Yong Shim, Jung Kwon Lee
    Korean Journal of Family Medicine.2010; 31(10): 778.     CrossRef
  • 2,415 View
  • 68 Download
  • 7 Crossref
Lifestyle and Health State in Individuals with Frequent Nocturnal Sleep Interruption.
Joon Sik Seo, Jae Ho Lee, Kang Kon Lee
J Korean Acad Fam Med 2006;27(12):967-974.   Published online December 10, 2006
Background
: Many studies have demonstrated that excessively long or short sleep duration and insomnia are associated with high risk of mortality. We intended to investigate the lifestyle and the state of health in frequently sleep interrupted people.

Methods : We have examined 2,540 subjects who visited a comprehensive medical testing center from January 2001 to June 2003. We divided into two groups of sleep disturbance into frequently interrupted group (two or more times per night) and infrequently interrupted group (less than twice per night). After frequency matching by age and sex, 1,900 subjects (each group of 950 subjects) were selected. Lifestyle, self-health perception, symptoms, clinical laboratory data and past history were compared by chi-square test and student's t-test. To identify the factors that influenced on sleep interruption, multiple logistic regression analysis was done.

Results : Sleep duration was not significantly different in both groups (P=0.486). The frequently interrupted group were likely to perceive themselves as bad state of health being in a (P=0.008) and to complain of various symptoms, i.e., fatigue (P<0.001), headache (P= 0.001), etc. Also, they had more incidence of mood disorders (P= 0.002), fatty liver (P=0.008), and arthritis (P=0.001) than the other group. By multiple logistic regression analysis, alcohol consumption (OR: 1.344, P= 0.007), irregular diet (OR: 1.325, P=0.003), and coffee intake (OR: 0.786, P= 0.013) were significantly different between the frequently interrupted group and the other group.

Conclusion : Patients who complain of insomnia should be evaluated on both sleep duration and interruption. The evaluation of sleep interruption is needed in patients who perceive themselves as being in a bad state of health, who complain of various symptoms (fatigue, headache, etc.), or have a history of mood disorder, fatty liver, or arthritis.
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