Sleep Apnea Quality Of Life Index Research Articles

Quality of Life, Mental Health, and CPAP Compliance in Thai Patients with Obstructive Sleep Apnea during COVID-19 Pandemic.

This study is aimed at determining the quality of life, mental health, and adherence to continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea (OSA) among Thai OSA patients during the coronavirus disease 2019 (COVID-19) pandemic as this data has been lacking. A cross-sectional study was conducted at a university hospital between September 2021 and April 2022. OSA patients aged 18 years or older who required home CPAP treatment were included. Sleep Apnea Quality of Life Index (SAQLI) and Depression Anxiety Stress Scales-21 (DASS-21) were used to assess quality of life and mental health, respectively. A total of 142 participants (62% male) were included, with a mean age of 54.4 ± 14.7 years and a body mass index of 29.9 ± 6.8 kg/m2. Polysomnographic data showed a mean apnea-hypopnea index of 48.0 ± 32.4 events/hour and a mean lowest oxygen saturation of 79.2 ± 12.2%. Severe OSA was observed in 66.9%. CPAP compliance was reported in 50.7%. The SAQLI score was 2.32 ± 1.12. Depression, anxiety, and stress scores in DASS-21 were 2.89 ± 3.31, 3.94 ± 3.67, and 4.82 ± 4.00, respectively. Compared to the CPAP compliance group, the CPAP noncompliance group had higher daily activity scores in SAQLI (2.98 ± 1.25 vs. 2.45 ± 1.33, P = 0.015). The quality of life for Thai OSA patients during the COVID-19 era was moderate degree. Poor CPAP compliance was significantly associated with limited daily activity. Enhancing CPAP compliance could improve the quality of life in these patients. This trial is registered with TCTR20211104004.

An Evaluation of Obstructive Sleep Apnea Patient's Quality of life Following Continuous Positive Airway Pressure and Uvulopalatopharyngoplasty.

Obstructive sleep apnea (OSA) is characterized by episodic sleep state-dependent upper airway collapse. OSA can markedly decrease quality of life (QoL) and productivity. Continuous Positive Airway Pressure (CPAP) has been used as an effective treatment for OSA. Recently, uvulopalatopharyngoplasty (UPPP) treatment has emerged as effective management among patients with OSA, especially non-adherent ones to conventional therapies such as CPAP. Our aim was to determine whether CPAP and UPPP treatment could improve the quality of life in patients with moderate OSA. Prospective. Patients with moderate OSA, confirmed by polysomnography from March 2019 to March 2020, participated. CPAP and UPPP treatments were considered for patients according to their preferences. The Sleep Apnea Quality of Life Index (SAQLI) questionnaire before and after treatment was completed. Change in their QoL was compared between the CPAP group and UPPP treatment. In addition, QoL was compared between these groups and patients who did not receive any of these treatment methods. Seventy-eight patients were included in treatment groups, 40 using CPAP and 38 undergoing UPPP treatment. Furthermore, 10 patients who did not receive treatment were considered the control. Both methods of treatment significantly (p < 0.001) improved QoL, but UPPP treatment was superior (p = 0.042) to CPAP. There was a poor correlation between post-treatment BMI (0.037), Respiratory Disturbance Index (RDI) (0.096), age (0.022), and post-treatment SAQLI score. Based on these results, CPAP and UPPP treatment can improve QoL. UPPP treatment could be considered an effective arm of OSA management among the study population.

Evaluating the effectiveness of barbed reposition palatopharyngoplasty compared to uvulopalatopharyngoplasty for treatment of obstructive sleep apnea

BackgroundThe majority of obstructive sleep apnea cases involve the oropharynx. The hypercollapsibility of the upper airway walls (UAWs) was the cause of obstructive sleep apnea syndrome (OSAS), which most often manifested itself at the retropalatal and/or retrolingual level. Modular and adaptable barbed snore surgery (BSS) is a novel treatment for retropalatal OSA (based on the anatomy and findings of drug-induced sleep endoscopy (DISE).ObjectivesTo compare between the outcomes of uvulopalatopharyngoplasty and the barbed reposition palatopharyngoplasty technique, and to establish if there is indeed a significant variance in post-operative results among both types of surgeries.Patients and methodsThis was a prospective randomized clinical trial conducted on Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, and it was carried out on 50 patients (28 males and 22 females) suffering from OSAS. They were randomly distributed into two groups: group A and group B.ResultsThere was a substantial distinction among the two groups regarding to post-operative data, comparison between values of all domains of Sleep Apnea Quality of Life Index (SAQLI) and bleeding and nasal regurgitation after surgery. There was no substantial distinction among the two groups in terms of age, sex, body mass index (BMI), smoking, hypertension, and diabetes mellitus.ConclusionBarbed reposition pharyngoplasty is superior to traditional uvulopalatopharyngoplasty in terms of results of Apnea Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), and in Sleep Apnea Quality of Life Index (SAQLI) in addition to producing less post-operative complications as well as being easy to learn.

Continuous Positive Airway Pressure therapy improves the Quality of Life among Obstructive Sleep Apnea individuals in Pakistani Population

Background: Continuous Positive Airway Pressure therapy is the most recommended treatment for OSA patients. Aim: To investigate a possible correlation between the Quality of life in obstructive sleep apnea patient’s pre and post-adhering to continuous positive airway pressure therapy for six months and compare them with the non-exposed group. Methods: This cohort study enrolled a sample of 180 participants, of which 90 were exposed to CPAP and 90 were not exposed by non-random purposive sampling from the Sleep Lab where obstructive Sleep apnea was diagnosed through Polysomnography. In the clinic, demographic data including gender, age, height, weight, body mass index, ESS, and Calgary Sleep Apnea Quality of Life Index were recorded in pre-CPAP therapy questionnaires and repeated after 6 months. Results: After six months of effective continuous positive airway pressure therapy, there was a remarkable increase in all individuals' all-around quality of life as measured by the total Sleep Apnea Quality of Life Index score. Total SAQLI score before treatment was 3.04±0.2 and after treatment was 5.3±0.5 p &lt; 0.01; Daily Functioning, 3.3±0.4 and 5.3±0.6; Social Interaction, 2.9±0.4 and 5.5±0.5; Emotional Functional, 2.9±0.5 and 5.1±0.5; Symptoms, 2.9±0.5 and 5.2±0.6 (p&lt;0.001). In contrast, the SAQLI scores in non-exposed individuals became worsened after six months. For domains A, B, C, and D, the mean difference was 1.96±0.74, 2.50±0.64, 2.21±0.70, and 2.34±0.80 respectively, has a statistically significant correlation (p=0.00). Conclusion: In conclusion, the current investigation yields some significant findings. Six months of continuous CPAP usage can help patients feel less sleepy, increase their SAQLI scores, and significantly lessen OSA-associated symptoms. Keywords: Quality of Life (QOL), Calgary Sleep Apnea Quality of Life Index (SAQLI), Obstructive Sleep Apnea (OSA), Continuous Positive Airway Pressures (CPAP), Daytime Sleepiness, Karachi.

Translation and adaptation of the sleep apnea quality of life index (SAQLI) to Brazilian Portuguese.

Obstructive sleep apnea syndrome (OSAS) is characterized by episodes of upper airway obstruction during sleep, with a risk of cardiovascular and cerebrovascular diseases. There is no tool in Brazil to measure the impact of treatment on patients with OSAS. To translate and culturally adapt the Sleep Apnea Quality of Life Index (SAQLI) into Brazilian Portuguese. The translation and cultural adaptation were carried out in five steps: translation, synthesis of the translations, back translation, review committee and pretesting. A version of a culturally compatible SAQLI was constructed after lexical changes, along with changes to the sentence structures, visual format, instructions and cards. The essence of the questionnaire and its social, emotional, and disease impact in treatment measures was maintained, with 80% understanding. The questionnaire was translated and adapted culturally to Brazilian Portuguese, and presented good comprehension in the study population.

Are the International Classification of Functioning, Disability and Health (ICF) domains considered in the obstructive sleep apnea instruments? An integrative review.

Obstructive Sleep Apnea (OSA) is related to cardiovascular, metabolic, and neurocognitive diseases. Furthermore, OSA symptoms, such as excessive sleepiness, fatigue, and mood disorders, may interfere in functioning. The assessment of this aspect in patients with OSA is not frequent and no specific instrument is available in the literature. Our aim is to identify if the International Classification of Functioning, Disability and Health (ICF) domains are considered in the validated instruments used to assess patients with OSA. In this integrative literature review, three databases were searched: Pubmed, Embase, and LILACS. Bibliographic survey was carried out in 2020, between March and July. Articles published in English, Portuguese, and Spanish with validated tools to assess OSA in adults were included. Thirty instruments have undergone a process of concept extraction and coding according to the ICF, generating a total of 769 significant concepts. It was observed that the function domain was the most prevalent, making 42% (n = 323) of the concepts, followed by domains of activity (16%), participation (10%), environmental factors (5%), personal factor (5%), and structure (1%). Only one instrument, the "Sleep Apnea Quality of Life Index (SAQLI)," encompasses all domains of the ICF in its constructs. In the analyzed instruments, the function domain prevails, with most concepts related to sleep functions. Only one validated instrument included in this research covered all the ICF domains. This instrument closely matched the recommended way of assessing functioning, though it approached the domains in an unbalanced way.

The Effect of Positive Airway Pressure Therapy on Sexual Life and Quality of Life in Women with Moderate or Severe Obstructive Sleep Apnea Syndrome

Background and Aim: Obstructive sleep apnea syndrome (OSAS) negatively affects quality of life and causes erectile dysfunction in men. However, there are few studies examining the effects of OSAS on women’s sexual health. This study used validated measurement tools to evaluate whether the presence and severity of OSAS had an impact on female sexual function and if there was a change after 6 months of CPAP treatment. Scores were compared before and after CPAP in the same and between groups. Material and Method: The patients were divided into moderate and severe groups based on the Apnea-Hypopnea Index (AHI). The female patients included in the study were administered the Female Sexual Function Index (FSFI), and the Calgary sleep apnea quality of life index (SAQLI) questionnaires to evaluate their sexual function. After CPAP treatment for 6 months, FSFI, and SAQLI questionnaires were compared with the results before treatment. Results: Among study participants, 72 had severe and 76 had moderate OSAS. The mean age (standard deviation or SD) in the severe OSAS group was 40.97±5.65 years and in the moderate OSAS group was 35.46 ± 5.43 years (p &lt; 0.001). Body mass indexes of the severe and moderate OSAS groups were 33.10 ± 3.33 kg/m2and 31.04 ± 3.42 kg/m2, respectively (p &lt; 0.001). The mean Epworth scores (SD) of the severe and moderate OSAS groups were 11.45 ± 3.27 and 9.52 ± 3.31, respectively (p = 0.001). Based on FSFI scores, in the pre-treatment period, desire, lubrication, and satisfaction were significantly better in the moderate OSAS group. After treatment, only desire and satisfaction were significantly better in the moderate OSAS group. In both groups, after treatment, all parameters of the FSFI score were significantly better compared with the pretreatment values (p = 0.001). When SAQLI scores were compared, in the pre-treatment period, all parameters were significantly better in the moderate OSAS group. In both groups, after treatment, all parameters of the SAQLI score were significantly better compared with the pre-treatment values (p = 0.001). Conclusion: In women with severe and moderate OSAS, sexual functions and satisfaction levels were negatively associated with OSAS severity. Sexual functions and quality of life were significantly improved with effective treatment of OSAS.

Improvement in quality of life after skeletal advancement surgery in patients with moderate-to-severe obstructive sleep apnoea: a longitudinal study

Skeletal advancement surgery with sagittal split ramus osteotomy (SSRO) or mandibular distraction osteogenesis (MDO) is effective in treating patients with obstructive sleep apnoea (OSA) and may improve their quality of life (QoL). This study aimed to evaluate the longitudinal QoL changes in moderate-to-severe OSA patients after skeletal advancement surgery. Eighteen patients were randomized to receive SSRO (n=9) or MDO (n=9) alone or as part of the skeletal advancement surgery. Baseline QoL was compared with that of a control group (n=36). QoL was compared between the SSRO group and MDO group over a period of 2 years postoperative. The Epworth Sleepiness Scale (ESS), Calgary Sleep Apnea Quality of Life Index (SAQLI), Functional Outcomes of Sleep Questionnaire (FOSQ), and Short Form Health Survey (SF-36) were used as instruments. The OSA group had worse ESS, SF-36, FOSQ, and SAQLI preoperatively than the control group. The MDO and SSRO groups showed significant improvements in ESS at all postoperative time points (P≤0.021). The FOSQ, SAQLI, and SF-36 of both groups at 2 years postoperative were similar to those of the control group. No differences in QoL were found between the SSRO and MDO groups. This study showed QoL was improved in patients with moderate-to-severe OSA after skeletal advancement surgery by SSRO or MDO.

Impact of Positive Pressure Treatment of the Airway on Health-Related Quality of Life in Elderly Patients With Obstructive Sleep Apnea.

Obstructive sleep apnea (OSA) is a chronic illness that increases in prevalence with age. Treatment includes continuous positive airway pressure (CPAP) devices. Studies about the use of CPAP in the elderly are scarce. The main objective of this study is to determine whether CPAP contributes to improvement in health-related quality of life (HRQL) in elderly patients with OSA. This was a prospective, pre-/postintervention assessment of a cohort of patients ≥65 years of age with OSA diagnosis by polysomnography who were being treated with CPAP and were physically independent and had good cognitive status. We determined HRQL before and after 3 months of CPAP treatment using the Short Form-36 Health Survey (SF-36, a 36-item, patient-reported survey) and Sleep Apnea Quality of Life Index (SAQLI). The effect of CPAP on daytime sleepiness was assessed with the Epworth Sleepiness Scale (ESS). Of the 103 participants with a mean age of 71.5 ± 4.19 years, 66% were male. After 3 months of therapy, the mean CPAP usage was 6.3 ± 1.41 hr/day. The effectiveness of CPAP in controlling the OSA was demonstrated (mean difference pre- and posttherapy: 34.30 ± 18.52 events/hr, p < .001). Postintervention, the categories of the SF-36 improved meaningfully ( p < .001). Moreover, all categories of SAQLI improved ( p < .001) with the exception of "symptoms" ( p = .073). ESS scores also improved significantly (difference = 5.2 ± 4.47, p < .001) postintervention. Therapy with CPAP in elderly patients with OSA helps improve their HRQL and reduces daytime sleepiness.

Quality of Life in Obstructive Sleep Apnea-hypopnea Syndrome

&lt;p&gt;Obstructive Sleep Apnea/hypopnea Syndrome (OSAHS) has as its fundamental mechanism the failure of tonic dilatation of the pharyngeal muscles during sleep. Its prevalence has been fixed between 2-4% in women and 4-8 % in men.&lt;strong&gt; &lt;/strong&gt;This pathology elevates blood pressure, increases the risk of cardiovascular and cerebrovascular disease, causes excessive drowsiness and decreases the quality of life of patients who suffer it. Approximately 5% of the general population is affected in their daily lives due to this disorder. Therefore, it is pertinent to have instruments that effectively measure every aspect involved in OSAHS. In Colombia, there is currently no validated scale that evaluates the quality of life in OSAHS; however, worldwide, there are several instruments useful in this topic; one of these is the Sleep Apnea Quality of Life Index (SAQLI), which is validated in four languages, including Spanish, but has not yet been validated in our country, which probably involves a language and cultural barrier at the time of application.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;

A Comparison of Uvulopalatopharyngoplasty and Modified Radiofrequency Tissue Ablation in Mild to Moderate Obstructive Sleep Apnea: A Randomized Clinical Trial

To compare the efficacy of modified radiofrequency tissue ablation (MRFTA) with uvulopalatopharyngoplasty (UPPP) based on both subjective and objective outcome measures in patients with mild to moderate obstructive sleep apnea (OSA). Forty patients with mild to moderate OSA were randomly divided into UPPP and MRFTA groups. Evaluation was made based on the apneahypopnea index (AHI), Sleep Apnea Quality of Life Index (SAQLI) and Epworth Sleepiness Scale (ESS), immediately before the surgery and 6 months postoperatively. The postoperative AHI scores were improved significantly in both groups, although the postoperative AHI in the UPPP group was significantly lower than in the MRFTA group (P = .02). The difference between success rates for moderate OSA in UPPP and MRFTA was significant (77% versus 30%, P = .03) but there was no significant difference between success rates for mild OSA in UPPP and MRFTA groups (70% versus 50%, P = .36). Comparing postoperative ESS scores in the 2 groups showed no significant difference (P = .24). The postoperative scores in social interaction, treatment-related symptoms domain, and SAQLI total score were significantly higher in the MRFTA group. MRFTA as well as UPPP can greatly improve daytime sleepiness and AHI, especially in patients with mild OSA. MRFTA proved to be more effective than UPPP to enhance quality of life of patients with OSA. Further studies with longer follow-up are required to evaluate long-term safety and efficacy of these procedures. A commentary on this article appears in this issue on page 1023. Trial name: Comparison of RFTA (Radio-Frequency-Tissue-Ablation) and UPPP (Uvulopalatopharyngoplasty) in patients with mild to moderate obstructive sleep apnea. URL: http://en.search.irct.ir/view/18617. Registration number: IRCT2014060910160N3.

Effects of Patent Foramen Ovale Closure on Obstructive Sleep Apnea Syndrome: PCOSA Study

BackgroundPrevious studies have shown a higher prevalence of patent foramen ovale (PFO) in patients with obstructive sleep apnea syndrome (OSAS). Right to left shunting through a PFO may be encouraged by the respiratory physiology of OSAS, contributing to the disease pathophysiology. We assessed whether PFO closure would improve respiratory polygraphy parameters compared with baseline measurements in patients with OSAS. MethodsTwenty-six patients with newly diagnosed OSAS and a moderate-large PFO (prevalence, 18% of 143 patients screened) were referred for PFO closure. The oxygen desaturation index (ODI), apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS), 6-minute walk test (6MWT), and Sleep Apnea Quality of Life Index (SAQLI) results were compared in these patients at baseline (before continuous positive pressure ventilation [CPAP]) and at 6-month follow-up (after interrupting CPAP for 1 week). ResultsAll PFOs were safely sealed at 6 months, as confirmed by repeated transthoracic echocardiography. The ODI (44.8 [interquartile range (IQR), 31.2-63.5) vs 42.3 [IQR, 34.0-60.8]; P = 0.89) and AHI (47.9 [IQR, 31.5-65.2] vs 42.3 [IQR, 32.1-63]; P = 0.99) did not change after PFO closure nor did the 6MWT, although the ESS (13.0 [IQR, 12.0-16.8] vs 6.0 [IQR, 4.0-8.8]; P < 0.001) and the SAQLI (3.4 [IQR, 2.8-4.3] vs 4.4 [IQR, 3.9-5.3]; P < 0.001) did improve. ConclusionsThe prevalence of PFO in OSAS appears to be no higher than that in the general population. Although PFO closure is safe and effective, it did not improve respiratory polygraphy measures of OSAS severity. The improvement in the ESS and SAQLI likely reflect residual benefits from CPAP.

The effects of integrated nursing education on quality of life and health-related outcomes among obstructive sleep apnea patients receiving continuous positive airway pressure therapy

This study sought to examine the effects of a nursing education program on quality of life and sleep disturbance among obstructive sleep apnea (OSA) patients receiving continuous positive airway pressure (CPAP) therapy. This study was a randomized controlled trial with an intervention group consisting of a nursing education program. The intervention group received the instruction of the CPAP nursing education program, and the control group received routine care. Data was collected for both groups before the intervention (pre-test), on the 7th day measurement after the intervention, and on the 30th day measurement after the intervention. The results showed, first, that the intervention group reported a significantly reduced level of disturbance from wearing CPAP compared with that of the control group after the intervention (β=-1.83, p=.040). Second, the Calgary sleep apnea quality of life index (SAQLI) total scores significantly improved after the intervention (β=1.669, p=0.014). Also, symptoms of the SAQLI sub-items were improved and significantly different (β=5.69, p=0.007) after the intervention in the intervention group. According to the results of the study, the disturbance from wearing CPAP, the total score of the SAQLI and the symptoms of the SAQLI were significantly improved after the nursing education intervention. Therefore, an adequate nursing education program is recommended for the initial period of CPAP use among OSA patients.

Obstructive Sleep Apnea and Quality of Life: Comparison of the SAQLI, FOSQ, and SF-36 Questionnaires.

The impact of sleep on quality of life (QoL) has been well documented; however, there is a great need for reliable QoL measures for persons with obstructive sleep apnea (OSA). We compared the QoL scores between the 36-Item Short Form of the Medical Outcomes Survey (SF-36), Calgary Sleep Apnea Quality of Life Index (SAQLI), and Functional Outcomes Sleep Questionnaire (FOSQ) in persons with OSA. A total of 884 participants from the Sleep Heart Health Study second examination, who completed the SF-36, FOSQ, and SAQLI, and in-home polysomnograms, were included. The apnea hypopnea index (AHI) at 4% desaturation was categorized as no OSA (<5 /hour), mild to moderate OSA (5-30 /hour) and severe OSA (>30 /hour). QoL scores for each questionnaire were determined and compared by OSA severity category and by gender. Participants were 47.6% male, 49.2% (n=435) had no OSA, 43.2% (n=382) had mild to moderate OSA, and 7.6% (n=67) had severe OSA. Participants with severe OSA were significantly older (mean age = 63.7 years, p <.0001), had higher BMI (mean = 34.3 kg/m2, p <.0001) and had lower SF-36 Physical Component scores (PCS) (45.1) than participants with no OSA (48.5) or those with mild to moderate OSA (46.5, p= .006). When analyzed according to gender, no significant differences were found in males for QoL by OSA severity categories. However, females with severe OSA had significantly lower mean scores for the SAQLI (5.4, p= .006), FOSQ (10.9, p= .02), and SF-36 PCS (37.7, p<.0001) compared to females with no OSA (6.0, 11.5, 44.6) and those with mild to moderate OSA (5.9, 11.4, 48, respectively). Females with severe OSA also had significantly higher mean BMI (41.8 kg/m2,) than females with no OSA (26.5 kg/m2) or females with mild to moderate OSA (30.6 kg/m2, p<.0001). The SF-36 PCS and Mental Component Scores (MCS) were correlated with the FOSQ and SAQLI (r=.37 PCS vs FOSQ; r=.31 MCS vs FOSQ; r=.42 PCS vs SAQLI; r=.52 MCS vs SAQLI; and r=.66 FOSQ vs SAQLI, p<.001 for all correlations). Linear regression analyses, adjusting for potential confounders, indicated that the impact of OSA severity on QoL is largely explained by the presence of daytime sleepiness. The impact of OSA on QoL differs between genders with a larger effect on females and is largely explained by the presence of daytime sleepiness. Correlations among QoL instruments are not high and various instruments may assess different aspects of QoL.

Impact of continuous positive airway pressure (CPAP) on quality of life in patients with obstructive sleep apnea (OSA).

Obstructive sleep apnea is a chronic illness with increasing prevalence. In addition to associated cardiovascular comorbidities, obstructive sleep apnea syndrome has been linked to poor quality of life, occupational accidents, and motor vehicle crashes secondary to excessive daytime sleepiness. Although continuous positive airway pressure is the gold standard for sleep apnea treatment, its effects on quality of life are not well defined. In the current study we investigated the effects of treatment on quality of life using the data from the Apnea Positive Pressure Long-term Efficacy Study (APPLES), a randomized controlled trial of continuous positive airway pressure (CPAP) versus sham CPAP. The Calgary Sleep Apnea Quality of Life Index (SAQLI) was used to assess quality of life. Overall we found no significant improvement in quality of life among sleep apnea patients after CPAP treatment. However, after stratifying by OSA severity, it was found that long-term improvement in quality of life might occur with the use of CPAP in people with severe and possibly moderate sleep apnea, and no demonstrable improvement in quality of life was noted among participants with mild obstructive sleep apnea.

Obstructive sleep apnea syndrome and the quality of life.

Background and aimsObstructive sleep apnea syndrome (OSA) affects the quality of life (QOL) due to the effects on the patient’s physical and mental function. QOL in sleep apnea may improve under continuous airway positive pressure (CPAP) therapy. The purpose of this study was to assess the OSA patients QOL before and after 3 months of CPAP therapy using Calgary Sleep Apnea Quality of Life Index (SAQLI).MethodsWe conducted a study in 79 sleep apnea subjects diagnosed using cardiorespiratory portable monitoring, under CPAP therapy, monitored in our Sleep Laboratory from January 2011 to December 2014. This is a cross-sectional study, achieved through quantitative research (SAQLI questionnaire application) about the perception of quality of life in patients with sleep apnea in the moment of diagnosis and 3 months after CPAP therapy.ResultsOf the 79 subjects, 59 (74.7%) were men and 20 (26.3%) women; mean age was 54.13 years (SD±10.87), the mean apnea-hypopnea index (AHI) was 52.46±20.83 events/h. In all 4 domains of SAQLI: daily functioning with mean pretreatment score 4.13±0.58 versus mean post treatment score 5.43±0.52; social interactions with mean pretreatment score 3.68±0.55 versus post treatment mean score 5.36±0.57; emotional functioning with mean pretreatment score 3.83±0.53 versus mean post treatment mean 5.38±0.56 and symptoms with mean pretreatment score 0.81±0.12 versus mean post treatment score 1.15±0.14, quality of life was improved after 3 months of therapy, with significantly statistical correlation (p=0.00). Also, an improvement was seen in mean total score of SAQLI after therapy as compared to baseline 3.11±0.32 versus 4.24±0.39 (p<0.01).ConclusionThe quality of life in sleep apnea was better after CPAP therapy than from baseline, according Calgary Sleep Apnea Quality of Life Index. The SAQLI is a useful toll to evaluate quality of life in sleep apnea, especially to highlight the benefits of CPAP therapy, even with short time monitoring.

Low Quality of Life and Depressive Symptoms as an Independent Risk Factor for Erectile Dysfunction in Patients with Obstructive Sleep Apnea.

Accumulating evidence indicates that obstructive sleep apnea (OSA) is associated with a high prevalence of erectile dysfunction (ED), but the factors that predict the risk of ED in OSA patients have yet to be defined clearly. The aims of the present study were to investigate the clinical characteristics of OSA patients with ED and to identify plausible predictors of ED. The present cross-sectional analysis included 713 male patients who visited Seoul National University Hospital for snoring and/or daytime sleepiness from 2006 to 2014. An in-laboratory polysomnography procedure was conducted to obtain objective recordings of OSA and other sleep parameters. The demographic data of all patients were obtained, and each patient completed all requirements of the following questionnaires: the Calgary Sleep Apnea Quality of Life Index (SAQLI), the Korean version of the International Index of Erectile Function (KIIEF-5), the Beck Depression Inventory (BDI), and the Epworth Sleepiness Scale (ESS). ED and OSA were defined as a KIIEF-5 < 21 and a respiratory disturbance index (RDI) ≥ 5, respectively. Depressive symptoms were defined as a BDI ≥ 10. The frequency of ED did not differ significantly according to OSA severity. In Spearman's correlation analysis, the BDI and the ESS were inversely correlated with the KIIEF-5, whereas the SAQLI was positively correlated with the KIIEF-5. The RDI and the lowest oxygen saturation (SaO2 ) did not exhibit significant correlations with the KIIEF-5. A multivariate logistic regression analysis adjusted for possible confounding factors showed that ED was independently associated with the SAQLI and depressive symptoms, but there was no significant association of ED with either the RDI or the lowest SaO2 . The present study demonstrated that depressive symptoms and a low quality of life specific to sleep apnea are independent risk factors for ED in OSA patients.

High Intensity Non-Invasive Positive Pressure Ventilation (HINPPV) for Stable Hypercapnic Chronic Obstructive Pulmonary Disease (COPD) Patients.

Introduction: High intensity non-invasive positive pressure ventilation (HI-NPPV) is an algorithm of non-invasive ventilation that has been shown to improve partial pressure of carbon dioxide (PaCO2), health-related quality of life and mortality in hypercapnic chronic obstructive pulmonary disease (COPD) patients. Objective: Assess 3 months of HI-NPPV in stable hypercapnic COPD patients. Methods: A single arm, non-randomized pilot study of HI-NPPV. Patients were eligible if they had clinically stable COPD and daytime arterial PaCO2 >50 mmHg. Results: Nine patients completed therapy. Patient characteristics: 2 male: 7 female, mean age of 64.4 years (SD ±6.6), mean forced expiratory volume in 1 second (FEV1) of 26% (SD±6.73), 8 patients on long term oxygen therapy (LTOT) and a median body mass index (BMI) of 26.6 (interquartile range [IQR] 25.5 - 32.5). Outcomes: There was a mean reduction in daytime PaCO2 by 4.66 mmHg (p=0.01) and bicarbonate by 2.16 mmHg (p=0.005). There was no statistically significant difference in lung function, maximal inspiratory pressures or 6 minute walk distance. There was no statistically significant difference in sleep duration, efficiency or percentage of sleep stage 3 ( N3) or rapid eye movement (REM). The Chronic Respiratory Questionnaire (CRQ) showed a trend towards improvement with an increase of 2.69 points (p=0.054), the dyspnea domain showed a statistically significant improvement (p=0.03). The Calgary Sleep Apnea Quality of Life Index (SAQLI) detected an improvement in daily functioning (p=0.007). The Severe Respiratory Insufficiency (SRI) Questionnaire showed a trend to improvement overall (p=0.05). Four patients had COPD exacerbations during the follow up period. Conclusions: HI-NPPV is able to substantially reduce PaCO2 in hypercapnic COPD patients; we detected a positive effect on quality of life measures with no significant change in sleep quality.

Lack of Impact of Mild Obstructive Sleep Apnea on Sleepiness, Mood and Quality of Life.

Obstructive sleep apnea (OSA) is associated with sleepiness, depression and reduced quality of life. However, it is unclear whether mild OSA has these negative impacts. Using data from the Apnea Positive Pressure Long-term Efficacy Study (APPLES), this study determined whether participants with mild OSA had greater sleepiness, more depressive symptoms and poorer quality of life in comparison to those without OSA. 239 individuals evaluated for participation in APPLES with a baseline apnea hypopnea index (AHI) < 15 /hour were assigned to 1 of 2 groups: No OSA (N=40, AHI < 5 /hour) or Mild OSA (N=199, 5 to <15 /hour) based on their screening polysomnogram. Scores on their Epworth Sleepiness Scale (ESS), Stanford Sleepiness Scale (SSS), Hamilton Rating Scale for Depression (HAM-D), Profile of Mood States (POMS) and Sleep Apnea Quality of Life Index (SAQLI) were compared between groups. There were no significant differences between the No OSA and Mild OSA groups on any of the 5 measures: ESS (No OSA, 9.8 ± 3.5 vs Mild OSA, 10.6 ± 4.3, p=0.26), SSS,(2.8 ± 0.9 vs. 2.9 ± 1.0, p=0.52), HAM-D (4.6 ± 3.0 vs. 4.9 ± 4.7, p=0.27), POMS (33.5 ± 22.3 vs. 28.7 ± 22.0, p=0.70), SAQLI (4.5 ± 0.8 vs. 4.7 ± 0.7, p=0.39). Individuals with mild OSA in this cohort do not have worse sleepiness, mood or quality of life in comparison to those without OSA.

Redefining the timing of surgery for obstructive sleep apnea in anatomically favorable patients.

Healthcare remunerating agencies in North America require patients with obstructive sleep apnea (OSA) to undergo a continuous positive airway pressure (CPAP) trial before funding surgical therapy. The adherence rate of CPAP is problematic. This study's objective was to determine the proportion of surgically favorable patients who failed CPAP who subsequently benefitted from surgical therapy, and to explore consideration of surgical therapy as first-line treatment in this specific OSA subpopulation. This was a prospective cohort study. Patients with moderate-severe OSA who had failed a minimum 6-month trial of CPAP were recruited. All had optimal anatomy for surgery and underwent tonsillectomy with palatoplasty ± septoplasty. Outcome measures included apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS), and Sleep Apnea Quality of Life Index (SAQLI-E), and blood pressure. Patients were followed for 1 year. By AHI measurement, 85.7% of patients in the entire cohort were successfully treated by surgery. ESS while on CPAP was 13.7 ± 2.9, improving to 4.1 ± 2.5 after surgery. SAQLI-E scores on CPAP were 25.7 ± 5.8, improving to 10.2 ± 3.2 after surgery. Blood pressure remained elevated during CPAP but normalized after surgery. All changes were significant at P < .001. Surgical intervention improved OSA severity as measured by the ESS, SAQLI-E, and blood pressure. These measures had not improved on CPAP. AHI improved as well. Our results suggest that certain patients with OSA may be managed more effectively with surgery than CPAP, without confounding issues of treatment adherence and with only minor surgical risk. 2 Laryngoscope 124:S1-S9, 2014.