Assessment Of Sleep Apnea Quality Of Life Index In Chinese Patients With OSAHS And Evaluate The Therapeutic Effects Of UPPP By SAQLI

Part One: Assessment of the Sleep Apnea Quality of Life Index OBJECTIVE: Obstructive sleep apnea hypopnea syndrome (OSAHS) is a very important and prevalent disease, which is associated with a poor quality of life in many patients. To creative a valid, sensitive, disease-specific quality of life questionnaire in Chinese for adult patients with OSAHS.METHOD: To translate the Sleep Apnea Quality of Life Index (SAQLI) into Chinese, and to determine the reliability and validity. â‘ In order to assess the reliability of SAQLI, 34 OSAHS patients without any therapy were enrolled randomly in this study, the Chinese SAQLI were filled up on entry and repeated among 24 hours. Test-retest reliability was assessed by t-test, Spearman correlation coefficient and intraclass correlation coefficient(ICC). Internal consistency was evaluated by Cronbach's Alphas. Content validity of SAQLI was assessed by validity coeffocients (Spearman correlation coefficients) .â‘¡To establish the confidence limit of the questionnaire,36 OSAHS patients were recuited with the same SAQLI filled up on entry and repeated 1 to 3 month if they became stable after managemented with uvulopalatopharyngoplasty (UPPP) .â‘¢Case-control study was used 35 non-OSAHS patients's and All 70 patient' s baseline data were included to assess the criterian validity and sensitivity of the questionnaire. RESULT:â‘  Scores were not significant different for all domains and total instrument between two measurements using paired-samples t test(all P > 0.05). The Spearman correlation coefficients between test-retest SAQLI scores ( n=34) were 0.93 to 0.97 (all P<0.001) for domain-to-domain and total-to-total scores. Intraclass correlation coefficients were from 0.92 to 0.95 for four domains and 0.94 for overall scores. So we can conclude SAQLI has a good reliability.â‘¡ Internal consistency for SAQLI Eath domain attained a good consistency, Cronbach's Alpha values (n=70)were >0.85 for 4 domains and 0.89 for whole questionnaire(P<0.001).This is satisfied for assessing SAQLI for individuals.â‘¢ By t-test, Among 36 OSAHS patients with therapy, there was significant changes in the scores after 1 to 3 month treatment as they become stable, - 2.02 to -1.10 points, (all P<0.001). SAQLI had great sensitivity.â‘£ By ANOVA, among non-OSAHS patients and all 70 patients with defferent severity grading, the SAQLI baseline data score had significant defferent (all P<0.05). Spearman correlation coefficients among four domains of SAQLI were from 0.51 to 0.86.CONCLUSION: Chinese SAQLI is an effective, sensitive and reliable quality of lifequestionnaire eligible for Chinese adult patients with OSAHS. Part two:Evaluate the Therapeutic Effects of Uvulopalatopharyngoplasty by the Sleep Apnea Quality of Life IndexOBJECTIVE: To evaluate the significance of the sleep apnea quality of life index(SAQLI) for the effection of uvulopalatopharyngoplasty (UPPP) and quality of life inpatients with obstruction sleep apnea syndrome(OSAHS).METHOD: Adult patients with OSAHS were diagnosed by PSG and treated byUPPP were randomly divided into the short-effect of UPPP group and the long-effectof UPPP group. Using the Calgary SAQLI questionnaire to evaluate the short-effectand the long-effect of UPPP. Analyz the correlation between the SAQLI and thephysiological index of PSG.RESULT:1, Before operation, the quality of life of patients with OSAHS was greatly reduced.2, In the short-effect of UPPP group, after operation, the total score of SAQLI including 4 domains increased significantly(P<0.01). Quality of life was improved in 83.3% cases in general. AHI index diminutus(P<0.05), LSa02 and Sa02 both elevate (P<0.01).We come to the conclusion that UPPP operation can relieve frequent apnea or hypoapnea and the degrade of oxygen saturation effectively. the change of sleep stage mainly lies in S₁ stage turning to S₂ stage. Patients gain more deep sleep stage than before operation,so their sleep quality improved.3, Poor correlation was find between the SAQLI and PSG parameters. The difference of domain-to-domain and total-to-total scores of different severity degrees before surgery have statistically significance.So we can classify OSAHS severity degree by SAQLI roughly.4, The change of SAQLI and PSG parameters does not readily relate to each other, so we can not regard the change of SAQLI as predictive index for UPPP therapeutic effectivenes.High correlation was find between The change of SAQLI and the baseline score of SAQLI.5, Scores were not significant different for all 4 domains and total instrument between the long-effect of UPPP group and the short-effect of UPPP group(P<0.05).CONCLUSION: The amelioration of Quality of life with OSAHS patients can be significant both in short and long term after treated by UPPP. The systematic use of UPPP indicates a clear improvement in the global quality of life as well as in the symptoms of patients with OSAHS. SAQLI can be a valuable measure in clinical diagnosis and treatment follow-up.But the change of SAQLI after operation can not be used as the predicitive index for therapeutic effectiveness.