Development and validation of a Chinese version of the Sleep Apnea Quality of Life Index

  • Shui-Tao HuEmail author
  • Lee-Ing Tsao
  • Chung-Chieh Yu
  • Chieh-Yu Liu
Sleep Breathing Physiology and Disorders • Original Article



A Chinese version of the Sleep Apnea Quality of Life Index (SAQLI) for patients with obstructive sleep apnea (OSA) undergoing treatment with continuous positive airway pressure (CPAP) was developed and validated. No Chinese versions of the SAQLI have been previously validated.


A convenience sample of 78 patients with OSA who received CPAP therapy at a Taiwanese teaching hospital was enrolled. The SAQLI is organized into four domains: daily functioning, social interactions, emotional functioning, and symptoms. This study evaluated the equivalence (forward translation and back translation), validity, and reliability of a Chinese version of the SAQLI.


The content validity index (CVI) values of the daily functioning, social interactions, emotional functioning, and symptom domains were .93, .93, .96, and 1.00, respectively. Construct validity of one factor was generated by exploratory factor analysis, and the factor explained the following: (A) daily functioning 54%, (B) social interactions 59%, (C) emotional functioning 64%, and (D) symptoms 75% of total explained variance. The Cronbach’s α internal consistency values for the daily functioning, social interactions, emotional functioning, and symptom domains were 0.68, 0.94, 0.93, and 0.92, respectively. The repeatability of the SAQLI at 7 days and 30 days after the first administration showed reliability coefficients of .94 and .93 (p = 0.001), respectively.


The results indicate that the Chinese version of the SAQLI has good reliability and validity, as well as refined indicators for assessing the tool’s accuracy. Clinicians may thus use the scale to examine the quality of life in Chinese-speaking patients with OSA undergoing CPAP therapy.


Chinese version Sleep apnea Life quality 



Continuous positive airway pressure


Content validity index


Exploratory factor analysis




Obstructive sleep apnea


Neck circumference


Quality of Life Index


Quality of life


Sleep Apnea Quality of Life Index



We wish to express our special thanks to SAQLI author W. Ward Flemons, who agreed to the adaption of this scale for use in Taiwan and provided much assistance in this study.

Authors’ contribution

S-T H designed the study, conducted the analysis, interpreted data, and contributed to the drafring of the manuscript. L-I T interpreted data, and contributed to the drafring of the manuscript. C-C Y contributed to the drafting of the manuscript and revised the paper. C-Y L conducted the analysis and interpreted the data. All of the authors read and approved the final manuscript.

Funding information

This study was funded by the Chang Gung Medical Research Program of Keelung, Taiwan (grant CMRPG2C0171).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study received approval from the Chang Gung Memorial Hospital Institutional Review Board (IRB ID: 101-4853B). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study. During the data collection process, the participants were guaranteed total privacy. The confidentiality of the collected data was strictly adhered to. Each participant was informed of the right to withdraw from the study at any time during the data collection.


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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of NursingChang Gung Memorial HospitalKeelungTaiwan
  2. 2.College of NursingChang Gung University of Science and TechnologyTaoyuanTaiwan
  3. 3.College of NursingNational Taipei University of Nursing and Health SciencesTaipeiTaiwan
  4. 4.Division of Pulmonary, Critical Care, & Sleep Medicine, and College of MedicineChang Gung Memorial Hospital and Chang Gung UniversityKeelung/TaoyuanTaiwan
  5. 5.Department of Speech Language Pathology and AudiologyNational Taipei University of Nursing and Health SciencesTaipeiTaiwan

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