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Using a generic measure of quality of life in patients with obstructive sleep apnea

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Abstract

Purpose

To evaluate the utility of a Multicultural Quality of Life Index (MQLI) in patients with Obstructive Sleep Apnea-Hypopnea (OSAH).

Methods

Physical examination, MQLI and the Epworth Sleepiness Scale (ESS) were applied to participants. In addition, a polysomnography or a respiratory polygraphy was carried out.

Results

A total of 221 patients participated, 186 (84%) males, mean age 48.8 ± 11.8 years. The MQLI scores 7were .73 ± 1.45 and the ESS 9.9 ± 5.2. A total of 188 (85%) patients had OSAH: 40 (21%) mild, 43 (23%) moderate, and 105 (56%) severe. The average time to answer the MQLI was 3.5 min. Cronbach’s alpha index was 0.930. MQLI score in patients with and without OSAH was 7.73 versus 7.75 (p = 0.949); and by severity: non-OSAH 7.75, mild 8.04, moderate 8.14, and severe 7.44 (p = 0.023). There was a slight correlation between MQLI score and Apnea-Hypopnea Index in total population, but it disappeared when we analyzed by severity. MQLI and ESS correlation was R = −0.3256 (p < 0.0001).

Conclusions

The MQLI has limitations in identifying quality of life (QOL) alterations and a poor correlation with severity in OSAH patients. The MQLI quantifies QOL in a general way. We recommend supplementing the QOL evaluation with disease-specific instruments.

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References

  1. American Academy of Sleep Medicine (2005) International classification of sleep disorders: Diagnostic and coding manual, 2nd edn. American Academy of Sleep Medicine, Westchester

    Google Scholar 

  2. Grupo Español de Sueño (2005) Consenso Nacional sobre el síndrome de apneas-hipopneas del sueño. Arch Bronconeumol 41(Suppl 4):3S–110S

    Google Scholar 

  3. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 328(17):1230–1235

    Article  PubMed  CAS  Google Scholar 

  4. Duran J, Esnaola S, Rubio R, Iztueta A (2001) Obstructive sleep apnea-hypopnea and related clinical features in a population-based sample of subjects aged 30 to 70 yr. Am J Respir Crit Care Med 163(3 Pt 1):685–689

    PubMed  CAS  Google Scholar 

  5. Hedner J, Bengtsson-Bostrom K, Peker Y, Grote L, Rastam L, Lindblad U (2006) Hypertension prevalence in obstructive sleep apnoea and sex: a population-based case-control study. Eur Respir J 27(3):564–570

    Article  PubMed  CAS  Google Scholar 

  6. Nieto FJ, Young TB, Lind BK, Shahar E, Samet JM, Redline S, D'Agostino RB, Newman AB, Lebowitz MD, Pickering TG (2000) Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. JAMA 283(14):1829–1836

    Article  PubMed  CAS  Google Scholar 

  7. Lavie P, Herer P, Hoffstein V (2000) Obstructive sleep apnoea syndrome as a risk factor for hypertension: population study. BMJ 320(7233):479–482

    Article  PubMed  CAS  Google Scholar 

  8. Rey de Castro J, Rosales E, Ferreyra J (2009) Relación entre la severidad del sindrome de apneas-hipopneas del sueño y la hipertensión arterial. Análisis en una población clínica. Rev Med Hered 20(3):123–132

    Google Scholar 

  9. Kuniyoshi FH, Garcia-Touchard A, Gami AS, Romero-Corral A, van der Walt C, Pusalavidyasagar S, Kara T, Caples SM, Pressman GS, Vasquez EC, Lopez-Jimenez F, Somers VK (2008) Day-night variation of acute myocardial infarction in obstructive sleep apnea. J Am Coll Cardiol 52(5):343–346

    Article  PubMed  Google Scholar 

  10. Marin JM, Carrizo SJ, Vicente E, Agusti AG (2005) Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet 365(9464):1046–1053

    PubMed  Google Scholar 

  11. Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V (2005) Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med 353(19):2034–2041

    Article  PubMed  CAS  Google Scholar 

  12. Bassetti CL, Milanova M, Gugger M (2006) Sleep-disordered breathing and acute ischemic stroke: diagnosis, risk factors, treatment, evolution, and long-term clinical outcome. Stroke 37(4):967–972

    Article  PubMed  Google Scholar 

  13. Gibson GJ (2004) Sleep disordered breathing and the outcome of stroke. Thorax 59(5):361–363

    Article  PubMed  CAS  Google Scholar 

  14. Teran-Santos J, Jimenez-Gomez A, Cordero-Guevara J (1999) The association between sleep apnea and the risk of traffic accidents. Cooperative Group Burgos-Santander. N Engl J Med 340(11):847–851

    Article  PubMed  CAS  Google Scholar 

  15. Ellen RL, Marshall SC, Palayew M, Molnar FJ, Wilson KG, Man-Son-Hing M (2006) Systematic review of motor vehicle crash risk in persons with sleep apnea. J Clin Sleep Med 2(2):193–200

    PubMed  Google Scholar 

  16. Gami AS, Howard DE, Olson EJ, Somers VK (2005) Day-night pattern of sudden death in obstructive sleep apnea. N Engl J Med 352(12):1206–1214

    Article  PubMed  CAS  Google Scholar 

  17. Young T, Finn L, Peppard PE, Szklo-Coxe M, Austin D, Nieto FJ, Stubbs R, Hla KM (2008) Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep 31(8):1071–1078

    PubMed  Google Scholar 

  18. Marshall NS, Wong KK, Liu PY, Cullen SR, Knuiman MW, Grunstein RR (2008) Sleep apnea as an independent risk factor for all-cause mortality: the Busselton Health Study. Sleep 31(8):1079–1085

    PubMed  Google Scholar 

  19. Rey de Castro J (2007) Síndrome de Apneas Hipopneas del Sueño ¿Asesino Silencioso? Rev Med Hered 18(4):222–227

    Google Scholar 

  20. Testa MA, Simonson DC (1996) Assesment of quality-of-life outcomes. N Engl J Med 334(13):835–840

    Article  PubMed  CAS  Google Scholar 

  21. Vermeire P (1997) Quality of life in the Mailing Luna. Proceedings of the Symposium held on November 10-12 EbPWJTEOCNMS. Eur Respir Rev 7:43–107

    Google Scholar 

  22. Moyer CA, Sonnad SS, Garetz SL, Helman JI, Chervin RD (2001) Quality of life in obstructive sleep apnea: a systematic review of the literature. Sleep Med 2(6):477–491

    Article  PubMed  CAS  Google Scholar 

  23. Mezzich JE, Ruiperez MA, Perez C, Yoon G, Liu J, Mahmud S (2000) The Spanish version of the quality of life index: presentation and validation. J Nerv Ment Dis 188(5):301–305

    Article  PubMed  CAS  Google Scholar 

  24. Zubaran C, Foresti K, Schumacher MV, Muller LC, Amoretti AL (2009) An assessment of maternal quality of life in the postpartum period in southern Brazil: a comparison of two questionnaires. Clinics (Sao Paulo) 64(8):751–756

    Google Scholar 

  25. Schwartz KI, Zapata-Vega MI, Mezzich JE, Mazzotti G (2006) Validation study of the Multicultural Quality of Life Index (MQLI) in a Peruvian sample. Rev Bras Psiquiatr 28(1):24–28

    Article  PubMed  Google Scholar 

  26. Jatuff D, Zapata-Vega MI, Montenegro R, Mezzich JE (2007) The multicultural quality of life index in Argentina: a validation study. Actas Esp Psiquiatr 35(4):253–258

    PubMed  CAS  Google Scholar 

  27. Alvarez I, Bados A, Pero M (2010) Factorial structure and validity of the Multicultural Quality of Life Index. Qual Life Res (in press)

  28. Zubaran C, Persch K, Tarso D, Ioppi A, Mezzich J (2004) Initial Study for the development of the Portuguese version of the Multicultural Quality of Life Index. Arq Bras Psiquiatr Neurol Med Legal 98(3):12–17

    Google Scholar 

  29. Liu JS, Mezzich JE, Zapata-Vega MI, Ruiperez MA, Yoon G (2008) Development and validation of the Chinese version of the Multicultural Quality of Life Index (MQLI-Ch). Cult Med Psychiatry 32(1):123–134

    Article  PubMed  CAS  Google Scholar 

  30. Yoon G, Mezzich JE, Shin SK, Ruiperez MA, Zapata-Vega MI, Liu J (2008) The Korean version of the Multicultural Quality of Life Index (MQLI-Kr): development and validation. J Immigr Minor Health 10(1):73–80

    Article  PubMed  Google Scholar 

  31. Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14(6):540–545

    PubMed  CAS  Google Scholar 

  32. Ferber R, Millman R, Coppola M, Fleetham J, Murray CF, Iber C, McCall V, Nino-Murcia G, Pressman M, Sanders M et al (1994) Portable recording in the assessment of obstructive sleep apnea. ASDA standards of practice. Sleep 17(4):378–392

    PubMed  CAS  Google Scholar 

  33. Rechtschaffen A, Kales A (1968) A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects. Washington DC: Government Printing Office. National Institutes of Health (U.S.): Publication no. 204

  34. Núñez R, Rey de Castro J, Socarrás E, Calleja J, Rubio R, Durán-Cantolla J (2003) Estudio de la validez de un equipo de poligrafía respiratoria (BREAS SC-20) para el diagnóstico del síndrome de apneas-hipopneas durante el sueño. Arch Bronconeumol 39(12):537–543

    Article  PubMed  Google Scholar 

  35. Bonnet M, Carley D, Carskadom M, Easton P, Guilleminault C, Harper R, Hayes B, Hirshkowitz M, Ktonas P, Keenan S, Pressman M, Roehrs T, Smith J, Walsh J, Weber S, Westbrook P (1992) ASDA Report. EEG Arousals: Scoring rules and examples. Sleep 15(2):173–184

    Google Scholar 

  36. Nunez R, Rey de Castro J, Socarras E, Calleja JM, Rubio R, Aizpuru F, Duran-Cantolla J (2003) Validation study of a polygraphic screening device (BREAS SC20) in the diagnosis of sleep apnea-hypopnea syndrome. Arch Bronconeumol 39(12):537–543

    Article  PubMed  CAS  Google Scholar 

  37. Chiner E, Arriero JM, Signes-Costa J, Marco J, Fuentes I (1999) Validation of the Spanish version of the Epworth Sleepiness Scale in patients with a sleep apnea syndrome. Arch Bronconeumol 35(9):422–427

    PubMed  CAS  Google Scholar 

  38. Rosales E (2009) Study of validity and reliability of the Epworth Sleepiness Scale in Peruvian population and modification of the scale for people without motor vehicles leads. Master’s Thesis. Universidad Peruana Cayetano Heredia, Lima

    Google Scholar 

  39. Johns M, Hocking B (1997) Daytime sleepiness and sleep habits of Australian workers. Sleep 20(10):844–849

    PubMed  CAS  Google Scholar 

  40. Weaver TE (2001) Outcome measurement in sleep medicine practice and research. Part 1: assessment of symptoms, subjective and objective daytime sleepiness, health-related quality of life and functional status. Sleep Med Rev 5(2):103–128

    Article  PubMed  Google Scholar 

  41. Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30(6):473–483

    Article  PubMed  Google Scholar 

  42. Flemons WW, Reimer MA (1998) Development of a disease-specific health-related quality of life questionnaire for sleep apnea. Am J Respir Crit Care Med 158(2):494–503

    PubMed  CAS  Google Scholar 

  43. Weaver TE, Laizner AM, Evans LK, Maislin G, Chugh DK, Lyon K, Smith PL, Schwartz AR, Redline S, Pack AI, Dinges DF (1997) An instrument to measure functional status outcomes for disorders of excessive sleepiness. Sleep 20(10):835–843

    PubMed  CAS  Google Scholar 

  44. Siccoli MM, Pepperell JC, Kohler M, Craig SE, Davies RJ, Stradling JR (2008) Effects of continuous positive airway pressure on quality of life in patients with moderate to severe obstructive sleep apnea: data from a randomized controlled trial. Sleep 31(11):1551–1558

    PubMed  Google Scholar 

  45. Ferrer M, Vilagut G, Monasterio C, Montserrat JM, Mayos M, Alonso J (1999) Measurement of the perceived impact of sleep problems: the Spanish version of the functional outcomes sleep questionnaire and the Epworth sleepiness scale. Med Clin (Barc) 113(7):250–255

    CAS  Google Scholar 

  46. Verstraeten E (2007) Neurocognitive effects of obstructive sleep apnea syndrome. Curr Neurol Neurosci Rep 7(2):161–166

    Article  PubMed  Google Scholar 

  47. Sateia MJ (2003) Neuropsychological impairment and quality of life in obstructive sleep apnea. Clin Chest Med 24(2):249–259

    Article  PubMed  Google Scholar 

  48. Engleman HM, Douglas NJ (2004) Sleep. 4: Sleepiness, cognitive function, and quality of life in obstructive sleep apnoea/hypopnoea syndrome. Thorax 59(7):618–622

    Article  PubMed  CAS  Google Scholar 

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Acknowledgment

This was not an industry supported study.

Conflict of interest

The authors indicate no financial conflicts of interest.

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Authors and Affiliations

  1. Centro de Trastornos Respiratorios del Sueño (CENTRES), Clínica Anglo Americana, Av. Alfredo Salazar 314, San Isidro, Lima, 27, Peru

    Jorge Rey de Castro, Edmundo Rosales-Mayor & Jenny Ferreyra-Pereyra

  2. Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru

    Jorge Rey de Castro & Edmundo Rosales-Mayor

  3. Grupo de Investigación en Sueño (GIS), Lima, Peru

    Jorge Rey de Castro & Edmundo Rosales-Mayor

  4. Hospital Clínic de Barcelona, Barcelona, Spain

    Edmundo Rosales-Mayor

Authors
  1. Jorge Rey de Castro
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  2. Edmundo Rosales-Mayor
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  3. Jenny Ferreyra-Pereyra
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Correspondence to Jorge Rey de Castro.

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Rey de Castro, J., Rosales-Mayor, E. & Ferreyra-Pereyra, J. Using a generic measure of quality of life in patients with obstructive sleep apnea. Sleep Breath 15, 729–735 (2011). https://doi.org/10.1007/s11325-010-0429-1

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  • DOI: https://doi.org/10.1007/s11325-010-0429-1

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