• obstructive sleep apnoea
• quality of life
• questionnaire
• Quebec Sleep Questionnaire

Patients suspected of suffering from sleep apnoea present to primary care physicians with several typical symptoms including habitual snoring (often disruptive to bed partners), waking feeling unrefreshed, daytime sleepiness, or fatigue. The disorder is increasingly being recognised in patients who are hypertensive, obese, or who have unexplained respiratory failure. Randomised placebo controlled trials have proved that sleep apnoea has an adverse impact on mood, quality of life, functional status, and vigilance, and that treatment with continuous positive airway pressure (CPAP) results in statistically significant improvements. Although sleep apnoea is strongly suspected to be a risk factor for developing systemic hypertension, and some preliminary evidence suggests that it is associated with an increased risk for cardiovascular and cerebrovascular disease, there is no convincing evidence yet that CPAP reduces these risks.¹ In most patients treatment is therefore primarily aimed at improving their quality of life. Although symptoms and quality of life are often used interchangeably, the former is a subset of the latter and does not capture the complete impact of the disorder.

When patients are treated for sleep apnoea it is important to document whether the treatment is effective. All too often this evaluation is limited to determining whether the apnoea-hypopnoea index has been satisfactorily reduced. A Medline search of the English language literature for randomised controlled trials of adult sleep apnoea syndromes over the past 10 years produced 95 studies, 40% of which did not report any symptom or quality of life outcomes. It is well recognised that …