Validation of the snore outcomes survey for patients with sleep-disordered breathing

Objective: To develop and validate a self-reported outcomes measure for patients with sleep-disordered breathing-the Snore Outcomes Survey. Design: Item areas of the SOS were developed by an expert panel. Consecutive patients were enrolled into the study in a prospective manner. Patients received the SOS, the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index, the Medical Outcomes Study 36-Item Short-Form Health Survey, and standard overnight polysomnography at baseline and after 4 months of continuous positive airway pressure therapy. Setting: A tertiary care, academic otolaryngology and sleep disorders referral center. Patients: One hundred fifty-six adult patients presenting with a chief complaint of snoring or sleep-disordered breathing to the Massachusetts Eye and Ear Infirmary, Boston. Main Outcome Measures: Test-retest reliability, intrasurvey reliability, internal consistency, validity, and standardized response means of the SOS. Results: Overall, reliability of the SOS was excellent (test-retest reliability r=0.86; P<.001; Cronbach alpha coefficient, 0.85). The SOS index significantly correlated with the Epworth Sleepiness Scale (r=-0.42; P<.001) and the global Pittsburgh Sleep Quality Index score (r=-0.38; P<.001), as well as with the number of recorded arterial oxygen saturation levels below 85% (r=-0.46; P=.02). The SOS index was sensitive to clinical changes after intervention (standardized response mean, 0.57). Conclusion: The SOS is a reliable and valid instrument for assessing sleep-related health status for patients with snoring and sleep-disordered breathing and for measuring change in health status following therapy.