Reliability and Validity of Thai Version Quality of Life
Questionnaire (OSA-18) for Pediatric
Obstructive Sleep Apnea
Teeradej Kuptanon MD*, Jaruwan Chukumnerd MD*,
Anchalee Leejakpai**, Aroonwan Preutthipan MD, FCCP*
Affiliation :
* Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
** Sleep Technician, Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Background : Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a chronic illness affecting either cardiopulmonary
or neuropsychiatric function. Besides the functional health, the quality of life of patients with obstructive sleep apnea (OSA)
is of interest in literature. In children, the quality of life questionnaire, which consists of 18 items (OSA-18), has been widely
accepted as a reliable, valid, and simple to administer. This questionnaire may also be useful in Thai children with OSA.
Objective : To assess the reliability and validity of the Thai version of OSA-18 in Thai children.
Material and Method: This was a cross-sectional study. The original English version of the 18-item pediatric obstructive
sleep apnea quality of life questionnaire was translated into Thai following the guidelines of cross-cultural adaptation with
permission from Rosenfeld RM, Department of Otolaryngology, SUNY Health Science Center at Brooklyn, USA. The
questionnaire was divided into five domains, sleep disturbance, physical suffering, emotional distress, daytime problems,
and caregiver concerns. The suspected obstructive sleep apnea children, aged less than 15 years, who did not have
cardiovascular diseases, lung diseases, or neuromuscular diseases, and who underwent standard full night polysomnography
were included. The child’s caregiver was asked to complete the questionnaire without assistance to determine its reliability
and validity.
Results : Forty-three children (30 boys, and 13 girls) were enrolled in the present study. The median age was five years
(range 2 to 14 years). The median apnea hypopnea index (AHI) was six events/hour and median OSA-18 total score was
66.7 (range 25 to 107). There were excellent test-retest reliability (Cronbach’s alpha = 0.91) and internal consistency
(Cronbach’s alpha = 0.77) between each domain. Correlation between the Thai OSA-18 total scores and AHI was r = 0.48,
p = 0.001, which was similar to the original English version (r = 0.43, p<0.001).
Conclusion : The level of reliability and validity of the Thai version of the OSA-18 has been found to be satisfactory. Therefore,
this instrument can be used in future research for measuring the quality of life in Thai children with OSA and assess the
benefit of treatment.
Keywords : Obstructive sleep apnea-hypopnea syndrome, Children, Questionnaire (OSA-18)
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