Abstract
Objectives: Snoring patients present to otolaryngologists with many physical and social complaints. The widely used Epworth Sleepiness Scale (ESS) is useful in the assessment of diurnal somnolence but does not address many other symptoms associated with snoring. Our aims were to develop a comprehensive, reliable, patient-derived symptom questionnaire for snoring, to determine its factor structure, and to determine its relationship to the ESS.
Methods: The Snoring Symptoms Inventory (SSI) was developed by asking 120 habitual snorers to list all the problems they experienced due to snoring, in order of importance. The derived 25 items were each given a 5-point severity scale and used to compose the SSI. This study reports on a subsequent group of 261 patients (200 M and 61F; aged 25–69 years [mean, 43.6 years]) attending a snoring clinic between April 1998 and August 2002 who completed both the SSI and the ESS.
Results: On a principal components analysis, 3 SSI factors (groups of questions) were identified: (1) direct effects of snoring (eg, disturbed sleep, feeling tired); (2) psychological aspects (eg, embarrassment when staying with friends); and (3) interpersonal problems (eg, family complaints about snoring). The first two factors had a significant correlation with the ESS (r = 0.42, P < 0.01 and r = 0.20, P < 0.01, respectively). The Cronbach's alpha for the 25 questions was .81, demonstrating good reliability.
Conclusions: The SSI is a comprehensive measure for assessing severity and outcomes. The factor that correlated best with the ESS was the direct effect of snoring. The psychological aspect of snoring was also well correlated with the ESS, and this may imply that snorers with greatest affective disturbance are also those who are diurnally somnolent.