Researchers have developed and validated SNORE (Symptoms of Nocturnal Obstruction and Related Events)-25, a novel scoring algorithm, for use as a sleep apnea-specific quality-of-life instrument, according to study results published in  JAMA Otolaryngology–Head & Neck Surgery.

SNORE-25 is a self-reported, 25-item, OSA-specific quality-of-life instrument that contains 5 subscales: sleep problems, awake problems, medical problems, emotional and personal problems, and occupational problems. Utility scoring of SNORE-25 was then mapped from the Short-Form 6-Dimension (SF-6D) utility index.

The SNORE-25 was developed and validated in patients with newly diagnosed obstructive sleep apnea (OSA) from a randomized clinical trial and related observational cohort study (TURBO [Randomized Clinical Trial of Nasal Turbinate Reduction to Improve Continuous Positive Airway Pressure Outcomes for Sleep Apnea]; Identifier: NCT00503802). Patients were subdivided into either development or validation groups.

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Of the 500 patients, 300 were randomly assigned to the development group and 200 to the validation group (mean age, 48.6 years; 59% men). Reliability testing showed good internal consistency for the total instrument (Cronbach α=0.91). Subscale internal consistency was adequate for sleep problems (Cronbach α=0.67) and good for awake problems (Cronbach α=0.80), medical problems (Cronbach α=0.72), emotional problems (Cronbach α=0.88), and occupational problems (Cronbach α=0.80).

The study investigators wrote, “The SNORE utility instrument provides a validated disease specific, preference-weighted utility scoring algorithm that can be used in future studies of OSA treatments.” They added, “Further studies of change in SNORE utility with OSA treatment are needed to test the responsiveness of this measure and provide information for future comparative effectiveness and cost-effectiveness studies.”


Skirko JR, James KT, Garrison LP, Weaver EM. Development of a sleep apnea-specific health state utility algorithm [published online January 30, 2020]. JAMA Otolaryngol Head Neck Surg. doi:10.1001/jamaoto.2019.4469