Changes in quality of life before and after treatment by age in patients with obstructive sleep apnea
The severity of obstructive sleep apnea （OSA） is not necessarily linked to worsening quality of life （QOL）, and improvement in OSA with treatment does not necessarily mean improvement in QOL. In addition, QOL may differ by age group. The subjects of this study were 34 patients （29 males and 5 female...
Saved in:
| Published in | Stomato-pharyngology Vol. 36; no. 2; pp. 153 - 165 |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Japan Society of Stomato-pharyngology
2023
日本口腔・咽頭科学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0917-5105 1884-4316 |
| DOI | 10.14821/stomatopharyngology.36.153 |
Cover
| Abstract | The severity of obstructive sleep apnea （OSA） is not necessarily linked to worsening quality of life （QOL）, and improvement in OSA with treatment does not necessarily mean improvement in QOL. In addition, QOL may differ by age group. The subjects of this study were 34 patients （29 males and 5 females） who underwent bilateral tonsillectomy and soft palate plasty for OSA, and 71 patients （59 males and 12 females） who were treated with nasal continuous positive airway pressure ventilators （nCPAP）. Three months after treatment, changes in quality of life in each treatment group by age group were investigated using the Medical Outcome Study 36-Item Short Form Health Survey （SF-36） version 2 questionnaire. As a result, among patients in their 30s and 40s, the improvement in physical QOL was remarkable in the group treated with surgery, but among those in their 50s, the QOL was better in the CPAP treatment group both physically and mentally. The results indicated that CPAP is not always suitable as a treatment method from the viewpoint of QOL improvement. It is necessary to select a treatment method that takes into account the age group and QOL, and it is also important to evaluate not only whether OSA improves, but also whether QOL improves. |
|---|---|
| AbstractList | The severity of obstructive sleep apnea （OSA） is not necessarily linked to worsening quality of life （QOL）, and improvement in OSA with treatment does not necessarily mean improvement in QOL. In addition, QOL may differ by age group. The subjects of this study were 34 patients （29 males and 5 females） who underwent bilateral tonsillectomy and soft palate plasty for OSA, and 71 patients （59 males and 12 females） who were treated with nasal continuous positive airway pressure ventilators （nCPAP）. Three months after treatment, changes in quality of life in each treatment group by age group were investigated using the Medical Outcome Study 36-Item Short Form Health Survey （SF-36） version 2 questionnaire. As a result, among patients in their 30s and 40s, the improvement in physical QOL was remarkable in the group treated with surgery, but among those in their 50s, the QOL was better in the CPAP treatment group both physically and mentally. The results indicated that CPAP is not always suitable as a treatment method from the viewpoint of QOL improvement. It is necessary to select a treatment method that takes into account the age group and QOL, and it is also important to evaluate not only whether OSA improves, but also whether QOL improves.
閉塞性睡眠時無呼吸（OSA）の重症度とQuality of Life（QOL）の悪化は必ずしも連動しておらず，治療によってOSAが改善してもQOLが改善するとは限らない．本研究では，OSAに対して咽頭への手術あるいは経鼻持続陽圧呼吸（nasal Continuous Positive Airway Pressure：nCPAP）装置による治療を行った症例について，3ヵ月後にそれぞれの治療群におけるQOLの変化を年齢層別にSF-36 version2問診票を用いて調べた．その結果，年齢層によってQOL向上が期待できる治療法が異なっていた．QOL改善という視点でみれば，治療法としてCPAPが常に望ましいとは限らず，QOLを考慮した治療法の選択が必要であると考えた． The severity of obstructive sleep apnea （OSA） is not necessarily linked to worsening quality of life （QOL）, and improvement in OSA with treatment does not necessarily mean improvement in QOL. In addition, QOL may differ by age group. The subjects of this study were 34 patients （29 males and 5 females） who underwent bilateral tonsillectomy and soft palate plasty for OSA, and 71 patients （59 males and 12 females） who were treated with nasal continuous positive airway pressure ventilators （nCPAP）. Three months after treatment, changes in quality of life in each treatment group by age group were investigated using the Medical Outcome Study 36-Item Short Form Health Survey （SF-36） version 2 questionnaire. As a result, among patients in their 30s and 40s, the improvement in physical QOL was remarkable in the group treated with surgery, but among those in their 50s, the QOL was better in the CPAP treatment group both physically and mentally. The results indicated that CPAP is not always suitable as a treatment method from the viewpoint of QOL improvement. It is necessary to select a treatment method that takes into account the age group and QOL, and it is also important to evaluate not only whether OSA improves, but also whether QOL improves. |
| Author | Hasukawa, Akihito Shibano, Akira Kitahara, Tadashi |
| Author_FL | 蓮川 昭仁 北原 糺 芝埜 彰 |
| Author_FL_xml | – sequence: 1 fullname: 芝埜 彰 – sequence: 2 fullname: 蓮川 昭仁 – sequence: 3 fullname: 北原 糺 |
| Author_xml | – sequence: 1 fullname: Shibano, Akira organization: Department of Otolaryngology-Head and Neck Surgery, Osaka Kaisei Hospital – sequence: 1 fullname: Hasukawa, Akihito organization: Department of Otolaryngology-Head and Neck Surgery, Osaka Kaisei Hospital – sequence: 1 fullname: Kitahara, Tadashi organization: Department of Otolaryngology-Head and Neck Surgery, Nara Medical University |
| BackLink | https://cir.nii.ac.jp/crid/1390015133365900672$$DView record in CiNii |
| BookMark | eNptkMtOwzAQRS1UJErpP1iCbYrHjyReooqXVMSm-8hOJq2r1AmxC8rf4wrEis2d0ejMaO69JjPfeyTkFtgKZMnhPsT-aGI_7M04-V3f9btpJfIVKHFB5lCWMpMC8hmZMw1FpoCpK7IMwVnGOGOSazYnuN4bv8NAnacfJ9O5ONG-pZ1rkVps-xGp8Q01bcSRxhFNPKKP1E7U7PC8NJjo0iTQLxf3tLchjqc6uk-koUMcqBk8mhty2Zou4PK3Lsj26XG7fsk278-v64dNdtCaZ0YAcNBG1kVRcK4anv7WVkipuJQtcCMKK3TelMlBqwoobF5jkyu0oEtoxILc_Zz1zlW1OysIzRgoEELkKrV5wRP29oMdQkwuqmF0xxRhZcbo6g6rf3KtRF7xs6Rw_7g6ARV68Q3M2nuW |
| ContentType | Journal Article |
| Copyright | 2023 Japan Society of Stomato-pharyngology |
| Copyright_xml | – notice: 2023 Japan Society of Stomato-pharyngology |
| DBID | RYH |
| DOI | 10.14821/stomatopharyngology.36.153 |
| DatabaseName | CiNii Complete |
| DatabaseTitleList | |
| DeliveryMethod | fulltext_linktorsrc |
| DocumentTitleAlternate | 閉塞性睡眠時無呼吸症例における年齢別にみた治療前後のQOLの変化 |
| DocumentTitle_FL | 閉塞性睡眠時無呼吸症例における年齢別にみた治療前後のQOLの変化 |
| EISSN | 1884-4316 |
| EndPage | 165 |
| ExternalDocumentID | article_stomatopharyngology_36_2_36_153_article_char_en |
| GroupedDBID | ABJNI ALMA_UNASSIGNED_HOLDINGS JSF KQ8 MOJWN RJT RYH |
| ID | FETCH-LOGICAL-j992-a311219a4c777225d29179b3445244f12a37b396d8b00f5717b6ced65eb1981d3 |
| ISSN | 0917-5105 |
| IngestDate | Thu Jun 26 22:15:07 EDT 2025 Wed Sep 03 06:30:37 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | false |
| IsScholarly | false |
| Issue | 2 |
| Language | Japanese |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j992-a311219a4c777225d29179b3445244f12a37b396d8b00f5717b6ced65eb1981d3 |
| OpenAccessLink | https://www.jstage.jst.go.jp/article/stomatopharyngology/36/2/36_153/_article/-char/en |
| PageCount | 13 |
| ParticipantIDs | nii_cinii_1390015133365900672 jstage_primary_article_stomatopharyngology_36_2_36_153_article_char_en |
| PublicationCentury | 2000 |
| PublicationDate | 2023 |
| PublicationDateYYYYMMDD | 2023-01-01 |
| PublicationDate_xml | – year: 2023 text: 2023 |
| PublicationDecade | 2020 |
| PublicationTitle | Stomato-pharyngology |
| PublicationTitleAlternate | Stomato-pharyngol |
| PublicationTitle_FL | 口咽科 Stomato-pharyngology 口腔・咽頭科 Stomato-pharyngol |
| PublicationYear | 2023 |
| Publisher | Japan Society of Stomato-pharyngology 日本口腔・咽頭科学会 |
| Publisher_xml | – name: Japan Society of Stomato-pharyngology – name: 日本口腔・咽頭科学会 |
| References | 29） Lin SW, Chen NH, Li HY, et al: A comparison of the long-term outcome and effects of surgery or continuous positive airway pressure on patients with obstructive sleep apnea syndrome. Laryngoscope 2006；116：1012-1016. 20） 芝埜 彰，北野博也，榎本雅夫，他：睡眠時無呼吸症候群における重症度とQOLとの関連．済生会吹田病院医学雑誌 2010；16：40-46. 17） Levine CG, Weaver EM：Functional comorbidity index in sleep apnea. Otolaryngol Head Neck Surg 2014；150：494-500. 8） Siccoli MM, Pepperell JC, Kohler M, et al: Effects of continuous positive airway pressure on quality of life in patients with moderate to severe obstructive sleep apnea：data from a randomized controlled trial. Sleep 2008；31：1551-1558. 9） Batool-Anwar S, Goodwin JL, Kushida CA, et al: Impact of continuous positive airway pressure （CPAP） on quality of life in patients with obstructive sleep apnea （OSA）. J Sleep Res 2016；25：731-738. 25） Karkoulias K, Lykouras D, Sampsonas F, et al: The impact of obstructive sleep apnea syndrome severity on physical performance and mental health. The use of SF-36 questionnaire in sleep apnea. Eur Rev Med Pharmacol Sci 2013；17：531-536. 15） Gliklich RE, Taghizadeh F, Winkelman JW, et al: Health status in patients with disturbed sleep and obstructive sleep apnea. Otolaryngol Head Neck Surg 2000；122：542-546. 22） Pichel F, Zamarrón C, Magán F, et al: Health-related quality of life in patients with obstructive sleep apnea: effects of long-term positive airway pressure treatment. Respir Med 2004；98：968-976. 18） Butner KL, Hargens TA, Kaleth AS, et al: Association of Obstructive Sleep Apnea Severity with Exercise Capacity and Health-related Quality of Life. N Am J Med Sci 2013；5：362-366. 26） Lopes C, Esteves AM, Bittencourt LR, et al: Relationship between the quality of life and the severity of obstructive sleep apnea syndrome. Braz J Med Biol Res 2008；41：908-913. 31） Martínez-García MA, Soler-Cataluña JJ, Román-Sánchez P, et al: Obstructive sleep apnea has little impact on quality of life in the elderly. Sleep Med 2009；10：104-111. 11） Silva GE, Goodwin JL, Vana KD, et al: Obstructive Sleep Apnea and Quality of Life: Comparison of the SAQLI, FOSQ, and SF-36 Questionnaires. Southwest J Pulm Crit Care 2016；13：137-149. 12） Kobayashi M, Kobayashi M, Suwa H, et al: The validity and usefulness of the Japanese version of the Calgary sleep apnea quality of life index in patients with obstructive sleep apnea hypopnea syndrome. Intern Med 2013；52：309-315. 28） Meurice JC, Cornette A, Philip-Joet F, et al: Evaluation of autoCPAP devices in home treatment of sleep apnea/hypopnea syndrome. Sleep Med 2007；8：695-703. 21） Lee W, Lee SA, Ryu HU, et al: Quality of life in patients with obstructive sleep apnea: Relationship with daytime sleepiness, sleep quality, depression, and apnea severity. Chron Respir Dis 2016；13：33-39. 30） Robinson S, Chia M, Carney AS, et al: Upper airway reconstructive surgery long-term quality-of-life outcomes compared with CPAP for adult obstructive sleep apnea. Otolaryngol Head Neck Surg 2009；141：257-263. 5） Keenan SP, Burt H, Ryan CF, et al: Long-term survival of patients with obstructive sleep apnea treated by uvulopalatopharyngoplasty or nasal CPAP. Chest 1994；105：155-159. 19） 鈴鴨よしみ，福原俊一：SF-36日本語版の特徴と活用．日本腰痛学会雑誌 2002；8：38-43. 2） 福原俊一，鈴鴨よしみ：SF-36 v2日本語版マニュアル：健康関連QOL尺度．福原俊一，鈴鴨よしみ，SF-36v2 日本語版マニュアル．京都，iHope International株式会社；2019. 24） Galetke W, Puzzo L, Priegnitz C, et al: Long-term therapy with continuous positive airway pressure in obstructive sleep apnea: adherence, side effects and predictors of withdrawal - a ‘real-life’ study. Respiration 2011；82：155-161. 27） Baldwin CM, Griffith KA, Nieto FJ, et al: The association of sleep-disordered breathing and sleep symptoms with quality of life in the Sleep Heart Health Study. Sleep 2001；24：96-105. 16） Stevens D, Loffler KA, Buman MP, et al: CPAP increases physical activity in obstructive sleep apnea with cardiovascular disease. J Clin Sleep Med 2021；17：141-148. 10） Kondratavičienė L, Malakauskas K, Vaitukaitienė G, et al: Short-Term Continuous Positive Air Pressure Treatment: Effects on Quality of Life and Sleep in Patients with Obstructive Sleep Apnea. Medicina （Kaunas） 2022；58：350. 14） Sanner BM, Klewer J, Trumm A, et al: Long-term treatment with continuous positive airway pressure improves quality of life in obstructive sleep apnoea syndrome. Eur Respir J 2000；16：118-122. 23） Jing J, Huang T, Cui W, et al: Effect on quality of life of continuous positive airway pressure in patients with obstructive sleep apnea syndrome: a meta-analysis. Lung 2008；186：131-144. 6） Goncalves MA, Paiva T, Ramos E, et al: Obstructive sleep apnea syndrome, sleepiness, and quality of life. Chest 2004；125：2091-2096. 1） Nakata S, Noda A, Yanagi E, et al: Tonsil size and body mass index are important factors for efficacy of simple tonsillectomy in obstructive sleep apnoea syndrome. Clin Otolaryngol 2006；31：41-45. 4） Wellman A, Edwards BA, Sands SA, et al: A simplified method for determining phenotypic traits in patients with OSA. J Appl Physiol 2013；114：911-922. 13） Serrano Merino J, Pérula de Torres LÁ, Bardwell WA, et al: Impact of Positive Pressure Treatment of the Airway on Health-Related Quality of Life in Elderly Patients With Obstructive Sleep Apnea. Biol Res Nurs 2018；20：452-461. 7） Li HY, Chen NH, Shu YH, et al: Changes in quality of life and respiratory disturbance after extended uvulopalatal flap surgery in patients with obstructive sleep apnea. Arch Otolaryngol Head Neck Surg 2004；130：195-200. 3） Kawahara S, Akashiba T, Akahoshi T, et al: Nasal CPAP improves the quality of life and lessens the depressive symptoms in patients with obstructive sleep apnea syndrome. Intern Med 2005；44：422-427. |
| References_xml | – reference: 26） Lopes C, Esteves AM, Bittencourt LR, et al: Relationship between the quality of life and the severity of obstructive sleep apnea syndrome. Braz J Med Biol Res 2008；41：908-913. – reference: 5） Keenan SP, Burt H, Ryan CF, et al: Long-term survival of patients with obstructive sleep apnea treated by uvulopalatopharyngoplasty or nasal CPAP. Chest 1994；105：155-159. – reference: 8） Siccoli MM, Pepperell JC, Kohler M, et al: Effects of continuous positive airway pressure on quality of life in patients with moderate to severe obstructive sleep apnea：data from a randomized controlled trial. Sleep 2008；31：1551-1558. – reference: 19） 鈴鴨よしみ，福原俊一：SF-36日本語版の特徴と活用．日本腰痛学会雑誌 2002；8：38-43. – reference: 9） Batool-Anwar S, Goodwin JL, Kushida CA, et al: Impact of continuous positive airway pressure （CPAP） on quality of life in patients with obstructive sleep apnea （OSA）. J Sleep Res 2016；25：731-738. – reference: 31） Martínez-García MA, Soler-Cataluña JJ, Román-Sánchez P, et al: Obstructive sleep apnea has little impact on quality of life in the elderly. Sleep Med 2009；10：104-111. – reference: 28） Meurice JC, Cornette A, Philip-Joet F, et al: Evaluation of autoCPAP devices in home treatment of sleep apnea/hypopnea syndrome. Sleep Med 2007；8：695-703. – reference: 20） 芝埜 彰，北野博也，榎本雅夫，他：睡眠時無呼吸症候群における重症度とQOLとの関連．済生会吹田病院医学雑誌 2010；16：40-46. – reference: 29） Lin SW, Chen NH, Li HY, et al: A comparison of the long-term outcome and effects of surgery or continuous positive airway pressure on patients with obstructive sleep apnea syndrome. Laryngoscope 2006；116：1012-1016. – reference: 10） Kondratavičienė L, Malakauskas K, Vaitukaitienė G, et al: Short-Term Continuous Positive Air Pressure Treatment: Effects on Quality of Life and Sleep in Patients with Obstructive Sleep Apnea. Medicina （Kaunas） 2022；58：350. – reference: 27） Baldwin CM, Griffith KA, Nieto FJ, et al: The association of sleep-disordered breathing and sleep symptoms with quality of life in the Sleep Heart Health Study. Sleep 2001；24：96-105. – reference: 21） Lee W, Lee SA, Ryu HU, et al: Quality of life in patients with obstructive sleep apnea: Relationship with daytime sleepiness, sleep quality, depression, and apnea severity. Chron Respir Dis 2016；13：33-39. – reference: 6） Goncalves MA, Paiva T, Ramos E, et al: Obstructive sleep apnea syndrome, sleepiness, and quality of life. Chest 2004；125：2091-2096. – reference: 2） 福原俊一，鈴鴨よしみ：SF-36 v2日本語版マニュアル：健康関連QOL尺度．福原俊一，鈴鴨よしみ，SF-36v2 日本語版マニュアル．京都，iHope International株式会社；2019. – reference: 4） Wellman A, Edwards BA, Sands SA, et al: A simplified method for determining phenotypic traits in patients with OSA. J Appl Physiol 2013；114：911-922. – reference: 23） Jing J, Huang T, Cui W, et al: Effect on quality of life of continuous positive airway pressure in patients with obstructive sleep apnea syndrome: a meta-analysis. Lung 2008；186：131-144. – reference: 15） Gliklich RE, Taghizadeh F, Winkelman JW, et al: Health status in patients with disturbed sleep and obstructive sleep apnea. Otolaryngol Head Neck Surg 2000；122：542-546. – reference: 18） Butner KL, Hargens TA, Kaleth AS, et al: Association of Obstructive Sleep Apnea Severity with Exercise Capacity and Health-related Quality of Life. N Am J Med Sci 2013；5：362-366. – reference: 13） Serrano Merino J, Pérula de Torres LÁ, Bardwell WA, et al: Impact of Positive Pressure Treatment of the Airway on Health-Related Quality of Life in Elderly Patients With Obstructive Sleep Apnea. Biol Res Nurs 2018；20：452-461. – reference: 16） Stevens D, Loffler KA, Buman MP, et al: CPAP increases physical activity in obstructive sleep apnea with cardiovascular disease. J Clin Sleep Med 2021；17：141-148. – reference: 25） Karkoulias K, Lykouras D, Sampsonas F, et al: The impact of obstructive sleep apnea syndrome severity on physical performance and mental health. The use of SF-36 questionnaire in sleep apnea. Eur Rev Med Pharmacol Sci 2013；17：531-536. – reference: 14） Sanner BM, Klewer J, Trumm A, et al: Long-term treatment with continuous positive airway pressure improves quality of life in obstructive sleep apnoea syndrome. Eur Respir J 2000；16：118-122. – reference: 11） Silva GE, Goodwin JL, Vana KD, et al: Obstructive Sleep Apnea and Quality of Life: Comparison of the SAQLI, FOSQ, and SF-36 Questionnaires. Southwest J Pulm Crit Care 2016；13：137-149. – reference: 7） Li HY, Chen NH, Shu YH, et al: Changes in quality of life and respiratory disturbance after extended uvulopalatal flap surgery in patients with obstructive sleep apnea. Arch Otolaryngol Head Neck Surg 2004；130：195-200. – reference: 12） Kobayashi M, Kobayashi M, Suwa H, et al: The validity and usefulness of the Japanese version of the Calgary sleep apnea quality of life index in patients with obstructive sleep apnea hypopnea syndrome. Intern Med 2013；52：309-315. – reference: 22） Pichel F, Zamarrón C, Magán F, et al: Health-related quality of life in patients with obstructive sleep apnea: effects of long-term positive airway pressure treatment. Respir Med 2004；98：968-976. – reference: 3） Kawahara S, Akashiba T, Akahoshi T, et al: Nasal CPAP improves the quality of life and lessens the depressive symptoms in patients with obstructive sleep apnea syndrome. Intern Med 2005；44：422-427. – reference: 1） Nakata S, Noda A, Yanagi E, et al: Tonsil size and body mass index are important factors for efficacy of simple tonsillectomy in obstructive sleep apnoea syndrome. Clin Otolaryngol 2006；31：41-45. – reference: 30） Robinson S, Chia M, Carney AS, et al: Upper airway reconstructive surgery long-term quality-of-life outcomes compared with CPAP for adult obstructive sleep apnea. Otolaryngol Head Neck Surg 2009；141：257-263. – reference: 24） Galetke W, Puzzo L, Priegnitz C, et al: Long-term therapy with continuous positive airway pressure in obstructive sleep apnea: adherence, side effects and predictors of withdrawal - a ‘real-life’ study. Respiration 2011；82：155-161. – reference: 17） Levine CG, Weaver EM：Functional comorbidity index in sleep apnea. Otolaryngol Head Neck Surg 2014；150：494-500. |
| SSID | ssib002004290 ssib029852135 ssj0000389738 |
| Score | 1.9012374 |
| Snippet | The severity of obstructive sleep apnea （OSA） is not necessarily linked to worsening quality of life （QOL）, and improvement in OSA with treatment does not... |
| SourceID | nii jstage |
| SourceType | Publisher |
| StartPage | 153 |
| SubjectTerms | CPAP QOL SF-36 sleep apnea tonsillectomy 口蓋扁桃摘出術 睡眠時無呼吸 |
| Title | Changes in quality of life before and after treatment by age in patients with obstructive sleep apnea |
| URI | https://www.jstage.jst.go.jp/article/stomatopharyngology/36/2/36_153/_article/-char/en https://cir.nii.ac.jp/crid/1390015133365900672 |
| Volume | 36 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | Stomato-pharyngology, 2023, Vol.36(2), pp.153-165 |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV1bb9MwFLa6ISFeEAgQGwxZgrcqBV9iO48IMU0gkNCKtLfIThyabkqrtQONv8af4xzbTTOxSTDxYlVJnbg-X32-Y58LIa8Ud6ypmcya2heZFJ5ljjObNc7Y2hSVFqGcz6fP6uir_HCSn4xGvwZeSxdrN6l-XhtXchupwjWQK0bJ_oNk-4fCBfgM8oUWJAztX8k4hgYEj9YYHBmOy8_axo-dBzYajwZiGfCtRzkQTnTU2SZVTRFuC5eSyX7349WZ98uxXXbeDunr8XoBDHeRLWf2_LL7dmVL_njWOtvFqJnT9txu17bVxan9YdONGSwh24P_tcWE0QE0tsa6TsNdiBgiHHUD6PSudzHFQJubRpK2HUErIqmL-icuusbIDEPyh6tyTIuS0McHSyyLyYWTtmax0sQfikAajppgFQczHMtEqEn_jCuZtpMcy2s6lUKVHBvoWW6-h3FxAMMdcodrzdCf9OOXge0WdH2_GPLCAFNK3DTQBKCKOlRa7-fkLnm5Gfvrm0cOXGkOlgOmhNjp2nZAh6YPyP1kx9C3cZAPyWhuHxGfAEnbjiZA0kVDEZA0ApICIGkAJO0BSd0lhfdgpw0gKQKSDgBJAyBpAORjMj18P313lKU6HtkcfZutAE7PCisrDaYcz2sOv7dwQsocuGXDuBXaiULVBmatyTXTTlW-VjnQiALMKfGE7HaLzj8l1ObYwTkFhrisLXPeyDfONFY3olJG7pHDODXlMuZqKW8p0z1yAFNbVi22YCShacGEEAqL7CrN9__Xi56Re_h3ipt6z8kuTKs_AJq7di8CnH4D0RO2KQ |
| linkProvider | Colorado Alliance of Research Libraries |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Changes+in+quality+of+life+before+and+after+treatment+by+age+in+patients+with+obstructive+sleep+apnea&rft.jtitle=Stomato-pharyngology&rft.au=Shibano%2C+Akira&rft.au=Hasukawa%2C+Akihito&rft.au=Kitahara%2C+Tadashi&rft.date=2023&rft.pub=Japan+Society+of+Stomato-pharyngology&rft.issn=0917-5105&rft.eissn=1884-4316&rft.volume=36&rft.issue=2&rft.spage=153&rft.epage=165&rft_id=info:doi/10.14821%2Fstomatopharyngology.36.153&rft.externalDocID=article_stomatopharyngology_36_2_36_153_article_char_en |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0917-5105&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0917-5105&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0917-5105&client=summon |