AnyQuest for Windows Questionnaire Definition File Version 2.36`$$ H$0TChhArialArial"Arial g"Arial Bg"Arial Bg"Arial P"Arial P"Arial hg"Arial PArialp (DoLo.,1Calgary Sleep Apnea Quality of Life QuestionnaireSAQLIEnglishqdw 0.3$8$py!uX*LThis questionnaire has been designed to find out how you have been doing and feeling over the last 4 weeks. You will be questioned about the impact that sleep apnea and / or snoring may have had on your daily activities, your emotional functioning, and your social interactions, and about any symptoms they might have caused.DPlease click at the "Continue"-button to display the first question!P$}< $s$s  !uX*? How much have you had to force yourself to do this activity? In regard to performing your most important, usual daily activity (e.g. work, school, childcare, housework, etc) over the past 4 weeks: 8A. Daily functioning I. Most important daily activity$M$,hd All the time1$"M$dA large amount of the time2 $(M$Pd&A moderate to large amount of the time3 $FM|$dA moderate amount of the time4$LM$td&A small to moderate amount of the time5$jM4$BdA small amount of the time6$pM<$d Not at all7$oXp$4N`zKI cannot answer this question7($o$4`K$I don't want to answer this question7$}8$s$s ?!uX*e How much of the time have you had to push yourself to remain alert while performing this activity? In regard to performing your most important, usual daily activity (e.g. work, school, childcare, housework, etc) over the past 4 weeks::A. Daily functioning I. Most important daily activity $M $,hd All the time1p$"MH $dA large amount of the time2$(M8 $Pd&A moderate to large amount of the time3|$FM $dA moderate amount of the time4X%LM%td&A small to moderate amount of the time5%jM%BdA small amount of the time6%pM%d Not at all78%oXp%4N`zKI cannot answer this question78%oX%4`K$I don't want to answer this question7p%}%s%s !uX*How often have you adjusted your schedule to avoid this activity because you felt that you would be unable to remain alert while doing it? In regard to performing your most important, usual daily activity (e.g. work, school, childcare, housework, etc) over the past 4 weeks::A. Daily functioning I. Most important daily activity %M%,hd All the time1L%"M(%dA large amount of the time2 %(M %Pd&A moderate to large amount of the time3 %FMd%dA moderate amount of the time4 %LMl%td&A small to moderate amount of the time5@ %jMt%BdA small amount of the time6 %pMt%d Not at all7%oXp%4N`zKI cannot answer this question7%o%4`K$I don't want to answer this question7D?}?s?s $!uX*L How often do you use all of your energy to accomplish only this activity? In regard to performing your most important, usual daily activity (e.g. work, school, childcare, housework, etc) over the past 4 weeks::A. Daily functioning I. Most important daily activity ?M?,hd All the time1?"M?dA large amount of the time2@?(M ?Pd&A moderate to large amount of the time3?FM?dA moderate amount of the time4P?LM<?td&A small to moderate amount of the time5?jMD?BdA small amount of the time6@?pML?d Not at all7?oXp?4N`zKI cannot answer this question7D?ol?4`K$I don't want to answer this question7?} ?s?s %-!uX*How much difficulty have you had finding the energy to exercise and / or do activities that you find relaxing (leisure activities) ?` In regard to activities other than your most important daily activitiy over the past 4 weeks:2A. Daily functioning II. Secondary activities , ?M@ ?,hdA very large amount1 ?"M ?dA large amount2| ?(M ?PdA moderate to large amount3d ?FM ?dA moderate amount4 ?LM$ ?tdA small to moderate amount5$ ?jM ?BdA small amount6@?pM,?dNone7?oXp?4N`zKI cannot answer this question7?oh?4`K$I don't want to answer this question7 ?}?sd?s .6!uX*[ How much difficulty have you had finding the time for activities that you find relaxing?` In regard to activities other than your most important daily activitiy over the past 4 weeks:2A. Daily functioning II. Secondary activities |?M?,hdA very large amount1 ?"M?dA large amount2?(M$?PdA moderate to large amount34?FM,?dA moderate amount4?LM?tdA small to moderate amount50?jM?BdA small amount6?pM\?dNone7?oXp?4N`zKI cannot answer this question7?o?4`K$I don't want to answer this question7T?}D?s?s 7?!uX*oHow much difficulty have you had with your ability to do exercise and / or activities that you find relaxing?` In regard to activities other than your most important daily activitiy over the past 4 weeks:2A. Daily functioning II. Secondary activities l?M?,hdA very large amount1?"M?dA large amount2?(M?PdA moderate to large amount3?FM?dA moderate amount4L?LM?tdA small to moderate amount5?jM,?BdA small amount6 ?0pM(?0dNone7?0oXp0?04N`zKI cannot answer this question7?0oD?04`K$I don't want to answer this question74?0}?0s?0s @H!uX*X How much difficulty have you had getting chores done around the place where you live?` In regard to activities other than your most important daily activitiy over the past 4 weeks:2A. Daily functioning II. Secondary activities ?0M?0,hdA very large amount1|?0"M?0dA large amount2?0(M(?0PdA moderate to large amount3d ?0FM?0dA moderate amount4 ?0LM?0tdA small to moderate amount5?0jM?0BdA small amount6?0pML?0dNone7p ?0oXp?04N`zKI cannot answer this question7 ?0o?04`K$I don't want to answer this question7x?0} ?0s?0s IQ!uX*C How much difficulty have you had with trying to remember things? Over the past 4 weeks:2A. Daily functioning III. General functioning ?0M ?0,hdA very large amount1?0"M?0dA large amount2?0(M?0PdA moderate to large amount3 ?0FM ?0dA moderate amount4?0LM0 ?0tdA small to moderate amount5(?0jM ?0BdA small amount6?0pMD ?0dNone7h?0oXp ?04N`zKI cannot answer this question7?0o ?04`K$I don't want to answer this question7)})sT)s RZ!uX*? How much difficulty have you had with trying to concentrate? Over the past 4 weeks:2A. Daily functioning III. General functioning $)M4),hdA very large amount1)"M)dA large amount2)(M)PdA moderate to large amount3)FM)dA moderate amount4)LM)tdA small to moderate amount5 )jM)BdA small amount6)pM)dNone7 )oXp)4N`zKI cannot answer this question7)o)4`K$I don't want to answer this question7 )}l)s)s [c!uX*I How much of a problem have you had with having to fight to stay awake? Over the past 4 weeks:2A. Daily functioning III. General functioning )M),hdA very large problem1)"M)dA large problem2)(M@ )PdA moderate to large problem3)FMd )dA moderate problem4)LM` )tdA small to moderate problem5)jM )BdA small problem6)pM )d No problem7)oXpd )4N`zKI cannot answer this question7|)o)4`K$I don't want to answer this question7&8&pd&s?!uX*FThe following questions pertain to how your relationship with your partner, other household members, relatives, and / or close friends have been over the previous 4 weeks. If you have not interacted with a partner etc. in the past 4 weeks, please try to work out how your relationship might have been with these people.CPlease click at the "Continue"-button to display the next question!B. Social interactions4G,}G,sG,s dl!uX*YHow upset have you been about being told that your snoring was bothersome or irritating? Over the past 4 weeks:B. Social interactionsG,M|G,,hdA very large amount1G,"MG,dA large amount2G,(MG,PdA moderate to large amount3G,FMDG,dA moderate amount4LG,LM,G,tdA small to moderate amount5G,jM4G,BdA small amount6G,pMlG,dNone7G,oXp|G,4N`zKI cannot answer this question7d G,oG,4`K$I don't want to answer this question7tG,} G,s G,s mu!uX*nHow upset have you been about having to (or possibly having to) sleep in separate bedrooms from your partner? Over the past 4 weeks:B. Social interactions G,MG,,hdA very large amount1 G,"MG,dA large amount2p G,(M G,PdA moderate to large amount38 G,FML G,dA moderate amount4dG,LM$G,tdA small to moderate amount5G,jMG,BdA small amount6G,pMG,dNone7G,oXp G,4N`zKI cannot answer this question7G,o(G,4`K$I don't want to answer this question7 G,}G,sG,s v~!uX*HHow upset have you been as a result of frequent conflicts or arguments? Over the past 4 weeks:B. Social interactionsXG,MG,,hdA very large amount1G,"MG,dA large amount2G,(MxG,PdA moderate to large amount3 G,FM(G,dA moderate amount4G,LM0G,tdA small to moderate amount5HG,jMG,BdA small amount6G,pMG,dNone7Hg+oXp4g+4N`zKI cannot answer this question7g+o<g+4`K$I don't want to answer this question78 g+}$g+sg+s !uX*@How aware have you been of not wanting to talk to other people? Over the past 4 weeks:B. Social interactionstg+MTg+,hdA very large amount1g+"Mhg+dA large amount2g+(Mg+PdA moderate to large amount3| g+FMhg+dA moderate amount4 g+LMg+tdA small to moderate amount5x g+jM@g+BdA small amount6g+pMg+dNone7Hg+oXpg+4N`zKI cannot answer this question7Dg+o g+4`K$I don't want to answer this question7`g+}4g+s g+s !uX*How much concern have you had about the need to make special sleeping arrangements if you were traveling and / or staying with someone? Over the past 4 weeks:B. Social interactionsPg+M g+,hdA very large amount1dg+"M g+dA large amount2g+(Mg+PdA moderate to large amount3g+FMg+dA moderate amount4g+LMg+tdA small to moderate amount5Dg+jM8g+BdA small amount6lg+pMtg+dNone7g+oXpxg+4N`zKI cannot answer this question7Lg+ohg+4`K$I don't want to answer this question7}s|s !uX*aHow guilty have you felt about your relationship with family members or close personal friends? Over the past 4 weeks:B. Social interactions8M,hdA very large amount1\"MdA large amount2(MPdA moderate to large amount3XFMdA moderate amount4 LMttdA small to moderate amount5jMBdA small amount6pMddNone7 oXp 4N`zKI cannot answer this question7 o 4`K$I don't want to answer this question7}Tsps !uX*7How often have you looked for excuses for being tired? Over the past 4 weeks:B. Social interactionsMd ,hd All the time1"M dA large amount of the time2(M, Pd&A moderate to large amount of the time3FM dA moderate amount of the time4LM td&A small to moderate amount of the time5jM BdA small amount of the time6pM,d Not at all7oXp@4N`zKI cannot answer this question7oP4`K$I don't want to answer this question7}Hsds !uX*9How often have you experienced wanting to be left alone? Over the past 4 weeks:B. Social interactionsMl,hd All the time1"MdA large amount of the time2(MPd&A moderate to large amount of the time3FMXdA moderate amount of the time4LMtd&A small to moderate amount of the time5HjM<BdA small amount of the time6DpMd Not at all7oXp4N`zKI cannot answer this question7oT4`K$I don't want to answer this question7 $}$s$s !uX*oHow often have you felt like not wanting to do things together with your partner, children, and / or friends? Over the past 4 weeks:B. Social interactions$Mx$,hd All the time1\$"M0$dA large amount of the time2d$(M8$Pd&A moderate to large amount of the time3 $FM$dA moderate amount of the time4 $LM$td&A small to moderate amount of the time5\ $jM<$BdA small amount of the time6$pMP$d Not at all7$oXp4$4N`zKI cannot answer this question7|$o<$4`K$I don't want to answer this question7<$}$s$s !uX*jHow much of a problem have you felt there is with your relationship to the person who is closest to you? Over the past 4 weeks:B. Social interactions$MD$,hdA very large problem1` $"M$dA large problem2T$(M$PdA moderate to large problem3$FM $dA moderate problem4$LM $tdA small to moderate problem5H $jM$BdA small problem6$pM$d No problem7$oXp$4N`zKI cannot answer this question7$o$4`K$I don't want to answer this question7} s(s !uX*QHow much of a problem have you had from not being involved in family activities? Over the past 4 weeks:B. Social interactions\M,hdA very large problem1t"MdA large problem2(MPdA moderate to large problem3pFMDdA moderate problem4PLM tdA small to moderate problem5ljM(BdA small problem6pMd No problem7 oXp4N`zKI cannot answer this question7\ o4`K$I don't want to answer this question7 }4 sP s !uX*XHow much of a problem have you had with inadequate and / or infrequent sexual intimacy? Over the past 4 weeks:B. Social interactionsM< ,hdA very large problem1,"MD dA large problem2$(MX PdA moderate to large problem3FM` dA moderate problem4HLM tdA small to moderate problem5@jMh BdA small problem6pM d No problem7oXp4N`zKI cannot answer this question7ol4`K$I don't want to answer this question7}s8s !uX*YHow much of a problem have you had with a lack of interest in being around other people? Over the past 4 weeks:B. Social interactions0M ,hdA very large problem1"MdA large problem2L(M PdA moderate to large problem3hFMdA moderate problem4LMtdA small to moderate problem5jMBdA small problem6 pMd No problem7DoXp4N`zKI cannot answer this question7o4`K$I don't want to answer this question7<%} %s%s !uX*DHow often have you been feeling depressed, down, and / or hopeless?HWith respect to how you have been feeling inside over the past 4 weeks:C. Emotional functioning %M%,hd All the time1D %"M%dA large amount of the time2 %(Mt %Pd&A moderate to large amount of the time3 %FM` %dA moderate amount of the time4` %LMh %td&A small to moderate amount of the time5 %jM %BdA small amount of the time6%pM( %d Not at all7$%oXp%4N`zKI cannot answer this question7H%op%4`K$I don't want to answer this question78%}%s%s !uX*IHow often have you been feeling anxious or fearful about what was wrong?HWith respect to how you have been feeling inside over the past 4 weeks:C. Emotional functioningh%Mx%,hd All the time1%"MH%dA large amount of the time2`%(M%Pd&A moderate to large amount of the time3(%FM%dA moderate amount of the time4\%LM%td&A small to moderate amount of the time5%jMx%BdA small amount of the time6%pM%d Not at all7%oXph%4N`zKI cannot answer this question7%o$%4`K$I don't want to answer this question7&}(&s@&s !uX*,How often have you been feeling frustrated?HWith respect to how you have been feeling inside over the past 4 weeks:C. Emotional functioningp&M&,hd All the time1&"M&dA large amount of the time2&(M&Pd&A moderate to large amount of the time3&FM&dA moderate amount of the time4&LM<&td&A small to moderate amount of the time5`&jMD&BdA small amount of the time6&pM&d Not at all7( &oXp0&4N`zKI cannot answer this question7 &o8&4`K$I don't want to answer this question7 &} &s &s !uX*:How often have you been feeling irritable and / or moody?HWith respect to how you have been feeling inside over the past 4 weeks:C. Emotional functioning|&M&,hd All the time1\&"M(&dA large amount of the time2&(M&Pd&A moderate to large amount of the time3&FM&dA moderate amount of the time4&LML &td&A small to moderate amount of the time5T&jMT &BdA small amount of the time6 &pMx &d Not at all7d&oXp &4N`zKI cannot answer this question7D&o &4`K$I don't want to answer this question7&}&s&s !uX*+How often have you been feeling impatient?HWith respect to how you have been feeling inside over the past 4 weeks:C. Emotional functioning &Mt &,hd All the time10&"M &dA large amount of the time2&(MH&Pd&A moderate to large amount of the time3L&FM&dA moderate amount of the time4&LM@&td&A small to moderate amount of the time5&jM&BdA small amount of the time6 &pML&d Not at all7&oXp0&4N`zKI cannot answer this question7<+od+4`K$I don't want to answer this question7+}d+s+s !uX*AHow often have you been feeling that you are being unreasonable?HWith respect to how you have been feeling inside over the past 4 weeks:C. Emotional functioning@+M+,hd All the time1+"M4+dA large amount of the time2+(M+Pd&A moderate to large amount of the time3\+FM+dA moderate amount of the time4$ +LM+td&A small to moderate amount of the time5L +jM+BdA small amount of the time6|+pM+d Not at all7 +oXpL +4N`zKI cannot answer this question7 +oT +4`K$I don't want to answer this question7, +}|+s\ +s !uX*.How often have you been getting easily upset?HWith respect to how you have been feeling inside over the past 4 weeks:C. Emotional functioning +M +,hd All the time1P+"Mx +dA large amount of the time2+(M +Pd&A moderate to large amount of the time3T+FM+dA moderate amount of the time4+LM+td&A small to moderate amount of the time5t+jMt+BdA small amount of the time6T+pM`+d Not at all7l+oXp+4N`zKI cannot answer this question7`+o+4`K$I don't want to answer this question70+}p+s+s  !uX*;How often have you experienced a tendency to become angry?HWith respect to how you have been feeling inside over the past 4 weeks:C. Emotional functioning+ML+,hd All the time1+"M+dA large amount of the time2+(M0+Pd&A moderate to large amount of the time3+FM+dA moderate amount of the time40+LM+td&A small to moderate amount of the time5+jM+BdA small amount of the time6`!pMl!d Not at all7x!oXpt!4N`zKI cannot answer this question7!o|!4`K$I don't want to answer this question7\!}!sd!s !)!uX*SHow often have you been feeling like you were unable to cope with everyday issues?HWith respect to how you have been feeling inside over the past 4 weeks:C. Emotional functioning!M!,hd All the time10!"M@!dA large amount of the time2!(M,!Pd&A moderate to large amount of the time3 !FM!dA moderate amount of the time4T !LM!td&A small to moderate amount of the time5 !jM!BdA small amount of the time6x!pM!d Not at all7$!oXp!4N`zKI cannot answer this question7!o!4`K$I don't want to answer this question7!}!sH!s *2!uX*/How concerned have you been about your weight?HWith respect to how you have been feeling inside over the past 4 weeks:C. Emotional functioningx !M` !,hdA very large amount1!"M !dA large amount2L!(M !PdA moderate to large amount3t!FM@ !dA moderate amount4!LM !tdA small to moderate amount5!jM !BdA small amount6d!pMl!dNone7,!oXpD!4N`zKI cannot answer this question7!o!4`K$I don't want to answer this question7}sds 3;uX*lHow concerned have you been about heart problems (heart attacks or heart failure) and / or premature death?HWith respect to how you have been feeling inside over the past 4 weeks:C. Emotional functioningM,hdA very large amount1d"MDdA large amount2(MLPdA moderate to large amount3$FMdA moderate amount4<LMtdA small to moderate amount5hjMBdA small amount6pM$dNone7oXp4N`zKI cannot answer this question70 o4`K$I don't want to answer this question7@8pXs?!uX*AThe next page shows a list of symptoms that some people with sleep apnea and / or who snore may experience. Please indicate all symptoms which have been a problem for you during the past 4 weeks. In the blank spaces, please also write down additional symptoms you may have had that are not included in the list.CPlease click at the "Continue"-button to display the next question! D. Symptoms #Fs<R: uX*4Please check all symptoms which have been a problem:41I .*LdDecreased energy144k h*dExcessive fatigue2@4 *dRFeeling that ordinary activities require an extra effort to perform or complete4,4cH *d2Falling asleep at inappropriate times or places8@4/ *2d*Falling asleep if not stimulated or active16 4Eu N*ld>Difficulty with a dry or sore mouth / throat upon awakening32 4c  *d5Waking up often (more than twice) during the night64l 4W *d<Difficulty returning to sleep if you wake up in the night1284! *d6Concern about the times you stop breathing at night256 4+[` 4*Rd3Waking up at night feeling like you were choking512T 4qh n*d(Waking up in the morning with a headache1024D4x *d>Waking up in the morning feeling unrefreshed and / or tired20482%U .(Ld0Waking up more than once per night to urinate4096L2kd  h(d%A feeling that your sleep is restless81922t  (d&Difficulty staying awake while reading1638442  (dCDifficulty staying awake while trying to carry on a conversation327682 ;@  (2dPDifficulty staying awake while trying to watch something (concert, movie, TV)65536x2QiP  N(ld.Fighting the urge to fall asleep while driving1310722  (d:A reluctance or inability to drive for more than 1 hour2621442  (dTConcern regarding close calls while driving due to your inability to remain alert524288H27!4  (d^Concern regarding your or other's safety when you're operating a motor vehicle or machinery1048576 7Ox4RdOther symptom:2097152h qxndOther symptom:4194304frsouaqmode cstop 0 39 41 copyc definition files:L H QUAL\ANYQUIN\temp\~s99dir.tmp!8!pD!s?!uX*lOn the next page, please select the 5 most important symptoms you have experienced over the past 4 weeks.CPlease click at the "Continue"-button to display the next question! D. Symptoms!#FsSi: uX*1Now, please select the 5 most important symptoms:!41I0! .*LdDecreased energy1!4k0! h*dExcessive fatigue2!4! *dRFeeling that ordinary activities require an extra effort to perform or complete4|!4c! *d2Falling asleep at inappropriate times or places8,!4/X! *2d*Falling asleep if not stimulated or active16!4Eu ! N*ld>Difficulty with a dry or sore mouth / throat upon awakening32!4c! *d5Waking up often (more than twice) during the night64L !4W ! *d<Difficulty returning to sleep if you wake up in the night128 !4!L ! *d6Concern about the times you stop breathing at night256 !4+[ ! 4*Rd3Waking up at night feeling like you were choking512| !4q ! n*d(Waking up in the morning with a headache1024$ !4d ! *d>Waking up in the morning feeling unrefreshed and / or tired2048 !2%U( ! .(Ld0Waking up more than once per night to urinate4096 !2k ! h(d%A feeling that your sleep is restless8192L!2t! (d&Difficulty staying awake while reading16384!20! (dCDifficulty staying awake while trying to carry on a conversation32768!2 ;! (2dPDifficulty staying awake while trying to watch something (concert, movie, TV)65536!2Qi! N(ld.Fighting the urge to fall asleep while driving131072l!2! (d:A reluctance or inability to drive for more than 1 hour2621444!2! (dTConcern regarding close calls while driving due to your inability to remain alert5242884!27!! (d^Concern regarding your or other's safety when you're operating a motor vehicle or machinery1048576D!37OX! 4)RdMy first symptom2097152!2q! n(dMy second symptom4194304+0 xOther#032Symptom 41 22 setls 41 23 setls41 23 setls clrs 39 41 copyc,(0 39 22 getns lens 0 = cstop 41 22 setls( 41(0 39 23 getns lens 0 = cstop 41 23 setlsx$yc`lsg!8g!p`g!s?!uX*LYou have selected more than 5 symptoms. Please select exactly 5 symptoms.CPlease click at the "Continue"-button to display the next question! D. Symptoms CCA41 5 <=EDAWFS43 5 <=, CCA41 5 >KEDAWFS43 5 >( 41`g!8g!pg!s?!uX*LYou have selected less than 5 symptoms. Please select exactly 5 symptoms.CPlease click at the "Continue"-button to display the next question! D. Symptoms CCA41 5 >=EDAWFS43 5 >=, CCA41 5 DeletedQn<]] 0 0Ja1?Jd0H ?+~L ?d0 Ja00 ?} ?CNs|d0Nee14Nee1,0(0$Zeer ,/V /p /s?!uX*UThe next page shows a list of symptoms that some people who have been treated for sleep apnea and / or snoring may experience. Please indicate all symptoms which have been a problem for you during the past 4 weeks. In the blank spaces, please also write down additional symptoms you may have had that are not included in the list.CPlease click at the "Continue"-button to display the next question!E. Treatment related symptoms_#ys=XK ##uX*4Please check all symptoms which have been a problem:0_445L<_ 1*Od Runny nose1_4kW_ t*d'Stuffed or congested or blocked nose2_4W_ *d3Excessive dryness of the nose or throat passages4p_4W!_ *d*Soreness in the nose or throat passages8 _4@5X_ =*[d Headaches16_458_ *dEye irritation32_45$_ *dEar pain64_4W-<_ *$d(Waking up frequently during the night128_4@Wp _ I*gd.Difficulty returning to sleep if you awaken256 _4W(_ *d"Air leakage from the nasal mask512 _)Y _\2zPdDiscomfort from the nasal mask1024X _t _\}zdMarks or rash on your face20488 _ _\zdFComplaints from your partner about the noise of the CPAP machine4096 _ : _\z1d;Having fluid / food pass into your nose when you swallow8192 _UH _\^z|d$A change in how your voice sounds16384__\zd%Pain in the throat when swallowing32768_'L_\zdOPain or aching in your jaw joint or jaw muscles especially upon awakening65536P_BZ\_\?z]dFeeling self conscious131072X__\zd3Aching in your teeth that lasts at least an hour262144|_)Y_2Pd1Discomfort, aching, or tenderness of your gums524288_th_}d1Hardship in being able to pay for the treatment1048576__dA sense of suffocation2097152_._1dExcessive salivation4194304(_U_^|d$Difficulty chewing in the morning8388608\dKDifficulty chewing with your back teeth that persists most of the day16777216'tdUMovement of the teeth so that the upper and lower teeth no longer meet properly33554432BZ?\dOther:671088640dOther: 134217728frsouaqmode cstop 0 69 71 copyc9 28 getns 71 28 setlsxx|)8)pD)s?!uX*lOn the next page, please select the 5 most important symptoms you have experienced over the past 4 weeks.CPlease click at the "Continue"-button to display the next question!E. Treatment related symptoms)#ysYtK $&uX*1Now, please select the 5 most important symptoms:,)445L8) 1*Od Runny nose10)4kWX) t*d'Stuffed or congested or blocked nose2)4W) *d3Excessive dryness of the nose or throat passages4x)4W!) *d*Soreness in the nose or throat passages8)4@5X$) =*[d Headaches16x)45) *dEye irritation32)45) *dEar pain64@)4W-l) *$d(Waking up frequently during the night128)4@Wp ) I*gd.Difficulty returning to sleep if you awaken256 )4W ) *d"Air leakage from the nasal mask512 ))Y8 )\2zPdDiscomfort from the nasal mask1024 )t )\}zdMarks or rash on your face20488 ) )\zdFComplaints from your partner about the noise of the CPAP machine4096 ) :T )\z1d;Having fluid / food pass into your nose when you swallow8192 )U )\^z|d$A change in how your voice sounds16384 ) )\zd%Pain in the throat when swallowing32768 )'p)\zdOPain or aching in your jaw joint or jaw muscles especially upon awakening65536)BZ()\?z]dFeeling self conscious131072))\zd3Aching in your teeth that lasts at least an hour262144H))Y|)2Pd1Discomfort, aching, or tenderness of your gums524288)t4)}d1Hardship in being able to pay for the treatment1048576))dA sense of suffocation20971528).P)1dExcessive salivation4194304)U)^|d$Difficulty chewing in the morning8388608X))dKDifficulty chewing with your back teeth that persists most of the day16777216H)')dUMovement of the teeth so that the upper and lower teeth no longer meet properly33554432P)BZ`)?]d Other Symptom67108864))d Other Symptom 134217728+0 xOther#032Symptom 71 27 setls 71 28 setls71 28 setls clrs 69 71 copyc,(0 69 27 getns lens 0 = cstop 71 27 setls( 71(0 69 28 getns lens 0 = cstop 71 28 setls 71 28 setlsoLLNYQUIN\SAQLIEN.QDWL4rmulaReceiveFromDialogoLNYQUIN\SAQLIEN.QDWlL4rmulaReceiveFromDialogoLNYQUIN\SAQLIEN.QDWL4rmulaReceiveFromDialogsLNYQUIN\SAQLIEN.QDWrrmulaReceiveFromDalogsNYQUIN\SAQLIEN.QDWLSNDEFINEDymptom 66 setqs 39 23 getns lens 0 = cstop 66 setqst 22 setlshdcstop 41 22 setlsetLH = cstop 41 22 setls2 s,ns(P*8*pl*s?!'(uX*LYou have selected more than 5 symptoms. Please select exactly 5 symptoms.CPlease click at the "Continue"-button to display the next question!E. Treatment related symptoms CCA71 5 <=EDAWFS43 5 <=, CCA71 5 >KEDAWFS43 5 >( 7188ps?!)*uX*LYou have selected less than 5 symptoms. Please select exactly 5 symptoms.CPlease click at the "Continue"-button to display the next question!E. Treatment related symptoms CCA71 5 >=EDAWFS43 5 >=, CCA71 5 =,4}\ss ~!,,uX*& Stuffed or congested or blocked noseNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptoms$M<,hdA very large problem1"MdA large problem2(M$PdA moderate to large problem3FMdA moderate problem4LMtdA small to moderate problem5ljM|BdA small problem6pMd No problem7DoXpd4N`zKI cannot answer this question7o4`K$I don't want to answer this question7 v71 2 and 0 =WFS43 5 >=,}Dss !--uX*2 Excessive dryness of the nose or throat passagesNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptomsM ,hdA very large problem1d"MtdA large problem2(MPdA moderate to large problem3PFMddA moderate problem4LMtdA small to moderate problem5<jMLBdA small problem6pMd No problem7oXp44N`zKI cannot answer this question7o4`K$I don't want to answer this question7 v71 4 and 0 =WFS43 5 >=,*}*s*s !..uX*) Soreness in the nose or throat passagesNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptomsL*M*,hdA very large problem1d*"M*dA large problem2`*(M*PdA moderate to large problem3 *FM0*dA moderate problem44 *LM*tdA small to moderate problem5L *jM *BdA small problem6\ *pM\ *d No problem7$*oXp *4N`zKI cannot answer this question7*oh *4`K$I don't want to answer this question7 v71 8 and 0 =WFS43 5 >=,} sps !//uX* HeadachesNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptomsM,hdA very large problem1P"MdA large problem2(MPdA moderate to large problem34FMHdA moderate problem4LMtdA small to moderate problem5 jM0BdA small problem6pMd No problem7oXp4N`zKI cannot answer this question7o4`K$I don't want to answer this question7v71 16 and 0 =FS43 5 >=, } s s !00uX* Eye irritationNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptoms M ,hdA very large problem1 "M dA large problem2l (M PdA moderate to large problem3 FM dA moderate problem4\ LMx tdA small to moderate problem5 jM BdA small problem64pM@d No problem7oXp4N`zKI cannot answer this question78o`4`K$I don't want to answer this question7v71 32 and 0 =FS43 5 >=,`}lss !11uX* Ear painNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptoms4M,hdA very large problem1"MdA large problem2(M0PdA moderate to large problem3FMdA moderate problem4LM tdA small to moderate problem5xjMBdA small problem6pMd No problem7PoXpp4N`zKI cannot answer this question7o4`K$I don't want to answer this question7v71 64 and 0 =FS43 5 >=,}(sxs !22uX*' Waking up frequently during the nightNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptomsM ,hdA very large problem1d"MtdA large problem2(MPdA moderate to large problem3PFMddA moderate problem4LMtdA small to moderate problem5<jMLBdA small problem6pMd No problem7oXp44N`zKI cannot answer this question7o4`K$I don't want to answer this question7v71 128 and 0 =S43 5 >=,o$}Lo$so$s !33uX*- Difficulty returning to sleep if you awakenNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptomso$Mo$,hdA very large problem1lo$"M|o$dA large problem2o$(Mo$PdA moderate to large problem3Xo$FMlo$dA moderate problem4o$LMo$tdA small to moderate problem5Do$jMTo$BdA small problem6o$pMo$d No problem7o$oXp<o$4N`zKI cannot answer this question7o$oo$4`K$I don't want to answer this question7v71 256 and 0 =S43 5 >=,\ o$} o$s@ o$s !44uX*! Air leakage from the nasal maskNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptoms o$M o$,hdA very large problem1, o$"M< o$dA large problem2 o$(M o$PdA moderate to large problem3 o$FM, o$dA moderate problem4 o$LM o$tdA small to moderate problem5o$jMo$BdA small problem6ho$pMto$d No problem7o$oXpo$4N`zKI cannot answer this question7lo$oo$4`K$I don't want to answer this question7v71 512 and 0 =S43 5 >=,o$}o$so$s !55uX* Discomfort from the nasal maskNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptoms|o$Mo$,hdA very large problem1o$"Mo$dA large problem2`o$(M|o$PdA moderate to large problem3o$FMo$dA moderate problem4Po$LMlo$tdA small to moderate problem5o$jMo$BdA small problem6(o$pM4o$d No problem7o$oXpo$4N`zKI cannot answer this question7,o$oTo$4`K$I don't want to answer this question7v71 1024 and 0 =43 5 >=,do$}o$so$s !66uX* Marks or rash on your faceNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptoms8o$MPo$,hdA very large problem1o$"Mo$dA large problem2o$(M8o$PdA moderate to large problem3o$FMo$dA moderate problem4 o$LM(o$tdA small to moderate problem5o$jMo$BdA small problem6o$pMo$d No problem7Xo$oXpxo$4N`zKI cannot answer this question7o$oo$4`K$I don't want to answer this question7v71 2048 and 0 =43 5 >=,w'}Xw'sw's !77uX*AComplaints from your partner about the noise of the CPAP machineNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptoms w'Mw',hdA very large problem1w'"Mw'dA large problem2w'(Mw'PdA moderate to large problem3lw'FMw'dA moderate problem4w'LMw'tdA small to moderate problem5Xw'jMhw'BdA small problem6w'pMw'd No problem70w'oXpPw'4N`zKI cannot answer this question7w'ow'4`K$I don't want to answer this question7v71 4096 and 0 =43 5 >=, w'}T w'sp w's !88uX*9Having fluid / food pass into your nose when you swallowNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptoms w'M w',hdA very large problem1X w'"Mh w'dA large problem2 w'(M w'PdA moderate to large problem3D w'FMX w'dA moderate problem4 w'LM w'tdA small to moderate problem50w'jM@w'BdA small problem6w'pMw'd No problem7w'oXp(w'4N`zKI cannot answer this question7w'ow'4`K$I don't want to answer this question7v71 8192 and 0 =43 5 >=,Hw'}w's8w's !99uX*!A change in how your voice soundsNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptomsw'Mpw',hdA very large problem1w'"M(w'dA large problem2w'(Mw'PdA moderate to large problem3w'FMw'dA moderate problem4|w'LMw'tdA small to moderate problem5w'jMw'BdA small problem6Tw'pM`w'd No problem7w'oXpw'4N`zKI cannot answer this question7Xw'ow'4`K$I don't want to answer this question7v71 16384 and 0 =3 5 >=,w'}w'sw's !::uX*$ Pain in the throat when swallowingNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptomslw'Mw',hdA very large problem1w'"Mw'dA large problem2Pw'(Mlw'PdA moderate to large problem3w'FMw'dA moderate problem4@w'LM\w'tdA small to moderate problem5w'jMw'BdA small problem6w'pM$w'd No problem7w'oXpw'4N`zKI cannot answer this question7w'oDw'4`K$I don't want to answer this question7v71 32768 and 0 =3 5 >=,}hss  !;;uX*JPain or aching in your jaw joint or jaw muscles especially upon awakeningNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptomsM0,hdA very large problem1"MdA large problem2(MPdA moderate to large problem3tFMdA moderate problem4LMtdA small to moderate problem5`jMpBdA small problem6pMd No problem78oXpX4N`zKI cannot answer this question7o4`K$I don't want to answer this question7v71 65536 and 0 =3 5 >=,x }( s s !<<uX* Feeling self consciousNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptoms M ,hdA very large problem1@ "MP dA large problem2 (M PdA moderate to large problem3, FM@ dA moderate problem4 LM tdA small to moderate problem5jM(BdA small problem6|pMd No problem7oXp4N`zKI cannot answer this question7o4`K$I don't want to answer this question7v71 131072 and 0 = 5 >=,}s4s !==uX*1Aching in your teeth that lasts at least an hourNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptomsM4,hdA very large problem1"M<dA large problem2(MPdA moderate to large problem3FMdA moderate problem4tLMtdA small to moderate problem5jMBdA small problem6LpMXd No problem7oXp4N`zKI cannot answer this question7Pox4`K$I don't want to answer this question7v71 262144 and 0 = 5 >=,}ss (!>>uX*0 Discomfort, aching, or tenderness of your gumsNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptomstM$,hdA very large problem1"MdA large problem2T(MpPdA moderate to large problem3FMdA moderate problem4DLM`tdA small to moderate problem5jMBdA small problem6pM(d No problem7oXp4N`zKI cannot answer this question7 oH4`K$I don't want to answer this question7v71 524288 and 0 = 5 >=,(*}\*s*s )1!??uX*0Hardship in being able to pay for the treatmentNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptoms*M*,hdA very large problem1p*"M*dA large problem2*(M*PdA moderate to large problem3\*FMp*dA moderate problem4*LM*tdA small to moderate problem5H*jMX*BdA small problem6*pM*d No problem7 *oXp@*4N`zKI cannot answer this question7*o*4`K$I don't want to answer this question7v71 1048576 and 0 =5 >=,` *} *sH *s 2:!@@uX* A sense of suffocationNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptoms *M *,hdA very large problem1( *"M8 *dA large problem2 *(M *PdA moderate to large problem3 *FM( *dA moderate problem4 *LM *tdA small to moderate problem5*jM*BdA small problem6d*pMp*d No problem7*oXp*4N`zKI cannot answer this question7h*o*4`K$I don't want to answer this question7v71 2097152 and 0 =5 >=,*}*s*s ;C!AAuX* Excessive salivationNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptomsx*M*,hdA very large problem1*"M$*dA large problem2P*(Ml*PdA moderate to large problem3*FM*dA moderate problem4@*LM\*tdA small to moderate problem5*jM*BdA small problem6*pM$*d No problem7*oXp*4N`zKI cannot answer this question7*oD*4`K$I don't want to answer this question7v71 4194304 and 0 =5 >=,H*}l*s*s DL!BBuX*# Difficulty chewing in the morningNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptoms4*M*,hdA very large problem1*"M*dA large problem2*(M,*PdA moderate to large problem3*FM*dA moderate problem4*LM*tdA small to moderate problem5t*jM*BdA small problem6*pM*d No problem7L*oXpl*4N`zKI cannot answer this question7*o*4`K$I don't want to answer this question7v71 8388608 and 0 =5 >=,G!}`G!sG!s MU!CCuX*GDifficulty chewing with your back teeth that persists most of the day NHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptomsG!M,G!,hdA very large problem1G!"MG!dA large problem2G!(MG!PdA moderate to large problem3pG!FMG!dA moderate problem4G!LMG!tdA small to moderate problem5\G!jMlG!BdA small problem6G!pMG!d No problem74G!oXpTG!4N`zKI cannot answer this question7G!oG!4`K$I don't want to answer this question7v71 16777216 and 0 = >=, G!}t G!st G!s V^!DDuX*PMovement of the teeth so that the upper and lower teeth no longer meet properlyNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptoms G!M G!,hdA very large problem1t G!"M G!dA large problem2 G!(M G!PdA moderate to large problem3` G!FMt G!dA moderate problem4 G!LM G!tdA small to moderate problem5LG!jM\G!BdA small problem6G!pMG!d No problem7$G!oXpDG!4N`zKI cannot answer this question7G!oG!4`K$I don't want to answer this question7v71 33554432 and 0 = >=,dG!}G!stG!s _g!EFuX* Other symptomNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptomsG!MG!,hdA very large problem1 G!"M0G!dA large problem2G!(MG!PdA moderate to large problem3 G!FM G!dA moderate problem4G!LMG!tdA small to moderate problem5G!jMG!BdA small problem6\G!pMhG!d No problem7G!oXpG!4N`zKI cannot answer this question7`G!oG!4`K$I don't want to answer this question7v71 61708864 and 0 = >=,G0 xOther#032Symptom 100 setqs clrs 69 27 getns lens 0 = cstop 100 setqsYC t h  4|41l71hdQS\TUNDEFINEDG!}G!sG!s hp!GHuX*Another symptomNHow much of a problem has this symptom been for you over the last four weeks?E. Treatment related symptoms`G!MxG!,hdA very large problem1G!"MG!dA large problem2DG!(M`G!PdA moderate to large problem3G!FMG!dA moderate problem44G!LMPG!tdA small to moderate problem5G!jMG!BdA small problem6 0pM,0d No problem7@0oXpt04N`zKI cannot answer this question70o|04`K$I don't want to answer this question7v71 134217728 and 0 =\XUIN\temp\~s99dir.tmpSociale interacties\<G0 xOther#032Symptom 101 setqs clrs 69 28 getns lens 0 = cstop 101 setqsYC t h  4|41l71hdQS\TUNDEFINED(}(s(sqt!uX*Having been treated for your sleep apnea and / or snoring, do you believe that overall there has been an improvement in your quality of life since you started treatment?=I. Please think of the questions in sections A, B, C, and D. F. ImpactX(N.\(}dYes1(.(AdNo0(oXp<(4N`zKI cannot answer this question3(o(4`K$I don't want to answer this question4D(}0 (s(suxp !IIuX*|How much of an impact on your quality of life has there been as reflected by the questions asked in sections A, B, C and D?=I. Please think of the questions in sections A, B, C, and D. F. Impact(x/(d00 (/ (Xd100100` (oXp (4N`zKI cannot answer this question3 (o (4`K$I don't want to answer this question4v102 0 = Quality Of Life Questionnaire - Nederlandse versie&@;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;<9;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;<996DeletedQn<]] %@;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;9<;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;<: (}`(s (sy|p !uX*GHow much of an impact on your quality of life have these symptoms had?II. Please think of the symptoms that developed as a result of being treated for sleep apnea and / or snoring that you highlighted in section E. F. Impact (x/(d00 (/(Xd100100(oXp(4N`zKI cannot answer this question3h(o(4`K$I don't want to answer this question4(d------!A I Most important activity total!A I Most important activity total A I total@@uX*v2 v3 v4 v5 4 sum(d------A II Other activities totalA II Other activities total A II total@@uX*v6 V7 v8 v9 4 sum(d------A III General functioning totalA III General functioning total A III total@@uX*v10 v11 v12 3 sum (d------B Social interactions totalB Social interactions totalB total@@uX*:v14 v15 v16 v17 v18 v19 v20 v21 v22 v23 v24 v25 v26 13 sum(d------C Emotional functioning totalC Emotional functioning totalC total@@uX*2v27 v28 v29 v30 v31 v32 v33 v34 v35 v36 v37 11 sum(------D Symptoms totalD Symptoms totalD total@@uX*bv44 v45 v46 v47 v48 v49 v50 v51 v52 v53 v54 v55 v56 v57 v58 v59 v60 v61 v62 v63 v64 v65 v66 23 sum(------"E Treatment related symptoms total"E Treatment related symptoms totalE total@@uX*xv74 v75 v76 v77 v78 v79 v80 v81 v82 v83 v84 v85 v86 v87 v88 v89 v90 v91 v92 v93 v94 v95 v96 v97 v98 v99 v100 v101 28 sum(d------ Domain A mean Domain A mean Domain A mean?@uX**v2 v3 v4 v5 v6 V7 v8 v9 v10 v11 v12 11 avg(d------ Domain B mean Domain B mean Domain B mean?@uX*:v14 v15 v16 v17 v18 v19 v20 v21 v22 v23 v24 v25 v26 13 avg|(d------ Domain C mean Domain C mean Domain C mean?@uX*2v27 v28 v29 v30 v31 v32 v33 v34 v35 v36 v37 11 avg(------ Domain D mean Domain D mean Domain D mean?@uX*bv44 v45 v46 v47 v48 v49 v50 v51 v52 v53 v54 v55 v56 v57 v58 v59 v60 v61 v62 v63 v64 v65 v66 23 avg(------Domain E re-coded meanDomain E re-coded meanDomain E re-coded mean@uX*|7 v74 v75 v76 v77 v78 v79 v80 v81 v82 v83 v84 v85 v86 v87 v88 v89 v90 v91 v92 v93 v94 v95 v96 v97 v98 v99 v100 v101 28 avg -(------=Treatment impact score I (QoL improvement domains A, B, C, D)=Treatment impact score I (QoL improvement domains A, B, C, D)Treatment impact I@uX*v103(------6Treatment impact score I (resulting symptoms eomain E)6Treatment impact score I (resulting symptoms domain E)Treatment Impact II@uX*v104(------ Weight factor Weight factor?uX*)14 FN 13 FN / dup testundefined + 1 2 max$(------ SAQLI Score SAQLI Score SAQLI Score@uX*/8 FN 9 FN + 10 FN + 11 FN + 12 FN 15 FN * - 4 /This questionnaire definition file is based upon the Calgary SAQLI Sleep Apnea Quality of Life Questionnaire Interviewer version Flemons WW, Reimer MA. Development of a disease-specific health-related quality of life questionnaire for sleep apnea. AM J RESPIR CRIT CARE MED 1998;158:494-503. W. Ward Flemons MD, FRCPC Foothills Medical Centre & University of Calgary 1403 29th Street N.W. Calgary, Alberta, Canada T2N 2T9 flemons@ucalgary.ca Questionnaire definition file for AnyQuest for Windows 2001 by Dr. med. Jrg M. Sigle, Freudenstein, Germany http://www.jsigle.com joerg.sigle@jsigle.com