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Multicenter Study
. 2013 Oct;123(10):2364-70.
doi: 10.1002/lary.24040. Epub 2013 Aug 5.

Sleep quality and disease severity in patients with chronic rhinosinusitis

Jeremiah A Alt  1 , Timothy L Smith, Jess C Mace, Zachary M Soler
Affiliations
Multicenter Study

Sleep quality and disease severity in patients with chronic rhinosinusitis

Jeremiah A Alt et al. Laryngoscope. 2013 Oct.

Abstract

Objectives/hypothesis: To evaluate sleep quality in patients with chronic rhinosinusitis (CRS) using a validated outcome measure and to compare measures of CRS disease severity with sleep dysfunction.

Study design: Cross-sectional evaluation of a multi-center cohort.

Methods: According to the 2007 Adult Sinusitis Guidelines, patients with CRS were prospectively enrolled from four academic, tertiary care centers across North America. Each subject completed the Pittsburgh Sleep Quality Index (PSQI) instrument, in addition to CRS-specific measures of quality-of-life (QOL), endoscopy, computed tomography (CT), and olfaction. Patient demographics, comorbid conditions, and clinical measures of disease severity were compared between patients with "good" (PSQI; ≤5) and "poor" (PSQI; > 5) sleep quality.

Results: Patients (n = 268) reported a mean PSQI score of 9.4 (range: 0-21). Seventy-five percent of patients reported PSQI scores above the traditional cutoff, indicating poor sleep quality. Patients with poor sleep quality were found to have significantly worse QOL scores on both the Rhinosinusitis Disability Index (P < 0.001) and 22-item Sinonasal Outcome Test (P < 0.001). No significant differences in average endoscopy, CT, or olfactory function scores were found between patients with good or poor sleep quality. Tobacco smokers reported worse average PSQI total scores compared to nonsmokers (P = 0.030). Patients reporting poor sleep were more likely to have a history of depression, even after controlling for gender (P = 0.020).

Conclusion: The majority of patients with CRS have a poor quality of sleep, as measured by the PSQI survey. Poor sleep quality is significantly associated with CRS-specific QOL, gender, comorbid depression, and tobacco use, but not CT score or endoscopy grade.

Level of evidence: 2b.

Trial registration: ClinicalTrials.gov NCT01332136.

Keywords: Sinusitis; chronic disease; quality of life; rhinology; sleep.

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Conflict of interest statement

Conflict of Interest: None

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