Impact of chronic rhinosinusitis on sleep: a controlled clinical study

Background Earlier studies have suggested that patients with chronic rhinosinusitis (CRS) report worse sleep quality than population norms. What remains unknown is whether these patients are actually experiencing measurable changes in objective sleep parameters. The goal of this study was to prospectively evaluate objective sleep measures in a cohort of patients with CRS. Methods A prospective, multi-institutional, case-control study was designed to compare patients with CRS to nondiseased controls. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (EpSS). Home sleep studies were administered across all subjects and a battery of objective sleep measurements were recorded using a portable sleep diagnostic device. Regression models were used to control for any factors that differed across groups. Results A total of 108 subjects were enrolled across 4 institutions, including 52 patients with CRS and 56 controls. Total PSQI scores were worse in patients with CRS when compared with controls (10.1 +/- 4.3 vs 4.7 +/- 2.5; p < 0.001). Similarly, daytime somnolence, as measured by the EpSS, was greater in patients with CRS (9.1 +/- 5.3 vs 6.5 +/- 3.7; p = 0.006). On home sleep studies, patients with CRS were found to have an increased number of awakenings during a night's sleep (8.6 +/- 4.8 vs 6.3 +/- 3.0; p = 0.004), lower average overnight oxygen saturation (93.2 +/- 2.6% vs 94.3 +/- 2.1%; p = 0.042), increased rapid eye movement sleep (REMS) latency (93.0 +/- 67.1 vs 66.7 +/- 35.3; p = 0.016), and spent a greater portion of the night snoring at >40 dB (24.7 +/- 27.4% vs 14.6 +/- 19.7%; p = 0.034). All differences except mean oxygen saturation remained significant after controlling for baseline differences. Conclusion Differences in both patient-reported and objective sleep measures exist between patients with CRS and controls.