TY - JOUR
T1 - Sleep and quality of life improvements after endoscopic sinus surgery in patients with chronic rhinosinusitis
AU - Alt, Jeremiah A.
AU - Smith, Timothy L.
AU - Schlosser, Rodney J.
AU - Mace, Jess C.
AU - Soler, Zachary M.
PY - 2014/9
Y1 - 2014/9
N2 - Background: Recent investigation has demonstrated that approximately 75% of patients with medically refractory chronic rhinosinusitis (CRS) report abnormal sleep quality, with strong correlation between worse sleep quality and more severe CRS disease severity. It remains unknown whether the treatment effect of endoscopic sinus surgery (ESS) for CRS results in appreciable sleep quality improvements. Methods: Adult patients (aged ≥18 years) with a current diagnosis of recalcitrant chronic rhinosinusitis (CRS), who voluntarily elected ESS as the next treatment modality (n = 301), were prospectively evaluated within 4 academic, tertiary care centers using treatment outcome instruments: the Rhinosinusitis Disability Index, the 22-item Sinonasal Outcome Test, the 2-item Patient Health Questionnaire, and the Pittsburgh Sleep Quality Index (PSQI) both before and after ESS. Results: Seventy-two percent (72%) of patients with CRS were found to have poor sleep (PSQI > 5) at baseline with a mean (standard deviation) global PSQI score of 9.4 (4.6). Surgery improved overall mean global PSQI scores (by 2.2 points), and all 7 subdomain scores of the PSQI. Similarly, the odds of good sleep quality (PSQI ≤ 5) in patients treated with sinus surgery increased significantly (odds ratio [OR] 5.94; 95% confidence interval [CI], 3.06 to 11.53; p < 0.001). Stepwise multivariate linear regression found that acetylsalicylic acid (ASA) intolerance (β [standard error], -1.94 [0.93]; 95% CI, -3.77 to -0.11; p = 0.038), history of prior sinus surgery (β [standard error], 1.10 (0.54); 95% CI, 0.03 to 2.16; p = 0.044), and frontal sinusotomy (β [standard error], -1.03 [0.62]; 95% CI, -2.26 to 0.20; p = 0.099) were found to significantly associate with improvement in PSQI sleep scores. Conclusion: Among patients with CRS, reduced sleep quality, poor disease-specific quality of life, and greater disease severity were improved following ESS. 2014 ARS-AAOA, LLC.
AB - Background: Recent investigation has demonstrated that approximately 75% of patients with medically refractory chronic rhinosinusitis (CRS) report abnormal sleep quality, with strong correlation between worse sleep quality and more severe CRS disease severity. It remains unknown whether the treatment effect of endoscopic sinus surgery (ESS) for CRS results in appreciable sleep quality improvements. Methods: Adult patients (aged ≥18 years) with a current diagnosis of recalcitrant chronic rhinosinusitis (CRS), who voluntarily elected ESS as the next treatment modality (n = 301), were prospectively evaluated within 4 academic, tertiary care centers using treatment outcome instruments: the Rhinosinusitis Disability Index, the 22-item Sinonasal Outcome Test, the 2-item Patient Health Questionnaire, and the Pittsburgh Sleep Quality Index (PSQI) both before and after ESS. Results: Seventy-two percent (72%) of patients with CRS were found to have poor sleep (PSQI > 5) at baseline with a mean (standard deviation) global PSQI score of 9.4 (4.6). Surgery improved overall mean global PSQI scores (by 2.2 points), and all 7 subdomain scores of the PSQI. Similarly, the odds of good sleep quality (PSQI ≤ 5) in patients treated with sinus surgery increased significantly (odds ratio [OR] 5.94; 95% confidence interval [CI], 3.06 to 11.53; p < 0.001). Stepwise multivariate linear regression found that acetylsalicylic acid (ASA) intolerance (β [standard error], -1.94 [0.93]; 95% CI, -3.77 to -0.11; p = 0.038), history of prior sinus surgery (β [standard error], 1.10 (0.54); 95% CI, 0.03 to 2.16; p = 0.044), and frontal sinusotomy (β [standard error], -1.03 [0.62]; 95% CI, -2.26 to 0.20; p = 0.099) were found to significantly associate with improvement in PSQI sleep scores. Conclusion: Among patients with CRS, reduced sleep quality, poor disease-specific quality of life, and greater disease severity were improved following ESS. 2014 ARS-AAOA, LLC.
KW - Chronic disease
KW - Endoscopic sinus surgery
KW - Quality of life
KW - Rhinitis
KW - Rhinosinusitis
KW - Sinusitis
KW - Sleep
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U2 - 10.1002/alr.21364
DO - 10.1002/alr.21364
M3 - Article
C2 - 25079334
AN - SCOPUS:84908333072
SN - 2042-6976
VL - 4
SP - 693
EP - 701
JO - International Forum of Allergy and Rhinology
JF - International Forum of Allergy and Rhinology
IS - 9
ER -