Get access

Chronic rhinosinusitis and sleep: a contemporary review

Authors

  • Jeremiah A. Alt MD, PhD,

    1. Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology–Head and Neck Surgery, Oregon Health and Science University, Portland, OR
    Search for more papers by this author
  • Timothy L. Smith MD, MPH

    Corresponding author
    1. Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology–Head and Neck Surgery, Oregon Health and Science University, Portland, OR
    • Correspondence to: Timothy L. Smith, MD, MPH, Oregon Health & Science University, Department of Otolaryngology–Head & Neck Surgery, Division of Rhinology and Sinus Surgery, Oregon Sinus Center, 3181 SW Sam Jackson Park Road, PV-01, Portland, OR 97239; e-mail: smithtim@ohsu.edu

    Search for more papers by this author

  • Potential conflict of interest: T.L.S. is supported by a grant from the NIH, National Institute on Deafness and Other Communication Disorders (NIDCD; 2R01 DC005805); public clinical trial registration (http://clinicaltrials.gov/show/NCT01332136; Determinants of Medical and Surgical Treatment Outcomes in Chronic Sinusitis); he is also a consultant for Intersect ENT (Palo Alto, CA.) which is not affiliated in any way with this investigation.

Abstract

Background

Patients with chronic rhinosinusitis (CRS) exhibit centrally mediated behavioral changes commonly referred to as “sickness behavior.” Sleep alteration is a component of sickness behavior which is estimated to affect up to 70 million patients annually. Patients with CRS have poor sleep quality, and little is known about the underlying etiology and pathophysiology. This narrative review aims to further organize and present the current knowledge associating sleep and CRS.

Methods

A literature search was conducted of the OVID MEDLINE database using key search words including: “chronic rhinosinusitis,” “sleep,” “sleep disorders,” and “sleep dysfunction.” Additional keywords “nasal obstruction,” “nasal polyp,” and “fatigue” were identified and used to further delineate relevant articles.

Results

The articles that specifically addressed sleep and CRS were dissected and presented as follows: (1) chronic rhinosinusitis and sleep; (2) chronic rhinosinusitis and fatigue; (3) chronic rhinosinusitis, nasal obstruction, and sleep; and (4) pathophysiology of sleep in chronic rhinosinusitis (cytokines in both sleep and chronic rhinosinusitis and their association to the neuroimmune biology of chronic rhinosinusitis).

Conclusion

Patients with CRS have sleep dysfunction that is associated with their disease severity and overall quality of life. The etiology of sleep dysfunction in CRS is most likely multifactorial. Increasing evidence suggests sleep dysfunction in patients with CRS is partly due to the inflammatory disease process, and sleep physiology in patients with CRS may be actively regulated by the inflammatory component of the disease.

Get access to the full text of this article

Ancillary