Accepted for oral presentation at the 116th Annual Meeting of the Triological Society within the Combined Otolaryngology Spring Meetings (COSM) in Orlando, Florida, April 10–14, 2013.
Sleep quality and disease severity in patients with chronic rhinosinusitis
Article first published online: 5 AUG 2013
Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.
Volume 123, Issue 10, pages 2364–2370, October 2013
How to Cite
Alt, J. A., Smith, T. L., Mace, J. C. and Soler, Z. M. (2013), Sleep quality and disease severity in patients with chronic rhinosinusitis. The Laryngoscope, 123: 2364–2370. doi: 10.1002/lary.24040
Zachary M. Soler, MD, MSc; Jess C. Mace, MPH; and Timothy L. Smith, MD, MPH are supported by a grant from the National Institute on Deafness and Other Communication Disorders (NIDCD), one of the National Institutes of Health, Bethesda, MD (2R01 DC005805; PI: T.L. Smith). Public clinical trial registration (http://www.clinicaltrials.gov) ID£NCT01332136. Timothy L. Smith, MD is also a consultant for Intersect ENT (Palo Alto, CA), which is not affiliated in any way with this investigation. The authors have no other funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 23 SEP 2013
- Article first published online: 5 AUG 2013
- Manuscript Accepted: 15 JAN 2013
- Manuscript Revised: 7 JAN 2013
- Manuscript Received: 7 DEC 2012
- chronic disease;
- quality of life;
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.
Cross-sectional evaluation of a multi-center cohort.
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.
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).
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. Laryngoscope, 123:2364–2370, 2013