To evaluate sleep quality in patients with chronic rhinosinusitis (CRS) using a validated outcome measure and compare measures of CRS disease severity with sleep dysfunction.
Cross-sectional evaluation of a multi-center cohort
Patients with CRS according to the 2007 Adult Sinusitis Guidelines 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). 75.0% of patients reported PSQI scores above the traditional cut-off 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 non-smokers(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.