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Improvements in sleep‐related symptoms after endoscopic sinus surgery in patients with chronic rhinosinusitis
Author(s) -
El Rassi Edward,
Mace Jess C.,
Steele Toby O.,
Alt Jeremiah A.,
Smith Timothy L.
Publication year - 2016
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.21682
Subject(s) - medicine , sleep (system call) , chronic rhinosinusitis , cohort , cohort study , anesthesia , computer science , operating system
Background Sleep impairment is highly prevalent in patients with chronic rhinosinusitis (CRS). Although endoscopic sinus surgery (ESS) has been shown to improve overall patient‐reported sleep quality, the postoperative impact on individual sleep symptoms remains unclear. Methods Patients with medically‐recalcitrant CRS who elected to undergo ESS were prospectively enrolled into a multi‐institutional, observational cohort study. Sleep‐related symptom severity and treatment outcomes were assessed using the sleep domain questions within the 22‐item Sino‐Nasal Outcome Test (SNOT‐22). Results A total of 334 participants met criteria and were followed postoperatively for an average of 14.5 ± 4.9 months (mean ± standard deviation [SD]). Mean SNOT‐22 sleep domain scores improved from 13.7 ± 6.8 to 7.7 ± 6.6 ( p < 0.001). Significant mean relative improvements were reported for “difficulty falling asleep” (45%; p < 0.001), “waking up at night” (40%; p < 0.001), “lack of a good night's sleep” (43%; p < 0.001), “waking up tired” (40%; p < 0.001), and “fatigue” (42%; p < 0.001) scores. A total of 66% of study participants reported postoperative improvement in “lack of a good night's sleep,” “waking up tired,” and “fatigue”; 62% reported improvement in “waking up at night”; and 58% reported improvement in “difficulty falling asleep.” Conclusion Patients with CRS report significant and sustained improvements following ESS in common sleep‐related symptoms as assessed by the SNOT‐22 sleep domain. Despite these significant improvements, some degree of persistent postoperative sleep impairment was reported. Further study is necessary to determine what factors are associated with continued sleep dysfunction after sinus surgery.