Rhinologic disease and its impact on sleep: a systematic review

Area of Science:

• Otolaryngology
• Sleep Medicine
• Respiratory Medicine

Background:

• Rhinologic diseases, including chronic rhinosinusitis (CRS), rhinitis, and nasal septal deviation (NSD), can cause systemic symptoms impacting mood, cognition, and sleep.
• The precise mechanisms, particularly the obstructive component, underlying sleep disturbances in these rhinologic conditions remain unclear.

Purpose of the Study:

• To review the impact of CRS, rhinitis, and NSD on objective and subjective sleep outcomes.
• To compare sleep metrics in these rhinologic disorders with normal controls and patients with obstructive sleep apnea (OSA).

Main Methods:

• A systematic review of four major databases (PubMed, Scopus, Cochrane Library, Web of Science) was conducted.
• Studies included were those reporting objective (e.g., apnea-hypopnea index) and subjective (e.g., Epworth Sleepiness Scale) sleep parameters, alongside disease-specific patient-reported outcome measures (PROMs).

Main Results:

• Analysis of 103 studies revealed elevated subjective sleep disturbance scores (Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index) across CRS, rhinitis, and NSD groups.
• Objective sleep measures indicated mild to moderate obstructive sleep apnea (OSA) characteristics, with significant differences compared to normative data (p < 0.001).

Conclusions:

• Rhinologic conditions such as CRS, rhinitis, and NSD significantly impact sleep quality.
• A mild obstructive component likely contributes to poor sleep, though other underlying mechanisms may also be involved.