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Sleep disruption in chronic rhinosinusitis improves using exhalation-delivery nasal steroid therapy
Donyea L Moore1, Rachel Nolte2, Shreya Maharana3
1Division of Allergy and Immunology, Department of Internal Medicine, The University of Texas Health Science Center, Houston, Texas; Division of Allergy and Immunology, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois.
Background:
Chronic rhinosinusitis is a common inflammatory condition that often leads to significant sleep disturbances, negatively affecting quality of life. Although intranasal steroids are a standard treatment, their effect on sleep disturbances in chronic rhinosinusitis has not been extensively studied.
Objective:
To determine whether a nasal steroid delivered through exhalation could improve sleep quality in chronic rhinosinusitis.
Methods:
Patients with chronic rhinosinusitis were treated with nasal fluticasone through an exhalation delivery system for 4 months. Sleep assessments were conducted at baseline and at 2 and 4 months post-treatment using comprehensive sleep and quality-of-life measures. Blood samples were taken at baseline to assess interleukin-6 levels. Regression analysis compared baseline and post-treatment data, adjusting for demographics. The influence of interleukin-6 levels and allergic comorbidities on treatment response was also evaluated.
Results:
Significant improvements were observed in sinonasal symptoms and sleep quality at 2 and 4 months (P < .05). Daytime sleepiness revealed trends toward improvement. Interleukin-6 levels below 6 ng/mL and absence of asthma were associated with response to treatment in terms of sleep quality.
Conclusion:
High-distribution nasal steroids delivered through an exhalation system significantly improved sleep quality in patients with chronic rhinosinusitis. However, certain subgroups, such as those with lower interleukin-6 and those without comorbid asthma, benefit more significantly in terms of sleep quality.
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