Sleep and chronic rhinosinusitis: a systematic review of postoperative data

Patients with nasal obstruction due to chronic rhinosinusitis with nasal polyposis may present with altered sleep quality. Data on this subject in the literature remains scarce.

To evaluate changes in sleep quality and polysomnographic parameters among patients who underwent functional endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis.

A systematic review was performed in three databases: PubMed, Cochrane, and Embase. The following keywords were used: chronic rhinosinusitis, nasal polyposis, sleep quality, and nasosinusal endoscopic surgery. Studies evaluating adults with nasal polyposis who underwent endoscopic nasosinusal surgery were selected. A meta-analysis was conducted to compare mean scores for polysomnographic and subjective variables from before to after the operation.

A systematic review and meta-analysis of three studies were performed, only one of which was randomized. The total sample consisted of 64 patients. There was a decrease in the mean AHI score and improvements in mean and minimum saturation. The mean difference in percentage of stage N3 from before to after the operation was 1.12 with a 95% CI from -3.51 to 5.75, which was non-significant. There was a mean percentage increase in REM sleep duration and a decrease in PSQI scores, which were both statistically significant ( p  < 0.05).

There were improvements in the quality of sleep and duration of REM sleep after surgery, with no improvement in polysomnographic respiratory parameters.