title: Sleep quality and disease severity in patients with chronic rhinosinusitis.
abstract: OBJECTIVE
  To evaluate sleep quality in patients with chronic rhinosinusitis (CRS) using a validated outcome measure and to compare measures of CRS disease severity with sleep dysfunction.
  
  
  METHODS
  Cross-sectional evaluation of a multi-center cohort.
  
  
  METHODS
  According to the 2007 Adult Sinusitis Guidelines, patients with CRS 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.
  
  
  RESULTS
  Patients (n = 268) reported a mean PSQI score of 9.4 (range: 0-21). Seventy-five percent of patients reported PSQI scores above the traditional cutoff, 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 nonsmokers (P = 0.030). Patients reporting poor sleep were more likely to have a history of depression, even after controlling for gender (P = 0.020).
  
  
  CONCLUSIONS
  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.
  
  
  METHODS
  2b.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Oregon Health and Science University, Portland, Oregon.
authors.forename: Jeremiah A
authors.initials: JA
authors.lastname: Alt
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Smith
authors.forename: Jess C
authors.initials: JC
authors.lastname: Mace
authors.forename: Zachary M
authors.initials: ZM
authors.lastname: Soler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012220:Rhinitis / Q000453:epidemiology*; D012307:Risk Factors; D012720:Severity of Illness Index; D012852:Sinusitis / Q000453:epidemiology*; D012890:Sleep; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult
keywords: Sinusitis; chronic disease; quality of life; rhinology; sleep
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