title: Risk factors for sleep impairment in adult patients with chronic rhinosinusitis.
abstract: OBJECTIVE
  Although sleep impairment is reported by patients with chronic rhinosinusitis, the associated factors have not been well studied. Therefore, we determined the associated risk factors for sleep impairment in patients with chronic rhinosinusitis (CRS).
  
  
  METHODS
  This study was a prospective cohort study. A total of 572 adult patients (171 women, 401 men; mean age, 49.0 years; range, 18-64 years) who completed a questionnaire, had a clinical examination, and underwent endoscopic sinus surgery were analyzed using stepwise multiple linear regression.
  
  
  RESULTS
  With regard to subjective symptoms, nasal obstruction (beta coef., 0.27; p<0.001), anterior nasal drainage (beta coef., 0.13; p=0.004), facial pain/pressure (beta coef., 0.09; p=0.048), headache (beta coef., 0.10; p=0.010), and cough (beta coef., 0.14; p<0.001) were predictors of an increased risk of sleep impairment of CRS (adjusted R(2), 0.240; p=0.048). In the matter of background parameters, total polyp score (polyp grading system) (beta coef., 0.16; p<0.001) and allergic rhinitis (beta coef., 0.09; p=0.034) were predictors of an increased risk of sleep impairment of CRS (adjusted R(2), 0.029; p=0.034).
  
  
  CONCLUSIONS
  These results suggest that sleep impairment in these patients is caused by the various mechanisms associated with nasal symptoms themselves, CRS and allergic rhinitis. However, the specific pathophysiology has not been clarified yet; further studies are expected to elucidate that of sleep impairment in patients with CRS.
authors.affiliation: Department of Otorhinolaryngology, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan. Electronic address: andoh523@jikeil.ac.jp.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ando
authors.affiliation: Department of Otorhinolaryngology, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Chiba
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Sleep Surgery Division, Stanford University Medical Center, Stanford, 450 Broadway Street, Pavilion B, 2nd Floor, B21, Redwood City, CA 94063, USA.
authors.forename: Robson
authors.initials: R
authors.lastname: Capasso
authors.affiliation: Department of Otorhinolaryngology, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan.
authors.forename: Tetsushi
authors.initials: T
authors.lastname: Okushi
authors.affiliation: Department of Otorhinolaryngology, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kojima
authors.affiliation: Department of Otorhinolaryngology, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan.
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Otori
authors.affiliation: Department of Otorhinolaryngology, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan.
authors.forename: Kota
authors.initials: K
authors.lastname: Wada
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D015331:Cohort Studies; D003371:Cough / Q000453:epidemiology*; D004724:Endoscopy; D005157:Facial Pain / Q000453:epidemiology*; D005260:Female; D006261:Headache / Q000453:epidemiology*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015508:Nasal Obstruction / Q000453:epidemiology*; D009298:Nasal Polyps / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery; D011446:Prospective Studies; D012220:Rhinitis / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D065631:Rhinitis, Allergic / Q000453:epidemiology / Q000503:physiopathology; D012307:Risk Factors; D012852:Sinusitis / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D012893:Sleep Wake Disorders; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Adult; Chronic rhinosinusitis; Nasal obstruction; Risk factors; Sleep impairment