title: Nasal obstruction has a limited impact on sleep quality and quality of life in patients with chronic rhinosinusitis.
abstract: Nasal obstruction is a cardinal symptom in diagnosing chronic rhinosinusitis (CRS), and decreased sleep quality (SQ) and quality of life (QOL) are commonly reported in CRS. It is, however, unclear what role nasal obstruction severity plays in this decreased SQ and QOL. Using validated instruments, we evaluated the relationship between nasal obstruction severity, SQ, and QOL.
  
  
  
  Prospective case series.
  
  
  
  Patients with CRS refractory to standard medical therapy (n = 28) were prospectively enrolled and completed the Nasal Obstruction Symptom Evaluation (NOSE), Pittsburg Sleep Quality Index (PSQI), Rhinosinusitis Disability Index, and the 22-item Sinonasal Outcome Test. CRS disease severity was evaluated with computed tomography and endoscopy. NOSE scores were compared to SQ, QOL, and disease severity measures. Spearman correlations were used to identify significant associations between measures.
  
  
  
  All patients reported symptomatic nasal obstruction (NOSE score ≥ 30), whereas poor sleep (PSQI ≥ 5) was reported by 82%. The NOSE sleeping subdomain correlated strongly with the PSQI total score, whereas other elements of the NOSE instrument correlated weakly or not at all with this measurement of SQ. Nasal obstruction correlated weakly with disease-specific QOL and had no correlation with the PSQI total.
  
  
  
  Nasal obstruction appears to have a limited association with CRS-specific QOL and CRS-associated decrease in SQ. Further, the NOSE instrument, because it contains a question about sleep, may have overlap with the PSQI as a measure of SQ. The total NOSE score in CRS patients does not appear to be purely a measure of nasal obstruction.
  
  
  
  4 Laryngoscope, 126:1971-1976, 2016.
authors.affiliation: Division of Head and Neck Surgery, Rhinology-Sinus and Skull Base Surgery Program, Department of Surgery, University of Utah, Salt Lake City, Utah.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Thomas
authors.affiliation: Division of Head and Neck Surgery, Rhinology-Sinus and Skull Base Surgery Program, Department of Surgery, University of Utah, Salt Lake City, Utah.
authors.forename: Richard R
authors.initials: RR
authors.lastname: Orlandi
authors.affiliation: Division of Head and Neck Surgery, Rhinology-Sinus and Skull Base Surgery Program, Department of Surgery, University of Utah, Salt Lake City, Utah.
authors.forename: Shaelene
authors.initials: S
authors.lastname: Ashby
authors.affiliation: Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, U.S.A.
authors.forename: Jess C
authors.initials: JC
authors.lastname: Mace
authors.affiliation: Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, U.S.A.
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Smith
authors.affiliation: Division of Head and Neck Surgery, Rhinology-Sinus and Skull Base Surgery Program, Department of Surgery, University of Utah, Salt Lake City, Utah.
authors.forename: Jeremiah A
authors.initials: JA
authors.lastname: Alt
mesh_terms: D002908:Chronic Disease; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000209:etiology*; D011446:Prospective Studies; D011788:Quality of Life; D012220:Rhinitis / Q000150:complications*; D012720:Severity of Illness Index; D012852:Sinusitis / Q000150:complications*; D012890:Sleep; D063189:Symptom Assessment
keywords: Nasal obstruction; chronic rhinosinusitis; quality of life; sleep quality