title: The pain-depression dyad and the association with sleep dysfunction in chronic rhinosinusitis.
abstract: Depression, pain, and sleep disturbance is a symptom cluster often found in patients with chronic illness, exerting a large impact on quality of life (QOL). A wealth of literature exists demonstrating a significant association between depression, pain, and sleep dysfunction in other chronic diseases. This relationship has not been described in patients with chronic rhinosinusitis (CRS).
  
  
  
  Sixty-eight adult patients with CRS were prospectively enrolled. Patients at risk for depression were identified using the Patient Health Questionnaire-2 (PHQ-2) using a cut-off score of ≥1. Pain experience was measured using the Brief Pain Inventory Short Form (BPI-SF) and the Short Form McGill Pain Questionnaire (SF-MPQ). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI).
  
  
  
  Forty-seven patients were at risk for depression. Significant positive correlations were found between total PSQI scores and all pain measures (R = 0.38-0.61, p ≤ 0.05) and between total PSQI scores and PHQ-2 scores (R = 0.46, p < 0.05). For patients at risk for depression, significant, positive correlations were found between pain measures, the total PSQI score, and the 3 PSQI subdomains (sleep latency, sleep quality, and daytime dysfunction; R = 0.31-0.61, p < 0.05). The relationship between pain and sleep dysfunction scores was not seen in the absence of depression.
  
  
  
  Depression, pain, and sleep dysfunction are interrelated in patients with CRS. In the absence of depression, significant correlations between pain and sleep are not observed, suggesting that depression plays a key role in this interaction. Further research is needed to investigate the complex relationship between depression, pain, and sleep dysfunction in CRS.
authors.affiliation: Sinus and Skull Base Surgery Program, Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah, Salt Lake City, UT.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Cox
authors.affiliation: Sinus and Skull Base Surgery Program, Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah, Salt Lake City, UT.
authors.forename: Shaelene
authors.initials: S
authors.lastname: Ashby
authors.affiliation: Rhinology and Skull Base Division, Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, OR.
authors.forename: Jess C
authors.initials: JC
authors.lastname: Mace
authors.affiliation: Rhinology and Anterior Skull Base, Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, GA.
authors.forename: John M
authors.initials: JM
authors.lastname: DelGaudio
authors.affiliation: Rhinology and Skull Base Division, Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, OR.
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Smith
authors.affiliation: Sinus and Skull Base Surgery Program, Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah, Salt Lake City, UT.
authors.forename: Richard R
authors.initials: RR
authors.lastname: Orlandi
authors.affiliation: Sinus and Skull Base Surgery Program, Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah, Salt Lake City, UT.
authors.forename: Jeremiah A
authors.initials: JA
authors.lastname: Alt
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003863:Depression / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000150:complications*; D012220:Rhinitis / Q000150:complications*; D012852:Sinusitis / Q000150:complications*; D012893:Sleep Wake Disorders / Q000150:complications*; D011795:Surveys and Questionnaires
keywords: chronic disease; depression; outcome assessment; pain; sinusitis; sleep