title: Chronic Rhinosinusitis Impairs Sleep Quality: Results of the GA2LEN Study.
abstract: To analyze the prevalence of sleep problems in subjects with Chronic rhinosinusitis (CRS) and to determine whether the disease severity of CRS affects sleep quality.
  
  
  
  Questionnaires were sent to a random sample of 45 000 adults in four Swedish cities. Questions on CRS, asthma, allergic rhinitis, co-morbidities, tobacco use, educational level, and physical activity were included. CRS was defined according to the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) epidemiological criteria. The disease severity of CRS was defined by the number of reported CRS symptoms. Sleep quality was assessed using the Basic Nordic Sleep Questionnaire.
  
  
  
  Of the 26 647 subjects, 2249 (8.4%) had CRS. Reported sleep problems were 50%-90% more common among subjects with CRS compared with those without or the total population. The prevalence of reported sleep problems increased in conjunction with the severity of CRS. After adjusting for gender, BMI, age, tobacco use, asthma, somatic diseases, physical activity level, and educational level, participants with four symptoms of CRS (compared with subjects without CRS symptoms) displayed a higher risk of snoring (adj. OR [95% CI]: 3.13 [2.22-4.41]), difficulties inducing sleep (3.98 [2.94-5.40]), difficulties maintaining sleep (3.44 [2.55-4.64]), early morning awakening (4.71 [3.47-6.38]) and excessive daytime sleepiness (4.56 [3.36-6.18]). The addition of persistent allergic rhinitis to CRS further increased the risk of sleep problems.
  
  
  
  Sleep problems are highly prevalent among subjects with CRS. The disease severity of CRS negatively affects sleep quality.
authors.affiliation: Department of Surgical Sciences, Otorhinolaryngology, Head and Neck Surgery, Uppsala University, Uppsala, Sweden.
authors.forename: Caroline
authors.initials: C
authors.lastname: Bengtsson
authors.affiliation: Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Lindberg
authors.affiliation: Department of Surgical Sciences, Otorhinolaryngology, Head and Neck Surgery, Uppsala University, Uppsala, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Jonsson
authors.affiliation: Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska University Hospital, Huddinge, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Holmström
authors.affiliation: Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Sundbom
authors.affiliation: Department of Sleep Medicine, Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Hedner
authors.affiliation: Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden.
authors.forename: Andrei
authors.initials: A
authors.lastname: Malinovschi
authors.affiliation: The Centre for Allergy Research, Karolinska Institutet and The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Roelinde
authors.initials: R
authors.lastname: Middelveld
authors.affiliation: Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors.forename: Bertil
authors.initials: B
authors.lastname: Forsberg
authors.affiliation: Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.
authors.forename: Christer
authors.initials: C
authors.lastname: Janson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012220:Rhinitis / Q000150:complications* / Q000175:diagnosis; D012307:Risk Factors; D012720:Severity of Illness Index; D012852:Sinusitis / Q000150:complications* / Q000175:diagnosis; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology*; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: CRS; Chronic rhinosinusitis; epidemiology; persistent allergic rhinitis; population-based; sleep quality.