Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Oregon Health and Science University, Portland, Oregon.
Laryngoscope. 2013 Oct;123(10):2364-70. doi: 10.1002/lary.24040. Epub 2013 Aug 5.
OBJECTIVES/HYPOTHESIS: 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.
Cross-sectional evaluation of a multi-center cohort.
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.
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).
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.
2b.
目的/假设：使用经过验证的结果测量方法评估慢性鼻-鼻窦炎（CRS）患者的睡眠质量，并比较 CRS 疾病严重程度与睡眠功能障碍的测量方法。
多中心队列的横断面评估。
根据 2007 年成人鼻窦炎指南，前瞻性地从北美四个学术性三级保健中心招募 CRS 患者。每位患者除了完成 CRS 特定的生活质量（QOL）、内窥镜、计算机断层扫描（CT）和嗅觉测量外，还完成了匹兹堡睡眠质量指数（PSQI）量表。将睡眠质量“好”（PSQI；≤5）和“差”（PSQI；>5）的患者的患者人口统计学、合并症和疾病严重程度的临床测量值进行比较。
患者（n=268）报告的平均 PSQI 评分为 9.4（范围：0-21）。75%的患者报告 PSQI 评分高于传统临界值，表明睡眠质量差。睡眠质量差的患者在鼻-鼻窦炎生活质量问卷（Rhinosinusitis Disability Index，RDI）（P<0.001）和 22 项鼻-鼻窦结局测试（22-item Sinonasal Outcome Test，SNOT-22）（P<0.001）上的 QOL 评分明显更差。睡眠质量好和差的患者之间的平均内窥镜、CT 或嗅觉功能评分无显著差异。与非吸烟者相比，吸烟者的平均 PSQI 总分报告更差（P=0.030）。即使在控制性别后，报告睡眠质量差的患者更有可能有抑郁病史（P=0.020）。
大多数 CRS 患者的睡眠质量较差，这可以通过 PSQI 调查来衡量。睡眠质量差与 CRS 特定的 QOL、性别、合并抑郁和烟草使用显著相关，而与 CT 评分或内窥镜分级无关。
2b。
