Hui Jessica W, Ong Jason, Herdegen James J, Kim Hajwa, Codispoti Christopher D, Kalantari Vahid, Tobin Mary C, Schleimer Robert P, Batra Pete S, LoSavio Phillip S, Mahdavinia Mahboobeh
Department of Internal Medicine and Pediatrics, Rush University Medical Center, Chicago, Illinois.
Sleep Disorders Service and Research Center, Rush University Medical Center, Chicago, Illinois.
Ann Allergy Asthma Immunol. 2017 Jun;118(6):685-688.e1. doi: 10.1016/j.anai.2017.03.009. Epub 2017 Apr 27.
It is widely known that patients with chronic rhinosinusitis (CRS) commonly experience sleep disruption. Many of these patients have the associated diagnosis of obstructive sleep apnea (OSA). However, little is known about the risk factors for developing OSA in the CRS population.
To identify the risk factors for OSA in CRS to determine who should be screened for OSA among patients with CRS.
We evaluated a large cohort of patients with confirmed diagnostic criteria for CRS. Patient medical records were reviewed to identify those with OSA confirmed by overnight polysomnography. Records were further reviewed for demographic information (age, sex, race, and ethnicity), body mass index, and medical history, including the presence of nasal polyps, asthma, aspirin-exacerbated respiratory disease, allergic rhinitis, and eczema. The number of endoscopic sinus operations, duration of CRS, presence of subjective smell loss, and computed tomography Lund-Mackay score were also ascertained.
A total of 916 patients with CRS were included in the study. Implementation of a multivariable regression model for identifying adjusted risk factors revealed that African American patients had a significantly higher risk for OSA than white patients, with an adjusted odds ratio of 1.98 (95% confidence interval, 1.19-3.29). Furthermore, patients with CRS without nasal polyps were at higher risk for OSA, with an odds ratio of 1.63 (95% confidence interval, 1.02-2.61) compared with patients with CRS with nasal polyps.
African American patients with CRS were at higher risk for OSA compared with white patients, and this patient group needs to be screened for OSA.
众所周知，慢性鼻-鼻窦炎（CRS）患者常出现睡眠障碍。这些患者中有许多人被诊断患有阻塞性睡眠呼吸暂停（OSA）。然而，对于CRS人群中发生OSA的危险因素知之甚少。
确定CRS患者发生OSA的危险因素，以确定CRS患者中哪些人应接受OSA筛查。
我们评估了一大群符合CRS确诊诊断标准的患者。查阅患者病历，以确定那些经夜间多导睡眠图证实患有OSA的患者。进一步查阅记录以获取人口统计学信息（年龄、性别、种族和族裔）、体重指数和病史，包括鼻息肉、哮喘、阿司匹林诱发的呼吸道疾病、过敏性鼻炎和湿疹的存在情况。还确定了鼻窦内窥镜手术的次数、CRS的持续时间、主观嗅觉丧失的存在情况以及计算机断层扫描Lund-Mackay评分。
本研究共纳入916例CRS患者。采用多变量回归模型确定校正后的危险因素，结果显示非裔美国患者患OSA的风险显著高于白人患者，校正后的优势比为1.98（95%置信区间，1.19-3.29）。此外，无鼻息肉的CRS患者患OSA的风险更高，与有鼻息肉的CRS患者相比，优势比为1.63（95%置信区间，1.02-2.61）。
与白人患者相比，非裔美国CRS患者患OSA的风险更高，这一患者群体需要接受OSA筛查。
