School of Medicine, West Virginia University, Morgantown, WV, United States.
Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, WV, United States.
Am J Otolaryngol. 2024 Sep-Oct;45(5):104423. doi: 10.1016/j.amjoto.2024.104423. Epub 2024 Jul 20.
To evaluate the impact of obstructive sleep apnea (OSA) on the quality-of-life (QoL) of patients with chronic rhinosinusitis (CRS).
Retrospective cohort study of all adult patients with CRS presenting to our rhinology clinic between August 2020 and February 2023 was performed. OSA was established based on positive polysomnography. Patients' characteristics, apnea-hypopnea index, comorbidities, endoscopy scores, and SNOT-22 scores were collected.
A total of 513 patients with CRS were included, 127 patients with OSA and 386 without OSA. CRS patients with OSA were older (p < 0.001), had higher BMI (p < 0.001), more likely to be males (p = 0.07), more likely to have asthma (p < 0.001), and more likely to have COPD (p = 0.001). Presence of nasal polyps did not differ between the two groups. Baseline SNOT-22 scores were worse in the OSA cohort (44.4 vs 40.5, p = 0.064) secondary to worse sleep (13.4 vs 11.1; p = 0.002) and psychological (14.2 vs 11.5; p = 0.002) domains. Worse SNOT scores were strongly associated with presence of OSA after adjusting for confounding variables, including age, gender, asthma, allergic rhinitis, nasal septal deviation, and smoking status.
OSA is an independent negative contributor to the disease specific QoL in patients with CRS. CPAP use does not seem to affect the QoL in CRS patients with OSA. Further research is warranted to explore the impact of OSA in the outcome of medical and surgical treatment of CRS patients.
评估阻塞性睡眠呼吸暂停（OSA）对慢性鼻-鼻窦炎（CRS）患者生活质量（QoL）的影响。
对 2020 年 8 月至 2023 年 2 月期间在我们鼻科诊所就诊的所有成人 CRS 患者进行回顾性队列研究。根据阳性多导睡眠图（PSG）结果确定 OSA 患者。收集患者特征、呼吸暂停低通气指数、合并症、内镜评分和 SNOT-22 评分。
共纳入 513 例 CRS 患者，其中 127 例患者患有 OSA，386 例患者无 OSA。与无 OSA 患者相比，患有 OSA 的 CRS 患者年龄更大（p<0.001）、BMI 更高（p<0.001）、男性比例更高（p=0.07）、哮喘发生率更高（p<0.001）、COPD 发生率更高（p=0.001）。两组患者中鼻息肉的存在情况无差异。OSA 组患者的 SNOT-22 基线评分较差（44.4 分比 40.5 分，p=0.064），这主要是由于睡眠（13.4 分比 11.1 分；p=0.002）和心理（14.2 分比 11.5 分；p=0.002）方面的评分更差。在调整混杂因素（包括年龄、性别、哮喘、变应性鼻炎、鼻中隔偏曲和吸烟状况）后，SNOT 评分较差与 OSA 的存在具有很强的相关性。
OSA 是 CRS 患者疾病特异性 QoL 的独立负面因素。CPAP 治疗似乎不会影响患有 OSA 的 CRS 患者的 QoL。需要进一步研究以探讨 OSA 对 CRS 患者接受药物和手术治疗的效果的影响。
