Endoscopic Sinus Surgery Improves Sleep Quality in Chronic Rhinosinusitis: A Systematic Review and Meta‐analysis

Abstract

Objective Up to 75% of patients with chronic rhinosinusitis (CRS) suffer with poor sleep quality and reduced quality of life. Endoscopic sinus surgery has demonstrated encouraging results in improving sleep function. The aim of this systematic review is to assess the change in sleep quality after surgery for CRS. Data Sources PubMed, Web of Science, EMBASE. Review Methods An electronic search was conducted with the keywords "sinusitis" or "rhinosinusitis" and "sleep." Studies were included only when adults underwent endoscopic sinus surgery and were evaluated pre- and postoperatively by the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), the Apnea-Hypopnea Index (AHI), the sleep domain of Sino-Nasal Outcome Test-22, or the sleep domain of Rhinosinusitis Disability Index. Results The database search yielded 1939 studies, of which 7 remained after dual-investigator screening. The standardized mean differences (95% CI) for the ESS, PSQI, and AHI were -0.94 (-1.63 to -0.26), -0.80 (-1.46 to -0.14), and -0.20 (-0.32 to -0.07), indicating large, moderate to large, and small improvements, respectively. All analyses displayed high heterogeneity ( I = 95%-99%). Conclusion Sleep quality, as measured by the ESS and PSQI surveys, shows substantial improvement after surgery for CRS, with smaller improvement seen for AHI. Generalizability of our results is limited by high heterogeneity among studies and by broad confidence intervals that cannot exclude small to trivial changes. The findings of this meta-analysis provide insight into the effect of CRS-related endoscopic sinus surgery on sleep quality, which should guide future research direction and counseling of patients in the clinical setting.

The impact of medical therapy on cognitive dysfunction in chronic rhinosinusitis

“…Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), a self‐report questionnaire measuring sleep quality and disturbance over the past month . The PSQI is a validated measure with high consistency and reliability, widely used in a variety of clinical populations, including CRS …”

Efecto de la intervención nasal y nasosinusal en calidad de sueño en el Hospital Edgardo Rebagliati Martins 2017

“…Respecto a las características preoperatorias, la muestra estudiada tuvo en promedio baja calidad de sueño medida por el índice de calidad de sueño de Pittsburgh, independientemente del tipo de operación. Estos datos coinciden con los diferentes estudios en pacientes sometidos tanto a intervenciones nasales (septoplastia, rinoseptolastia, reducción de cornetes) (1,(18)(19)(20) como a operación nasosinusal endoscópica por sinusitis crónica (2,5,21) .…”

Qualität in der chirurgischen Therapie chronisch entzündlicher Erkrankungen der Nasennebenhöhlen

“…In several prospective trials and systematic reviews, endonasal endoscopic sinus surgery proved to be effective in the treatment of chronic sinusitis [11,[13][14][15][16][17][18][19]. Combined with medical treatment, it can improve quality of life short-and long-term as well as improve associated disorders such as asthma and sleep disorders; it seems to be more cost-effective than medical therapy alone [20][21][22][23][24][25] (see below).…”