Effects of Endoscopic Sinus Surgery and Nasal Surgery in Patients with Obstructive Sleep Apnea

Yalamanchali, Sreeya; Cipta, Stephanie; Waxman, Jonathan; Pott, Thomas; Joseph, Ninos J.; Friedman, Michael

doi:10.1177/0194599814528296

Cited by 36 publications

(50 citation statements)

References 21 publications

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“…1 Furthermore, other investigators have shown that patients with CRS and OSA undergoing polypectomy do not reduce their AHI, whereas patients without nasal polyposis did demonstrate significant improvement in AHI scores. 27 Likewise, herein we demonstrate that the difference in polyp status between those with and without OSA did not appear to contribute to the observed difference in sleep dysfunction improvement.…”

Section: Discussionsupporting

confidence: 49%

“…Functional endoscopic sinus surgery has been shown to reduce AHI in patients with moderate to severe OSA, but these improvements were not clinically significant. 27 Likewise, we demonstrate that patients with CRS and OSA do not have significant improvements in sleep quality using the PSQI following FESS. Unfortunately, we did not objectively evaluate nasal obstruction and multilevel airway obstruction in this investigation and are unable to decipher the precise role that FESS plays in improving nasal obstruction as it relates to sleep in our cohort.…”

Section: Discussionmentioning

confidence: 58%

See 1 more Smart Citation

Quality of Life in Patients With Chronic Rhinosinusitis and Sleep Dysfunction Undergoing Endoscopic Sinus Surgery

Alt

DeConde

Mace

et al. 2015

JAMA Otolaryngol Head Neck Surg

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Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 58%

Quality of Life in Patients With Chronic Rhinosinusitis and Sleep Dysfunction Undergoing Endoscopic Sinus Surgery

Alt

DeConde

Mace

et al. 2015

JAMA Otolaryngol Head Neck Surg

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show abstract

“…More recently, a retrospective study divided CRS patients with comorbid OSA who underwent ESS into three groups: patients with mild OSA, moderate OSA, and severe OSA. Following surgery, patients underwent PSG studies which demonstrated no improvement in objective measures of SQ with no significant changes in NREM stage N2, stage N3, and REM sleep …”

Section: Discussionmentioning

confidence: 99%

“…Following surgery, patients underwent PSG studies which demonstrated no improvement in objective measures of SQ with no significant changes in NREM stage N2, stage N3, and REM sleep. 37 Treatment: Medical vs. Surgical. Typically, the treatment for patients with CRS begins with appropriate medical management.…”

Section: Objective Measures Of Sleep Qualitymentioning

confidence: 99%

Sleep Dysfunction and its Association to Chronic Rhinosinusitis: Updated Review

Orb

Orlandi

Alt

2017

Laryngoscope Investig Oto

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Background Poor sleep has significant effects on health contributing to increased morbidity and mortality. The direct and indirect costs of sleep dysfunction total well in to the billions of dollars annually in the US. Chronic rhinosinusitis (CRS) affects up to 16% of the US population and has been linked to poor sleep quality with up to three quarters of patients with CRS reporting poor sleep quality. There is a growing body of literature evaluating the relationship between sleep and CRS. In this review, we organize and present the current knowledge on the associations between sleep and CRS as well as identify areas for further investigation. Data Sources A structured literature search from 1946 to 2016 was conducted in the English language using OVID MEDLINE database, PubMed and EMBASE. Review Methods Abstracts were reviewed for relevance and appropriate studies were included in the narrative review. Results Studies were analyzed and discussed as they pertained to the following categories of CRS and sleep: (1) subjective measures of sleep dysfunction, (2) objective measures of sleep dysfunction, and (3) outcomes on sleep quality following treatment of CRS. Articles on the pathophysiology of sleep dysfunction in CRS were separately reviewed. Conclusions An evolving body of research demonstrates that quality of sleep is compromised in the majority of patients with CRS. Following treatment of CRS, there is significant improvement in subjective sleep quality, but additional research investigating objective measures following treatment is still needed. Additionally, further investigation is required to better elucidate the underlying pathophysiology of the relationship between sleep dysfunction and CRS.

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“…In this study, patients were grouped, based on their AHI, as mild, moderate, or severe OSA. AHI scores improved in patients with moderate OSA (from 22.3 ± 4.8 to 20.7 ± 8.2, p = 0.023) and severe OSA (from 52.3 ± 21.4 to 43.6 ± 23.9, p = 0.034), while patients with mild OSA did not show significant changes in AHI [57]. Of note, despite statistically significant changes of the AHI, surgery did not completely improve the AHI, which was still well above the cutoff of 5 for normal sleep, reinforcing the idea that in CRS patients with comorbid OSA, sleep apnea needs to be treated with effective therapeutic measures targeting OSA.…”

Section: Osa In Crsmentioning

confidence: 99%

Sleep disruption in chronic rhinosinusitis

Mahdavinia

Schleimer

Keshavarzian

2017

Expert Review of Anti-infective Therapy

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Introduction Chronic rhinosinusitis (CRS) is a common disease of the upper airways and paranasal sinuses with a marked decline in quality of life (QOL). CRS patients suffer from sleep disruption at a significantly higher proportion (60 to 75%) than in the general population (8–18%). Sleep disruption in CRS causes decreased QOL and is linked to poor functional outcomes such as impaired cognitive function and depression. Areas covered A systematic PubMed/Medline search was done to assess the results of studies that have investigated sleep and sleep disturbances in CRS. Expert commentary These studies reported sleep disruption in most CRS patients. The main risk factors for sleep disruption in CRS include allergic rhinitis, smoking, and high SNOT-22 total scores. The literature is inconsistent with regard to the prevalence of sleep-related disordered breathing (e.g. obstructive sleep apnea) in CRS patients. Although nasal obstruction is linked to sleep disruption, the extent of sleep disruption in CRS seems to expand beyond that expected from physical blockage of the upper airways alone. Despite the high prevalence of sleep disruption in CRS, and its detrimental effects on QOL, the literature contains a paucity of studies that have investigated the mechanisms underlying this major problem in CRS.

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Effects of Endoscopic Sinus Surgery and Nasal Surgery in Patients with Obstructive Sleep Apnea

Abstract: Although combined nasal and sinus surgery may slightly improve AHI in a certain group of patients, it does not cure OSA or have a significant clinical impact.

Cited by 36 publications

References 21 publications

Quality of Life in Patients With Chronic Rhinosinusitis and Sleep Dysfunction Undergoing Endoscopic Sinus Surgery

Quality of Life in Patients With Chronic Rhinosinusitis and Sleep Dysfunction Undergoing Endoscopic Sinus Surgery

Sleep Dysfunction and its Association to Chronic Rhinosinusitis: Updated Review

Sleep disruption in chronic rhinosinusitis

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