Obstructive Sleep Apnea and the Subsequent Risk of Chronic Rhinosinusitis: A Population-Based Study

Hung, Shih‐Han; Lin, Herng Ching; Liu, Chih Kuang; Huang, Hung Meng; Wu, Cheng-Shong

doi:10.1038/srep20786

Cited by 23 publications

(17 citation statements)

References 39 publications

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“…Although CRS and OSA are comorbid conditions, at this point it is difficult to assess whether there is a relationship between the 2 conditions. Kao et al 20 followed up patients with OSA for 5 years and concluded that both males and females with OSA had higher risk of developing subsequent CRS. Tan et al 21 also found that patients with CRS had increased premorbid prevalence of OSA.…”

Section: Discussionmentioning

confidence: 99%

Risk of obstructive sleep apnea in African American patients with chronic rhinosinusitis

Hui

Ong

Herdegen

et al. 2017

Annals of Allergy, Asthma & Immunology

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Background 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. Objective To identify the risk factors for OSA in CRS to determine who should be screened for OSA among patients with CRS. Methods 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. Results 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. Conclusion 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.

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Section: Discussionmentioning

confidence: 99%

Risk of obstructive sleep apnea in African American patients with chronic rhinosinusitis

Hui

Ong

Herdegen

et al. 2017

Annals of Allergy, Asthma & Immunology

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“…A large population-based retrospective cohort study comparing the incidence of CRS within 5 years after the index date showed an OR of 3.18 (95% CI, 1.38-5.01) for CRS in subjects with OSA compared with those without OSA. 27 Potential mechanisms for an increased risk of OSA related to CRS include the effect of nasal obstruction on collapsibility of the nasopharynx downstream. An increase in nasal resistance is the most likely mechanism and could be caused by inflammation related to an elevated nasal resistance.…”

Section: Discussionmentioning

confidence: 99%

Chronic Rhinosinusitis Is an Independent Risk Factor for OSA in World Trade Center Responders

Sunderram

Weintraub

Black

et al. 2019

Chest

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BACKGROUND: Many respiratory conditions have been attributed to toxic dust and fume exposure in World Trade Center (WTC) rescue and recovery workers, who frequently report symptoms of OSA. We examined the prevalence of new-onset OSA and tested if the prevalence and severity of OSA are related to the presence of chronic rhinosinusitis (CRS).METHODS: A total of 601 subjects (83% men; age, 33-87 years; BMI, 29.9 AE 5.5 kg/m 2 ) enrolled in the WTC Health Program, excluding those with significant pre-September 11, 2001, snoring or prior CRS, underwent two nights of home sleep testing. OSA was defined as Apnea Hypopnea Index 4% $ 5 events/h or respiratory disturbance index of $ 15 events/h. CRS was assessed using nasal symptom questionnaires. RESULTS:The prevalence of OSA was 75% (25% no OSA, 46% mild OSA, 19% moderate OSA, and 10% severe OSA), and the prevalence of CRS was 43.5%. Compared with no CRS, new and worsening CRS was a significant risk factor for OSA with an OR of 1.80 (95% CI, 1.18-2.73; P ¼ .006) unadjusted and 1.76 (95% CI, 1.08-2.88; P ¼ .02) after adjustment for age, BMI, sex, gastroesophageal reflux disorder, and alcohol use. CONCLUSIONS:The high prevalence of OSA in WTC responders was not explained fully by obesity and sex. Possible mechanisms for the elevated risk of OSA in subjects with CRS include increased upper airway inflammation and/or elevated nasal/upper airway resistance, but these need confirmation.

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“…A systematic review suggested that bothersome symptoms of rhinosinusitis is associated with sleep disordered breathing and is thought to be a key cause of sleep impairment 19 . However, recent population-based cohort study 20 showed that patients with obstructive sleep apnea (OSA) had a higher risk of CRS compared to patients without OSA. They explained that abnormal inflammatory reactions of OSA patients might contribute to the development and exacerbation of CRS.…”

Section: Discussionmentioning

confidence: 99%

Association between Sleep Duration and Chronic Rhinosinusitis among the Korean General Adult Population: Korea National Health and Nutrition Examination Survey

Kim

Jung

Choi

et al. 2019

Sci Rep

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An association between sleep duration and a wide spectrum of diseases has been reported, but little is known about its relationship with chronic rhinosinusitis (CRS). The present study aimed to investigate whether sleep duration was associated with CRS after adjusting for potential confounding factors in Korean adults. We analyzed data from the Korea National Health and Nutrition Examination Survey 2005–2009 and enrolled 24,658 participants aged ≥20 years. Data regarding sociodemographic characteristics, self-reported sleep duration, CRS, and other medical diseases were collected from questionnaires. Multiple logistic regression analyses were used to identify the relationship between sleep duration and CRS. The overall prevalence of CRS was 4.4%. Subjects with sleep duration ≤5 hours showed a highest prevalence for CRS (6.1%), compared to subjects with longer sleep duration ( p = 0.02). After adjusting for covariates (age, sex, household income, residency, dwelling type, education, depression, alcohol, allergic rhinitis, chronic otitis media, angina or myocardial infarction, asthma, chronic obstructive pulmonary disease, bronchiectasis, and gastric ulcer), the sleep duration of ≤5 hours was significantly associated with CRS (OR = 1.502; 95% CI = 1.164–1.938). Only in older subgroup (≥50 years old), shorter sleep duration (≤5 hours) showed higher odds for CRS. These results suggested that sleep duration may be negatively associated with CRS in older Korean adults.

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Obstructive Sleep Apnea and the Subsequent Risk of Chronic Rhinosinusitis: A Population-Based Study

Cited by 23 publications

References 39 publications

Risk of obstructive sleep apnea in African American patients with chronic rhinosinusitis

Risk of obstructive sleep apnea in African American patients with chronic rhinosinusitis

Chronic Rhinosinusitis Is an Independent Risk Factor for OSA in World Trade Center Responders

Association between Sleep Duration and Chronic Rhinosinusitis among the Korean General Adult Population: Korea National Health and Nutrition Examination Survey

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