Sleep impairment in patients with empty nose syndrome

Abstract

Background: Empty nose syndrome (ENS) is characterized by paradoxical nasal obstruction that usually occurs after turbinate surgery. Patients with ENS may also experience significant psychiatric symptoms and sleep dysfunction, which negatively affect the quality of life of affected subjects. This study aimed to evaluate sleep impairment and sleepiness in patients with ENS. Methods: Patients with ENS and control participants were recruited prospectively. The Sino-Nasal Outcome Test-25 (SNOT-25), Empty Nose Syndrome 6-item Questionnaire (ENS6Q), Epworth Sleepiness Scale (EpSS), and modified sleep quality index (MSQI) were used to evaluate the participants before and after nasal surgery. Results: Forty-eight patients with ENS and forty-eight age- and sex-matched control subjects were enrolled. The SNOT-25, ENS6Q, EpSS, and MSQI scores in the ENS group were all significantly higher than those in the control group before and after surgery. After surgery, ENS patients all exhibited significant improvements in SNOT-25, ENS6Q, EpSS, and MSQI scores. Regression analysis revealed that SNOT-25 score was a significant predictor of EpSS and MSQI in preoperative evaluations. ENS patients experiencing daytime sleepiness suffered from significantly more “dryness of nose” and “suffocation” than those not experiencing daytime sleepiness. Conclusions: Patients with ENS experienced significantly impaired sleep quality and sleepiness. Nasal reconstruction surgery improved the sleep quality of ENS patients. The severity of sleep dysfunction is associated with the severity of ENS symptoms. Recognizing individuals with significant sleep impairment and sleepiness and providing appropriate management are critical issues for ENS patients.

Impact of sleep dysfunction on psychological burden in patients with empty nose syndrome

“…Patients with ENS usually carry a substantial psychological burden and experience significant sleep dysfunction. [2][3][4] Previous studies have demonstrated that depression and anxiety are prevalent in patients with ENS and could be predictors of surgical outcomes and residual disease. the EpSS and MSQI in the present study.…”

“…The Empty Nose Syndrome 6-item Questionnaire (ENS6Q), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Epworth Sleepiness Scale (EpSS), and modified sleep quality index (MSQI) were used to measure the severity of symptoms, psychological burden (depression and anxiety), and sleep quality before and 6 months after surgery. 2,3 Data are shown as mean ± standard deviation (SD) and were statistically analyzed. Perioperative measurements were compared and analyzed using the Wilcoxon signedrank test and Pearson's correlation coefficient.…”

“…The Empty Nose Syndrome 6‐item Questionnaire (ENS6Q), Beck Depression Inventory‐II (BDI‐II), Beck Anxiety Inventory (BAI), Epworth Sleepiness Scale (EpSS), and modified sleep quality index (MSQI) were used to measure the severity of symptoms, psychological burden (depression and anxiety), and sleep quality before and 6 months after surgery 2,3 …”

“…Previous studies have also revealed significantly impaired sleep quality and sleepiness experienced by patients with ENS 2–4 . It is possible that poor sleep quality due to empty nose symptoms can lead to or aggravate the psychological burden in these patients 3 .…”

“…1 Previous studies have also revealed significantly impaired sleep quality and sleepiness experienced by patients with ENS. [2][3][4] It is possible that poor sleep quality due to empty nose symptoms can lead to or aggravate the psychological burden in these patients. 3 Besides, the psychological burden is an important determining factor for the surgical outcomes and residual disease after surgery.…”