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Incident chronic rhinosinusitis is associated with impaired sleep quality: Results of the RhiNE study

Journal article
Authors C. Bengtsson
L. Jonsson
M. Holmström
Johan Hellgren
K. Franklin
T. Gíslason
Mathias Holm
A. Johannessen
R. Jõgi
V. Schlünssen
C. Janson
E. Lindberg
Published in Journal of Clinical Sleep Medicine
Volume 15
Issue 6
Pages 899-905
ISSN 1550-9389
Publication year 2019
Published at Institute of Medicine, Department of Public Health and Community Medicine, Section of Occupational and environmental medicine
Institute of Clinical Sciences, Department of Otorhinolaryngology
Pages 899-905
Language en
Links dx.doi.org/10.5664/jcsm.7846
Keywords Chronic rhinosinusitis, CRS, Epidemiology, Insomnia, Sleep quality
Subject categories Epidemiology

Abstract

Study Objectives: Chronic rhinosinusitis (CRS) is a common inflammatory disease of the nasal cavity and paranasal sinuses. Associations between CRS and poor sleep quality have been reported. This 10-year follow-up study investigates possible associations between incident CRS and sleep quality. Methods: A questionnaire was sent to 16,500 individuals in Sweden, Norway, Denmark, Iceland and Estonia in 2000. It included questions on airway diseases, age, sex, body mass index, smoking habits, comorbidities, education and sleep quality. In 2010, a second questionnaire was sent to the same individuals, with a response rate of 53%. A subgroup of 5,145 individuals without nasal symptoms in 2000 was studied. Multiple logistic regression was performed to examine associations between CRS (defined according to the European position paper on rhinosinusitis and nasal polyps epidemiological criteria) at follow-up and sleep quality, with adjustment for potential confounders. Individuals with the respective sleep problem at baseline were excluded. Results: Over 10 years, 141 (2.7%) of the individuals without nasal symptoms in 2000 had developed CRS. CRS was associated with difficulties inducing sleep (adjusted odds ratio 2.81 [95% CI 1.67–4.70]), difficulties maintaining sleep (2.07 [1.35–3.18]), early morning awakening (3.03 [1.91–4.81]), insomnia (2.21 [1.46–3.35]), excessive daytime sleepiness (2.85 [1.79–4.55]), and snoring (3.31 [2.07–5.31]). Three insomnia symptoms at baseline increased the risk of CRS at follow-up by 5.00 (1.93–12.99). Conclusions: Incident CRS is associated with impaired sleep quality and excessive daytime sleepiness. Insomnia symptoms may be a risk factor for the development of CRS. © 2019 American Academy of Sleep Medicine. All rights reserved.

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