DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20200133

Sleep disturbances in patient with chronic nasal obstruction due to nasal polyp: a prospective study

Dhiraj Giri, Duane L. Salud

Abstract


Background: Nasal obstruction is thought to be a major cause of sleep impairment. Typical sleep-related problems seen with nasal polyp include snoring, sleep-disordered breathing and sleep apnoea. The impact of nasal polyposis on quality of life is well studied however its effects on sleep have been less well studied. In the current study, we aim to investigate sleep disturbances in Filipino patients with nasal polyposis using different sleep questionnaires VAS score for snoring, Epworth sleepiness scale (ESS) for daytime sleepiness and Pittsburgh sleep quality index (PSQI) for sleep quality and the effect of endoscopic sinus surgery on sleep quality.

Methods: A prospective, non-randomized study was done in the Department of Otorhinolaryngology Head and Neck Surgery of Southern Philippines Medical Center from February 2014 to July 2014. Number of 18 patients with chronic nasal obstruction for more than 6months due to nasal polyps at least grade II on endoscopic examination were included in the study. Visual analogue scale (VAS) score for snoring, ESS for daytime somnolence and PSQI for quality of sleep was compared preoperatively and 1month postoperatively.  

Results: Mean value of VAS score for snoring, mean value of excessive daytime sleepiness measured by ESS and mean PSQI score for sleep quality improved significantly with p<0.001 after endoscopic sinus surgery.

Conclusions: Nasal polyp patients mostly present with nasal obstruction, snoring and excessive daytime sleepiness. Correction of nasal obstruction significantly improves snoring and sleep quality. After endoscopic sinus surgery, patients may experience improvement in snoring and have better sleep quality with decreased daytime sleepiness.


Keywords


Nasal polyps, Nasal obstruction, Sleep disorder breathing, Endoscopic sinus surgery

Full Text:

PDF

References


History of removal of nasal polyps. A Folha Medica (Brazil) 1991;102:183-6.

Brain DJ. Historical background. In: Nasal polyps: epidemiology, pathogenesis and treatment. In: Settipane GA, Lund VJ, Bernstein JM, Tos M (eds.). Providence, RI: OceanSide Publications; 1997: 165-176.

Vancil ME. A historical survey of treatments for nasal polyposis. Laryngoscope. 1969;79:435-45.

Johns MW. A new method for measuring daytime sleepiness: The Epworth Sleepiness Scale. Sleep. 1991;14(6):540-5.

Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213.

Rappai M, Collop N, Kemp S, Deshazo R. The nose and sleep disordered breathing. Chest. 2003;124:2309-23.

Oslen KD, Kern EB, Westbrook PR. Sleep and breathing disturbances secondary to nasal obstruction. Otolaryngol Head Neck Surg. 1981;89:804-10.

Serrano, E., Neukirch, E., Pribil, C. et al. Nasal polyposis in France: impact on sleep and quality of life. J Laryngol Otol. 2005;119:543-9.

Chester AC. Symptoms of rhinosinusitis in patients with unexplained chronic fatigue or bodily pain: a pilot study. Arch Inter Med. 2003;163:1832-6.

Verse T, Maurer JT, Pirsig W. Effect of nasal surgery on sleep-related breathing disorders. Laryngoscope. 2002;112(1):64-8.

Stradling JR, Crosby JH, Payne CD. Self reported snoring and daytime sleepiness in men aged 35-65 years. Thorax. 1991;46:807-10.

Tosun F, Kemikli K, Yetkin S, Ozgen F, Durmaz A, Gerek M. Impact of endoscopic sinus surgery on sleep quality in patients with chronic nasal obstruction due to nasal polyposis. J Craniofac Surg. 2009;20:446-9.

Kim ST, Choi JH, Jeon HG, Cha HE, Kim DY, Chung YS. Polysomnographic effects of nasalsurgery for snoring and obstructive sleep apnea. Acta Otolaryngol. 2004;124:297-300.

Värendh M, Johannisson A, Hrubos-Strøm H, Andersson M. Sleep quality improves with endoscopic sinus surgery in patients with chronic rhinosinusitis and nasal polyposis. Rhinology. 2017;55:45-52.

Elsherif I, Hussein SN. The effect of nasal surgery on snoring. Am J Rhinol. 1998;12:77-9.

Friedman M, Tanyeri H, Lim JW, et al. Effect of improved nasal breathing on obstructive sleep apnea. Otolaryngol Head Neck Surg. 2000;122:71-4.

Li HY, Lin Y, Chen NH, Lee LA, Fang TJ, Wang PC. Improvement in quality of life after nasal surgery alone for patients with obstructive sleep apnea and nasal obstruction. Arch Otolaryngol Head Neck Surg. 2008;134:429-33.