Sleep Disruption in Chronic Rhinosinusitis Improves with Exhalation-Delivery Nasal Steroid Therapy.

Abstract

Background: Chronic rhinosinusitis is a common inflammatory condition that often leads to significant sleep disturbances, negatively affecting quality of life. While intranasal steroids are a standard treatment, their effect on sleep disturbances in chronic rhinosinusitis has not been extensively studied.

Objective: This study aimed to determine whether a nasal steroid delivered via exhalation could improve sleep quality in chronic rhinosinusitis.

Methods: Patients with chronic rhinosinusitis were treated with nasal fluticasone via an exhalation delivery system for four months. Sleep assessments were conducted at baseline, and at two- and four-months post-treatment using comprehensive sleep and quality of life measures. Blood samples were taken at baseline to assess interleukin-6 levels. Regression analysis compared baseline and post-treatment data, adjusting for demographics. The influence of interleukin-6 levels and allergic comorbidities on treatment response was also evaluated.

Results: Significant improvements were observed in sinonasal symptoms and sleep quality at two and four months (P < 0.05). Daytime sleepiness showed trends toward improvement. Interleukin-6 levels below 6 ng/mL and absence of asthma were associated with response to treatment in terms of sleep quality.

Conclusion: High-distribution nasal steroids delivered via an exhalation system significantly improved sleep quality in patients with chronic rhinosinusitis. However, certain subgroups, such as those with lower interleukin-6 and those without comorbid asthma, benefit more significantly in terms of sleep quality.