Tailoring Evaluations of Chronic Rhinosinusitis: Understanding Sleep and Its Effect on Memory Through Actigraphy.

Abstract

Background/Objectives: Chronic rhinosinusitis (CRS) is a persistent inflammatory condition of the sinonasal mucosa lasting for at least three months. For patients, CRS-related sleep disturbances can significantly disrupt circadian rhythms, leading to further health complications such as cognitive impairment. Despite the well-documented sleep disturbances associated with CRS, there is limited research on objective assessment methods. Additionally, the severity of these issues can vary among patients. This study aims to assess sleep quality and timing in CRS patients and investigate their impact on cognition, providing guidance for personalized and tailored assessment and management of CRS. Methods: Our case-control study compares sleep patterns and cognitive function between CRS patients and healthy controls utilizing actigraphy, a non-invasive device for measuring sleep-wake cycles and circadian rhythms. The actigraphy-derived sleep variables include inter-daily variability, intra-daily variability, highest 10 h activity (M10), lowest 5 h activity (L5), relative amplitude (RA), sleep onset latency, sleep efficiency, sleep and wake time, time spent in bed, total sleep time, and wakefulness after sleep onset. We also used a standard questionnaire assessing sleep quality, the Pittsburgh Sleep Quality Index (PSQI). Results: Our study enrolled 44 CRS and 43 control participants. Our findings indicate that the actigraphy-derived sleep variables were comparable between groups, all with a p-value > 0.05. However, CRS patients exhibited greater early morning activity and significantly lower PSQI-reported sleep quality compared to controls (8.78 ± 3.45, 4.71 ± 2.96, respectively; adjusted p < 0.001). Actigraphy-derived sleep variables showed trends towards significance in association with episodic memory (p = 0.051) and executive function (p = 0.15). Conclusions: Actigraphy-derived sleep outcomes revealed associations with episodic and executive function, underscoring the potential of actigraphy in understanding the individualized sleep-related cognitive impacts in CRS patients. This highlights the importance of personalized assessment and management strategies to address the unique sleep and cognitive challenges faced by each patient.