SLEEP quality in chronic rhinosinusitis with nasal polyposis improved after endoscopic surgery, showing longer REM sleep durations.
Sleep and Chronic Rhinosinusitis After Surgery
Adults with chronic rhinosinusitis with nasal polyps can experience persistent nasal obstruction that disrupts restorative sleep. In a systematic review of postoperative data, investigators evaluated whether functional endoscopic sinus surgery was associated with measurable improvements in sleep quality and polysomnographic outcomes in this population.
Study Design and Included Evidence
The review searched three databases, PubMed, Cochrane, and Embase, using terms related to chronic rhinosinusitis, nasal polyposis, sleep quality, and nasosinusal endoscopic surgery. Eligible studies enrolled adults with nasal polyps who underwent endoscopic nasosinusal surgery and reported sleep outcomes before and after the operation. A meta analysis compared mean changes in both subjective sleep measures and polysomnography variables.
Across three included studies, only one was randomized, and the combined sample totaled 64 patients. This limited evidence base underscores that postoperative sleep outcomes in chronic rhinosinusitis with nasal polyps remain under studied, despite frequent patient reported sleep disruption.
Postoperative Polysomnography and Sleep Quality Findings
Following surgery, the pooled analysis showed a decrease in AHI and improvements in both mean and minimum oxygen saturation. Changes in deep sleep were less clear, as the mean difference in stage N3 percentage was 1.12 with a 95% confidence interval from minus 3.51 to 5.75, which was not statistically significant.
In contrast, several sleep quality signals improved. REM sleep duration increased on average, and Pittsburgh Sleep Quality Index scores decreased, with both findings reported as statistically significant. Overall, the authors concluded that postoperative improvements were seen in sleep quality and REM sleep duration, without improvement in polysomnographic respiratory parameters.
Clinical Takeaway
For clinicians managing chronic rhinosinusitis with nasal polyps, these findings support discussing sleep as a meaningful postoperative outcome, while recognizing the small sample size and limited number of trials.
Reference: de Oliveira AMFF et al. Sleep and chronic rhinosinusitis: a systematic review of postoperative data. Sleep Sci. 2025;18(4):e436-e443.
