Burden of obstructive sleep apnea and CPAP use on patients with chronic rhinosinusitis

Objective: To evaluate the impact of obstructive sleep apnea (OSA) on the quality-of-life (QoL) of patients with chronic rhinosinusitis (CRS). Methods: Retrospective cohort study of all adult patients with CRS presenting to our rhinology clinic between August 2020 and February 2023 was performed. OSA was established based on positive polysomnography. Patients' characteristics, apnea-hypopnea index, comorbidities, endoscopy scores, and SNOT-22 scores were collected. Results: A total of 513 patients with CRS were included, 127 patients with OSA and 386 without OSA. CRS patients with OSA were older (p p < 0.001), had higher BMI (p p < 0.001), more likely to be males (p p = 0.07), more likely to have asthma (p p < 0.001), and more likely to have COPD (p p = 0.001). Presence of nasal polyps did not differ between the two groups. Baseline SNOT-22 scores were worse in the OSA cohort (44.4 vs 40.5, p = 0.064) secondary to worse sleep (13.4 vs 11.1; p = 0.002) and psychological (14.2 vs 11.5; p = 0.002) domains. Worse SNOT scores were strongly associated with presence of OSA after adjusting for confounding variables, including age, gender, asthma, allergic rhinitis, nasal septal deviation, and smoking status. Conclusion: OSA is an independent negative contributor to the disease specific QoL in patients with CRS. CPAP use does not seem to affect the QoL in CRS patients with OSA. Further research is warranted to explore the impact of OSA in the outcome of medical and surgical treatment of CRS patients.