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Title: Nasal obstruction has a limited impact on sleep quality and quality of life in patients with chronic rhinosinusitis.
Authors: Thomas, Andrew J;Orlandi, Richard R;Ashby, Shaelene;Mace, Jess C;Smith, Timothy L;Alt, Jeremiah a
Keywords: 00;000;2016;4;chronic rhinosinusitis;laryngoscope;level of evidence;nasal obstruction;quality of life;sleep quality
Issue Date: 2016
Abstract: CRSの鼻閉塞、睡眠とQOLに影響少ない 慢性副鼻腔炎(CRS)患者28例を対象に、鼻閉塞、睡眠の質、QOLとの関係を前向き症例集積研究で評価。全患者が鼻閉塞症状評価質問票(NOSEスコア30以上)、82%がピッツバーグ睡眠質問票(PSQI)5以上だった。NOSEスコアはPSQI総スコアと強く相関したが、その他項目と同スコアの相関は弱い、または相関しなかった。鼻閉塞は疾患特異的QOLとの相関が弱く、PSQI総スコアとは相関しなかった。 OBJECTIVES/HYPOTHESIS: Nasal obstruction is a cardinal symptom in diagnosing chronic rhinosinusitis (CRS), and decreased sleep quality (SQ) and quality of life (QOL) are commonly reported in CRS. It is, however, unclear what role nasal obstruction severity plays in this decreased SQ and QOL. Using validated instruments, we evaluated the relationship between nasal obstruction severity, SQ, and QOL.\n\nSTUDY DESIGN: Prospective case series.\n\nMETHODS: Patients with CRS refractory to standard medical therapy (n = 28) were prospectively enrolled and completed the Nasal Obstruction Symptom Evaluation (NOSE), Pittsburg Sleep Quality Index (PSQI), Rhinosinusitis Disability Index, and the 22-item Sinonasal Outcome Test. CRS disease severity was evaluated with computed tomography and endoscopy. NOSE scores were compared to SQ, QOL, and disease severity measures. Spearman correlations were used to identify significant associations between measures.\n\nRESULTS: All patients reported symptomatic nasal obstruction (NOSE score ≥ 30), whereas poor sleep (PSQI ≥ 5) was reported by 82%. The NOSE sleeping subdomain correlated strongly with the PSQI total score, whereas other elements of the NOSE instrument correlated weakly or not at all with this measurement of SQ. Nasal obstruction correlated weakly with disease-specific QOL and had no correlation with the PSQI total.\n\nCONCLUSIONS: Nasal obstruction appears to have a limited association with CRS-specific QOL and CRS-associated decrease in SQ. Further, the NOSE instrument, because it contains a question about sleep, may have overlap with the PSQI as a measure of SQ. The total NOSE score in CRS patients does not appear to be purely a measure of nasal obstruction.\n\nLEVEL OF EVIDENCE: 4 Laryngoscope, 2016.
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