Sleep dysfunction in aspirin exacerbated respiratory disease: A prospective cohort study

Abstract Objective Studies have described sleep dysfunction (SD) in patients with chronic rhinosinusitis (CRS). However, there is a paucity of literature describing sleep dysfunction in the context of aspirin‐exacerbated respiratory disease (AERD). The purpose of this study was to evaluate the preva...

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Main Authors: David J. Cvancara, Mohamed A. Aboueisha, Ayush A. Sharma, Dhruv Sharma, Ian M. Humphreys, Aria Jafari, Waleed M. Abuzeid
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:World Journal of Otorhinolaryngology-Head and Neck Surgery
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Online Access:https://doi.org/10.1002/wjo2.177
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author David J. Cvancara
Mohamed A. Aboueisha
Ayush A. Sharma
Dhruv Sharma
Ian M. Humphreys
Aria Jafari
Waleed M. Abuzeid
author_facet David J. Cvancara
Mohamed A. Aboueisha
Ayush A. Sharma
Dhruv Sharma
Ian M. Humphreys
Aria Jafari
Waleed M. Abuzeid
author_sort David J. Cvancara
collection DOAJ
description Abstract Objective Studies have described sleep dysfunction (SD) in patients with chronic rhinosinusitis (CRS). However, there is a paucity of literature describing sleep dysfunction in the context of aspirin‐exacerbated respiratory disease (AERD). The purpose of this study was to evaluate the prevalence and severity of SD in patients with AERD relative to CRS. Methods This study is a prospective cohort study. Patients diagnosed with CRS without polyposis (CRSsNP, n = 206), CRS with nasal polyposis (CRSwNP, n = 38), and AERD (n = 28) were recruited prospectively in academic center rhinology clinic. SD was assessed using the Neuro‐QOL Short Form v1.0‐Sleep Disturbance (sleep‐QOL), for which severe SD is defined as a score >2.0 standard deviations from the normalized mean. Demographic and patient‐reported outcome measures (including SNOT‐22 and PHQ‐2) were collected to adjust for sleep confounders. Comparisons were made between groups using univariate and multivariate analyses. Results The prevalence of severe SD was significantly higher in AERD (57.1%) than in CRSsNP (32.5%) or CRSwNP (34.2%), p = 0.038. After adjusting for sleep confounders, the risk of sleep dysfunction remained higher among patients with AERD (odds ratio [OR] = 2.72 vs. CRSsNP, 95% confidence interval [CI] = 1.18–6.27, p = 0.02; OR = 3.06 vs. CRSwNP, 95% CI = 1.06–8.82, p = 0.04). SNOT‐22 total score and the sleep subdomain showed no correlation with sleep‐QOL score. Conclusions The frequency and severity of SD are greater in AERD patients than in patients with CRS with or without nasal polyposis, independent of confounders of sleep quality. While the putative link between AERD and SD remains elusive, this study suggests that SD in AERD may be greater than previously recognized.
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spelling doaj-art-e8f8dfcc3e2f45a2883b6b060ac403c62025-08-20T01:58:17ZengWileyWorld Journal of Otorhinolaryngology-Head and Neck Surgery2095-88112589-10812025-03-011111910.1002/wjo2.177Sleep dysfunction in aspirin exacerbated respiratory disease: A prospective cohort studyDavid J. Cvancara0Mohamed A. Aboueisha1Ayush A. Sharma2Dhruv Sharma3Ian M. Humphreys4Aria Jafari5Waleed M. Abuzeid6Department of Otolaryngology—Head and Neck Surgery University of Washington School of Medicine Seattle Washington USADepartment of Otolaryngology—Head and Neck Surgery University of Washington School of Medicine Seattle Washington USADepartment of Otolaryngology—Head and Neck Surgery University of Washington School of Medicine Seattle Washington USADepartment of Otolaryngology—Head and Neck Surgery University of Washington School of Medicine Seattle Washington USADepartment of Otolaryngology—Head and Neck Surgery University of Washington School of Medicine Seattle Washington USADepartment of Otolaryngology—Head and Neck Surgery University of Washington School of Medicine Seattle Washington USADepartment of Otolaryngology—Head and Neck Surgery University of Washington School of Medicine Seattle Washington USAAbstract Objective Studies have described sleep dysfunction (SD) in patients with chronic rhinosinusitis (CRS). However, there is a paucity of literature describing sleep dysfunction in the context of aspirin‐exacerbated respiratory disease (AERD). The purpose of this study was to evaluate the prevalence and severity of SD in patients with AERD relative to CRS. Methods This study is a prospective cohort study. Patients diagnosed with CRS without polyposis (CRSsNP, n = 206), CRS with nasal polyposis (CRSwNP, n = 38), and AERD (n = 28) were recruited prospectively in academic center rhinology clinic. SD was assessed using the Neuro‐QOL Short Form v1.0‐Sleep Disturbance (sleep‐QOL), for which severe SD is defined as a score >2.0 standard deviations from the normalized mean. Demographic and patient‐reported outcome measures (including SNOT‐22 and PHQ‐2) were collected to adjust for sleep confounders. Comparisons were made between groups using univariate and multivariate analyses. Results The prevalence of severe SD was significantly higher in AERD (57.1%) than in CRSsNP (32.5%) or CRSwNP (34.2%), p = 0.038. After adjusting for sleep confounders, the risk of sleep dysfunction remained higher among patients with AERD (odds ratio [OR] = 2.72 vs. CRSsNP, 95% confidence interval [CI] = 1.18–6.27, p = 0.02; OR = 3.06 vs. CRSwNP, 95% CI = 1.06–8.82, p = 0.04). SNOT‐22 total score and the sleep subdomain showed no correlation with sleep‐QOL score. Conclusions The frequency and severity of SD are greater in AERD patients than in patients with CRS with or without nasal polyposis, independent of confounders of sleep quality. While the putative link between AERD and SD remains elusive, this study suggests that SD in AERD may be greater than previously recognized.https://doi.org/10.1002/wjo2.177aspirin exacerbated respiratory diseasechronic rhinosinusitissleep dysfunction
spellingShingle David J. Cvancara
Mohamed A. Aboueisha
Ayush A. Sharma
Dhruv Sharma
Ian M. Humphreys
Aria Jafari
Waleed M. Abuzeid
Sleep dysfunction in aspirin exacerbated respiratory disease: A prospective cohort study
World Journal of Otorhinolaryngology-Head and Neck Surgery
aspirin exacerbated respiratory disease
chronic rhinosinusitis
sleep dysfunction
title Sleep dysfunction in aspirin exacerbated respiratory disease: A prospective cohort study
title_full Sleep dysfunction in aspirin exacerbated respiratory disease: A prospective cohort study
title_fullStr Sleep dysfunction in aspirin exacerbated respiratory disease: A prospective cohort study
title_full_unstemmed Sleep dysfunction in aspirin exacerbated respiratory disease: A prospective cohort study
title_short Sleep dysfunction in aspirin exacerbated respiratory disease: A prospective cohort study
title_sort sleep dysfunction in aspirin exacerbated respiratory disease a prospective cohort study
topic aspirin exacerbated respiratory disease
chronic rhinosinusitis
sleep dysfunction
url https://doi.org/10.1002/wjo2.177
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