Symptom Profile of Chronic Rhinosinusitis Versus Obstructive Sleep Apnea in a Tertiary Rhinology Clinic.
OBJECTIVES
Patients with undiagnosed obstructive sleep apnea (OSA) often present to an otolaryngologist with symptoms of chronic rhinosinusitis (CRS). This study analyzes symptom profiles of such patients to help identify those who may benefit from polysomnography.


METHODS
This is a 2-year retrospective analysis of adult patients at an academic practice with a rhinologic chief complaint. Results of the 22-Item Sinonasal Outcomes Test (SNOT-22) were compared between patients with untreated OSA without CRS (OSA group) and a control group of CRS patients (CRS group). Univariate analysis with Bonferroni correction and multiple logistic regression were used.


RESULTS
Forty-one patients were included in the OSA group (mean apnea-hypopnea index = 28.8, SD = 21.0) and 124 patients in the CRS group. CRS group demonstrated higher scores in nasal, extra-nasal, and ear/facial symptom domains (P < .001), while OSA group displayed higher psychological (P = .020) and sleep domain scores (P = .048). Nasal discharge (P < .001) and loss of smell/taste (P = .004) scores were higher in CRS group, whereas facial pain (P = .285) and nasal obstruction (P = .822) were not significantly different. On logistic regression, thick nasal discharge, loss of smell/taste, and ear pain were predictive of CRS, while waking up tired was predictive of OSA. Finally, OSA group was more likely to choose a sleep-related issue as a most important symptom (MIS) (P < .001).


CONCLUSIONS
OSA and CRS have significant overlap in symptom profiles. The SNOT-22 can help identify those with undiagnosed OSA. OSA should be suspected in patients who report a sleep-related item as a MIS and display higher psychological and sleep domain scores.
['Ji|Keven|K|https://orcid.org/0000-0003-4702-466X', 'Risoli|Thomas J|TJ|', 'Kuchibhatla|Maragatha|M|', 'Chan|Lyndon|L|', 'Hachem|Ralph Abi|RA|', 'Jang|David W|DW|']
D000328:Adult D000368:Aged D002908:Chronic Disease D003937:Diagnosis, Differential D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D000071066:Patient Reported Outcome Measures D017286:Polysomnography D012189:Retrospective Studies D012220:Rhinitis D012852:Sinusitis D020181:Sleep Apnea, Obstructive
sleep apnea SNOT-22 quality of life sinusitis