Sinonasal outcomes in obstructive sleep apnea syndrome.

OBJECTIVES/HYPOTHESIS Obstructive sleep apnea syndrome (OSAS) is a common adult and pediatric sleep disorder, which, if left untreated, is associated with severe medical consequences. Otolaryngologists are often challenged by the impact of OSAS on sinonasal symptoms, as well as by the contribution of primary nasal disorders to exacerbation of OSAS. The objectives of this study are to explore the relationship between patients with known OSAS and quality-of-life outcomes as measured by 22-iem Sino-Nasal Outcome Test (SNOT-22) questionnaire scores. STUDY DESIGN Retrospective chart review. METHODS Patients with a polysomnographic diagnosis of OSAS completed SNOT-22 questionnaires. SNOT-22 questionnaire items were subcategorized into rhinologic, nonrhinologic otolaryngic, sleep, and psychological symptoms. Total, individual, and subcategorized SNOT-22 scores were correlated with apnea-hypopnea index (AHI), body mass index (BMI), lowest oxygen desaturation, and sleep efficiency using Spearman rank correlation. RESULTS A total of 30 consecutive OSAS patients were included in the analysis. BMI was positively correlated with nonrhinologic otolaryngic symptoms (P=.03), specifically ear fullness (P=.02) and facial pain/pressure (P=.04). AHI was negatively correlated with postnasal drip (P=.02). Lowest oxygen saturation was correlated with reduced productivity (P=.03). Sleep efficiency was negatively correlated with difficulty falling asleep (P=.03) and feelings of frustration (P=.01), with a trend toward significant correlation with overall sleep symptoms (P=.08). CONCLUSIONS Several sinonasal complaints appear to be correlated with OSAS severity. As such, otolaryngologists should utilize a comprehensive approach to the care of the OSAS patient, with special attention to sinonasal factors. LEVEL OF EVIDENCE NA.