Abstract
BACKGROUND: Chronic rhinosinusitis is a common inflammatory condition that often leads to significant sleep disturbances, negatively affecting quality of life. Although intranasal steroids are a standard treatment, their effect on sleep disturbances in chronic rhinosinusitis has not been extensively studied. OBJECTIVE: To determine whether a nasal steroid delivered through exhalation could improve sleep quality in chronic rhinosinusitis. METHODS: Patients with chronic rhinosinusitis were treated with nasal fluticasone through an exhalation delivery system for 4 months. Sleep assessments were conducted at baseline and at 2 and 4 months post-treatment using comprehensive sleep and quality-of-life measures. Blood samples were taken at baseline to assess interleukin-6 levels. Regression analysis compared baseline and post-treatment data, adjusting for demographics. The influence of interleukin-6 levels and allergic comorbidities on treatment response was also evaluated. RESULTS: Significant improvements were observed in sinonasal symptoms and sleep quality at 2 and 4 months (P < .05). Daytime sleepiness revealed trends toward improvement. Interleukin-6 levels below 6 ng/mL and absence of asthma were associated with response to treatment in terms of sleep quality. CONCLUSION: High-distribution nasal steroids delivered through an exhalation system significantly improved sleep quality in patients with chronic rhinosinusitis. However, certain subgroups, such as those with lower interleukin-6 and those without comorbid asthma, benefit more significantly in terms of sleep quality.