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Snoring in patients with chronic rhinosinusitis after endoscopic sinus surgery

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Abstract

Purposes

In patients with chronic rhinosinusitis (CRS), we assessed quality of life (QOL) of chronic rhinosinusitis (CRS) patients with different self-reported snoring frequencies after endoscopic sinus surgery (ESS), and explored factors associated with pre-ESS snoring and post-ESS snoring reduction.

Methods

This prospective cohort study was conducted in a tertiary referral center in Chengdu, China. Adult patients with medically recalcitrant CRS receiving initial ESS were engaged. Self-reported snoring was measured at baseline and 3-year follow-up, along with Sino-Nasal Outcome Test-22 and snoring visual analog scale assessment. Mouth breathing (MB), demographics, behavior, comorbidity factors, and objective CRS severity were considered.

Results

In 210 patients who completed this study, 63 (30%) patients reported pre-ESS habitual snoring, and post-operative habitual snoring was observed in 52 (25%) patients. The presence of self-reported snoring was correlated with worse CRS QOL at baseline and 3-year follow-up. Obesity (odds ratio [OR] = 4.30; 95% confidence interval [CI], 1.64–11.28; p < 0.01) and posterior-to-anterior ethmoid sinus ratio greater than one (PE/AE, OR = 0.32; 95% CI, 0.10–0.99; p = 0.05) were associated with pre-ESS snoring in univariable and multivariable analysis. The post-operative reduction of snoring frequency was related with patient age over 65 (OR = 11.55; 95%CI, 1.35–98.79; p = 0.03) and bilateral opacification in the Lund-Mackay system (OR = 8.04; 95%CI, 1.24–51.90; p = 0.03) in multivariable analysis. Pre-operative snoring and MB were associated with increased risk of post-operative snoring (p < 0.01 for each comparison).

Conclusions

Post-ESS, self-reported snoring was associated with worse CRS QOL. Obesity and PE/AE > 1 were risk factors of pre-operative snoring. Advanced age and bilateral opacification were associated with greater improvement of snoring after ESS.

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Data availability

The data supporting the findings of this study is available from the corresponding author, YZ, upon reasonable request.

Change history

  • 22 December 2023

    The second entry in the Keywords section should read "Sleep".

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Acknowledgements

The authors thank the staff involved in treatment and care of these patients, the research staff in Yu Zhao’s office in West China Hospital, and patients themselves for their contribution.

Funding

West China Hospital provided financial support in the form of 1·3·5 project for disciplines of excellence–Clinical Research Incubation Project (grant numbers 2019HXFH003). Chengdu Science and Technology Bureau provided financial support in the form of Key Research and Development Support Programs of Chengdu Science and Technology Bureau funding (grant number 2019-YF05-00461-SN). The National Natural Youth Science Foundation of China provided financial support (grant number 82002868). The sponsors had no role in the design or conduct of this research.

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China

    Yang Xu, Wen Yang & Yu Zhao

  2. President & Dean’s Office, West China Hospital, Sichuan University, Chengdu, Sichuan, China

    Min Cao

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  1. Yang Xu
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Contributions

All authors contributed to the study conception and design. YX: conceptualization, methodology, writing - original draft. MC: software, formal analysis. WY: data curation. YZ: writing - reviewing and editing, investigation, supervision.

Corresponding author

Correspondence to Yu Zhao.

Ethics declarations

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Biomedical Research Ethics Committee of West China Hospital of Sichuan University and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare no competing interests.

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Highlights

• Pre-operative snoring and mouth breathing were associated with increased risk of developing post-operative snoring.

• Worse CRS QOL was reported in patients who snored compared to patients who did not snore before and after ESS.

• In CRS patients, obesity and PE/AE > 1 were associated with pre-operative snoring, while post-operative weight loss did not significantly reduce post-ESS snoring

• There was greater snoring reduction after ESS in patients with pre-operative bilateral opacification and advanced age.

Study design

An observational cohort study.

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Xu, Y., Cao, M., Yang, W. et al. Snoring in patients with chronic rhinosinusitis after endoscopic sinus surgery. Sleep Breath 28, 895–904 (2024). https://doi.org/10.1007/s11325-023-02957-3

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  • DOI: https://doi.org/10.1007/s11325-023-02957-3

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