Struggling to breathe with sinus troubles can keep you from getting a good
night's sleep. But a new study suggests that surgery to deal with
chronically stuffed sinuses can help people breathe and sleep better,
including people with sleep apnea.
The study found that 15 percent of people with chronically stuffed sinuses
also had the sleep disorder obstructive sleep apnea. After surgery to
clear the sinuses, people reported better quality of life and improved
sleep, regardless of whether or not they had a sleep disorder.
"Poor sleep, feeling tired, and fatigue are all frequent complaints
of patients with chronic sinus disease," said study author Dr. Jeremiah
Alt, an ear, nose and throat surgeon at the University of Utah in Salt
According to Dr. Jordan Josephson, an ear, nose and throat specialist at
Lenox Hill Hospital in New York City, "Sinus and nasal problems often
are part of the problem leading to snoring and sleep apnea, and are often
overlooked and left untreated." Josephson was not involved in the
current study, but reviewed its findings.
He added that patients with sinus problems and nasal breathing problems
"should all be evaluated for snoring and sleep apnea."
The study was published online Sept. 10 in
JAMA Otolaryngology -- Head & Neck Surgery.
Obstructive sleep apnea is a condition that causes people to stop breathing
for short periods of time throughout the night, according to the U.S.
National Institutes of Health (NIH). When people with this condition are
asleep, the tongue and other structures can relax a little too much, close
off the airway and prevent breathing. Snoring, choking and gasping for
air, and daytime fatigue are signs of obstructive sleep apnea, the NIH said.
To find out if patients with both chronic sinus problems and sleep apnea
might feel better following sinus surgery, Alt and his colleagues used
questionnaires to check outcomes for more than 400 patients who underwent
Sixty people also had sleep apnea. Following surgery, the patients had
improved on several measures, including psychological and sleep problems,
the study found.
The link between obstructive sleep apnea and chronic sinus problems is
unclear, said Alt, but might include changes in how air flows through
the nose and airways, or how sleep affects the body's ability to manage
Peter Fotinakes, a neurologist and sleep disorders specialist at St. Joseph
Hospital in Orange, Calif., who reviewed the study's findings, has
an idea of how the two conditions might intersect.
"When we're asleep, we prefer to breathe through our noses,"
Fotinakes said. "When we can't, we open our mouth to breathe,
and when you open your mouth, it sets your tongue free." That freed-up
tongue, he said, can fall back into the airway, blocking it.
Do the study findings mean that anyone with a persistent runny or stuffy
nose and fatigue should go straight for sinus surgery? No, said Alt. Patients
should try medication first before they get into talks with their doctors
about surgery, he suggested.
"However, many patients see tremendous benefits in both disease severity
and overall quality of life after sinus surgery" that they didn't
get with medicines alone, Alt added.
Fotinakes, giving the perspective from the sleep disorder side of things,
agreed that treatment with medicines comes first. He said that patients
might initially have a trial of steroid nasal sprays or antihistamines.
If those don't work, he said, "you might consider some sort of
surgical treatment, but you want to exercise all noninvasive approaches
before you get to that point."
Josephson agreed with the other experts that medication should come first,
but pointed out that surgery is an option if medication doesn't work.
"The good news is that with newer surgical techniques, most of these
procedures can be performed on an outpatient basis without general anesthesia,
requiring no packing, no black and blues, with minimal discomfort and
most patients can go back to work or school the next day," Josephson added.
Emily Willingham, HealthDay Reporter