Impact of sleep dysfunction on psychological burden in patients with empty nose syndrome.

Abstract

Background Empty nose syndrome (ENS) is a paradoxical nasal obstruction that occurs after turbinate surgery. This study aimed to evaluate the impact of sleep dysfunction on the psychological burden in patients with ENS by simultaneously measuring sleep quality and psychological symptoms using validated questionnaire instruments. Methods Patients with ENS were prospectively enrolled over 5 years. The Empty Nose Syndrome 6-item questionnaire (ENS6Q), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Epworth Sleepiness Scale (EpSS), and modified sleep quality index (MSQI) were used to evaluate the participants before and after reconstruction surgery with submucosal Medpor implantation. Results Forty-six patients with ENS were included in this study. The BDI-II and BAI depression and anxiety scores were significantly associated with the MSQI and EpSS sleep scores in preoperative evaluations and perioperative changes. Multivariable regression models revealed that the preoperative EpSS score (coefficient=0.76, p=0.046) was a significant predictor of preoperative BDI-II scores. The receiver operating characteristic (ROC) curves of EpSS (p=0.003) and MSQI (p<0.001) scores had an area under the ROC curve that was significantly greater than 0.5 in detecting moderate-to-severe depression. The optimal cut-off values for these variables were EpSS >13 (sensitivity, 52.6%; specificity, 85.2%) and MSQI >28 (sensitivity, 78.9%; specificity, 81.5%). Conclusions There is a close association between the evaluation of sleep dysfunction and psychological symptoms in ENS patients. Recognizing individuals with significant sleep impairment and providing appropriate management to improve sleep quality and diminish their psychological burden are crucial issues for ENS patients. This article is protected by copyright. All rights reserved