Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) and Sleep Quality

Chronic rhinosinusitis with nasal polyps (CRSwNP) has long been a source of discomfort for many, impacting patients' quality of life and sleep. Now, a promising development offers new hope. A recent study published in the Annals of Allergy, Asthma & Immunology Journal found that Dupilumab, a monoclonal antibody, can significantly improve the sleep quality of CRSwNP patients in real-life settings.

CRSwNP and Type 2 Inflammation

The most common form of CRSwNP is characterized by type 2 inflammation, marked by increased levels of interleukin (IL)-4, IL-5, and IL-13. Dupilumab works by targeting the IL-4 receptor-α, inhibiting signals from both IL-4 and IL-13, and has recently received approval for CRSwNP treatment.

Study Overview

In a study involving 29 consecutive patients, the impact of Dupilumab on sleep quality was examined over a three-month period. Before treatment, these patients reported sleep quality issues, with:

• Excessive daytime sleepiness affecting 24.1%
• 79.3% reporting insomnia
• 93.1% experiencing globally impaired sleep quality

Results and Implications

However, the results were highly encouraging. After just one month of Dupilumab treatment, patients reported significant improvements across various sleep quality parameters, as measured by the Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and the sinonasal outcome test 22 (SNOT-22) sleep domain. Importantly, the proportion of patients suffering from insomnia and globally impaired sleep quality decreased, providing a ray of hope for those living with CRSwNP.

This research underscores the profound impact CRSwNP has on sleep quality, with a particular emphasis on insomnia. The rapid improvement observed in patients undergoing Dupilumab treatment highlights the need to consider sleep disturbances as an essential outcome in the treatment of CRSwNP. It signifies a significant breakthrough, promising a better quality of life and better sleep for those affected by this condition.

Source

Ferri, S., Montagna, C., Malvezzi, L., Pirola, F., Russo, E., Racca, F., Messina, M. R., Del Moro, L., Mercante, G., Spriano, G., Canonica, G. W., Paoletti, G., & Heffler, E. (2023). Sleep quality burden in chronic rhinosinusitis with nasal polyps and its modulation by dupilumab. In Annals of Allergy, Asthma & Immunology. Elsevier BV. https://doi.org/10.1016/j.anai.2023.08.594