Pooled Analysis of Sleep Outcomes After Treatment With Temperature‐Controlled Radiofrequency in Nasal Airway Obstruction Patients

Objective To assess the long‐term impact of temperature‐controlled radiofrequency (TCRF) treatment on sleep‐related symptoms in patients with nasal airway obstruction (NAO), including those with documented obstructive sleep apnea (OSA). Study Design Pooled analysis of prospective multicenter studies. Setting Seven academic and 25 private otolaryngology sites. Methods A pooled analysis of 345 adults across four prospective multicenter studies (PIVOTAL, VATRAC, SWELL, and AERWAY) from 7 academic and 25 private otolaryngology sites was conducted. Participants had severe‐to‐extreme NAO and received a single, office‐based TCRF treatment targeting the nasal valve or septal swell body (SSB). Outcomes included sleep‐related components of the Nasal Obstruction Symptom Evaluation (NOSE) scale, 22‐item Sino‐Nasal Outcome Test (SNOT‐22) sleep domain, and Epworth Sleepiness Scale (ESS). Analyses included stratification by the presence or absence of OSA and linear regression. Results TCRF treatment was associated with significant, durable improvements in sleep‐related symptoms through 24 months. At 24 months, the “Trouble Sleeping” subcomponent of the NOSE score improved by −1.9 (95% CI, −2.0 to −1.7) points, a 64% improvement. SNOT‐22 sleep domain scores declined by −9.0 (95% CI, −10.5 to −7.6) points, with more than 80% of participants achieving clinical improvement. Among those with excessive daytime sleepiness (ESS ≥ 10), ESS dropped by −8.3 (95% CI, −9.7 to −6.9), and the prevalence of sleepiness fell from 53.8% to 9.8%. Improvements were consistent across the OSA+ subgroup. Conclusion Office‐based TCRF therapy targeting the nasal valve and/or SSB is associated with clinically meaningful, durable improvements in sleep‐related symptoms and daytime somnolence in NAO patients, including a subset of those with documented OSA.