The Impact of Rhinosinusitis and Its Treatment on Sleep-Disordered Breathing: A Systematic Review

Background and Objectives: Rhinosinusitis contributes to the development of sleep-disordered breathing (SDB) by causing nasal obstruction and airway inflammation; however, the extent to which treatment improves these conditions remains unclear. To address this, this study systematically evaluated the impact of rhinosinusitis-directed therapy on nasal symptoms, endoscopic findings, and sleep-related respiratory parameters. Materials and Methods: Methodologically, this systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A comprehensive search was conducted across the PubMed, Medline, Web of Science, Science Direct, and Google scholar databases. Specifically, studies reporting pre- and post-treatment outcomes in patients with rhinosinusitis were included. Due to substantial clinical and methodological heterogeneity among the included studies, a quantitative meta-analysis was not performed; instead, findings were synthesized narratively. Results: Ultimately, fifteen studies met the inclusion criteria and demonstrated consistent improvements in sleep-related outcomes following the treatment of rhinosinusitis. Across the surgical and medical interventions, reductions in apnea-hypopnea index (AHI) and improvement in endoscopic findings were frequently reported. For instance, functional endoscopic sinus surgery (FESS) produced notable enhancements in sleep quality, daytime sleepiness, and sinonasal symptom scores in several studies, while biologic therapy and medical management also showed benefit in reducing nasal obstruction, rhinorrhea, and inflammatory markers. Conclusions: The available evidence suggests that rhinosinusitis treatment may be associated with improvements in measures of sleep-disordered breathing (SDB) and mucosal inflammation, although subjective nasal symptom outcomes were more variable across studies. Consequently, targeted sinonasal therapy may play an important role in reducing SDB burden, particularly in patients with inflammatory airway compromise.