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Author Notes:

Correspondence to: Jeremiah A. Alt, MD, PhD, Sinus and Skull Base Surgery Program, Division of Otolaryngology– Head & Neck Surgery, Department of Surgery, University of Utah, 50 North Medical Drive, SOM 3C120, Salt Lake City, UT 84132; e-mail: jeremiah.alt@hsc.utah.edu

Accepted for oral presentation to the American Rhinologic Society during the 119th annual Combined Otolaryngologic Spring Meeting (COSM) in Chicago, IL, May 18-22nd, 2016.

Jeremiah A. Alt and Richard R. Orlandi are consultants for IntersectENT, Inc and Medtronic, Inc, which are not affiliated with this investigation.

Financial Disclosures: There are no relevant financial disclosures for Daniel R. Cox, Shaelene Ashby, or John M. DelGaudio for this investigation.

Conflict of Interest: None


Research Funding:

Jeremiah A. Alt, Jess C. Mace, and Timothy L. Smith were supported for this investigation by a grant from the National Institute on Deafness and Other Communication Disorders (NIDCD), one of the National Institutes of Health, Bethesda, MD (R01 DC005805; PI/PD: TL Smith).

Public clinical trial registration number (www.clinicaltrials.gov) NCT01332136.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Otorhinolaryngology
  • chronic disease
  • depression
  • outcome assessment
  • pain
  • sinusitis
  • sleep

The pain-depression dyad and the association with sleep dysfunction in chronic rhinosinusitis


Journal Title:

International Forum of Allergy and Rhinology


Volume 7, Number 1


, Pages 56-63

Type of Work:

Article | Post-print: After Peer Review


Background: Depression, pain, and sleep disturbance is a symptom cluster often found in patients with chronic illness, exerting a large impact on quality of life (QOL). A wealth of literature exists demonstrating a significant association between depression, pain, and sleep dysfunction in other chronic diseases. This relationship has not been described in patients with chronic rhinosinusitis (CRS). Methods: Sixty-eight adult patients with CRS were prospectively enrolled. Patients at risk for depression were i dentified using the Patient Health Questionnaire-2 (PHQ-2) using a cut-off score of ≥1. Pain experience was measured using the Brief Pain Inventory Short Form (BPI-SF) and the Short Form McGill Pain Questionnaire (SF-MPQ). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Results: Forty-seven patients were at risk for depression. Significant positive correlations were found between total PSQI scores and all pain measures (R = 0.38-0.61, p ≤ 0.05) and between total PSQI scores and PHQ-2 scores (R = 0.46, p < 0.05). For patients at risk for depression, significant, positive correlations were found between pain measures, the total PSQI score, and the 3 PSQI subdomains (sleep latency, sleep quality, and daytime dysfunction; R = 0.31-0.61, p < 0.05). The relationship between pain and sleep dysfunction scores was not seen in the absence of depression. Conclusion: Depression, pain, and sleep dysfunction are interrelated in patients with CRS. In the absence of depression, significant correlations between pain and sleep are not observed, suggesting that depression plays a key role in this interaction. Further research is needed to investigate the complex relationship between depression, pain, and sleep dysfunction in CRS.

Copyright information:

© 2016 ARS-AAOA, LLC

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