Dupilumab improves sleep quality in chronic rhinosinusitis with nasal polyps

• DOI: 10.1016/j.amjoto.2024.104310
• Publication Date: 2024-04-19T06:09:34Z
• Authors: Giuseppe Riva; Marco Garetto; Mario Borgione; Federica Piazza; Carmine Prizio; Davide Dellea; Andrea Albera; Andrea Canale; Giancarlo Pecorari
• Keywords: Male; Adult; Rhinosinusitis; Biological therapy; Chronic rhinosinusitis; Dupilumab; Nasal polyposis; Quality of life; Sleep; Sleepiness; Middle Aged; Antibodies, Monoclonal, Humanized; Nasal Polyps; Sleep Quality; Treatment Outcome; Chronic Disease; Quality of Life; Humans; Female; Sinusitis; Rhinitis; Retrospective Studies; Aged

Chronic rhinosinusitis with nasal polyps (CRSwNP) often alters sleep quality. Dupilumab emerged as an innovative and effective therapy for refractory/recurrent severe CRSwNP. The aim of this observational retrospective study was to evaluate the sleep quality in patients with CRSwNP who underwent treatment with dupilumab.Forty-five patients treated with dupilumab for CRSwNP were enrolled. Clinical parameters (age, sex, comorbidities, Nasal Polyp Score - NPS, Asthma Control Test - ACT), nasal cytology, quality of life (Sino Nasal Outcome Test 22 - SNOT-22), sleep quality (Pittsburgh Sleep Quality Index - PSQI, Epworth Sleepiness Scale - ESS), and risk of sleep apnea (STOP-BANG) were recorded before treatment (T0), and after 3 (T1), 6 (T2), and 12 months (T3).NPS, ACT and SNOT-22 total score improved during treatment (p < 0.05). Meanwhile, all sleep parameters evaluated with SNOT-22, ESS and PSQI improved over time (p < 0.001), expect for PSQI Use of sleeping medications. Indeed, sleep drugs are rarely used before and during the treatment. The global sleep quality was classified as poor in 88.9 % of cases at T0 and decreased to 5.7 % at T3. A high risk of sleep apnea was revealed by the STOP-BANG in 68.9 % of cases at T0 and 2.8 % of patient at T3 (p < 0.001).Dupilumab improves the sleep quality and reduce the risk of sleep apnea in patients with severe CRSwNP. Its favorable effect occurs within 3 months and is maintained during the treatment.