0894 Effects of Chronic Rhinosinusitis (CRS) on Sleep Duration and Variability in World Trade Center (WTC) Responders

Abstract Introduction 43.5% of World Trade Center rescue and recovery workers demonstrate symptoms of chronic rhinosinusitis (CRS). Subjects with CRS report increased sleep complaints and shorter subjective sleep duration compared to those without CRS. Discomfort from nasal symptoms during sleep may result in shorter sleep duration and an increased night-to-night variability. We compare actigraphic assessment of sleep duration and variability in subjects with and without CRS. Methods WTC-responders in an on-going study assessing sleep apnea and Alzheimer's disease biomarkers underwent 2-week actigraphy with sleep diary before in-lab polysomnography. Demographics, CRS symptoms, Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), sleep duration and complaint information were obtained. CRS+ was defined as ≥3 symptoms: facial pain, post-nasal drip, nasal congestion, blocked nose, loss of smell, sneezing, sore throat or hoarseness. Nightly actigraphy data were analyzed using Cole-Kripke algorithm and averaged over all nights to obtain mean total sleep time (TST) and coefficient of variability (CV) across nights. Group comparisons were performed using two-sample t-test with significance level at p< 0.05. Results 42 subjects (74%M/26%F, age 64.7±5, BMI 28.6±6kg/m2) had 14 nights (range=11-17) of actigraphy data. Subjective sleep duration and TST by actigraphy were correlated (r=0.4, p=0.02). 19(45%) were CRS+ vs 23(55%) CRS-. Age, sex, BMI, and sleep apnea prevalence did not differ between CRS+ vs CRS- groups. Mean (SD) ISI in CRS+=8.4(5.4), CRS- =5.4(5.4), p=0.08. ESS in CRS+=4.2(2.5), CRS- =4.6(3.0), p=0.6. Although not statistically significant, mean subjective sleep duration in hours was shorter and more variable in CRS+=7.84(1.3) than CRS- =8.34(0.7), p=0.1. Actigraphic sleep duration (TST) in hours was shorter and more variable in CRS+ [6.59(1.2), CV=22.7(9.5)] than CRS- [6.80(0.8), CV=20.7(7.2)]. Conclusion WTC-responders with CRS symptoms report shorter subjective sleep and greater insomnia similar to our previous findings. While we did not demonstrate a significant difference in actigraphic sleep duration or variability between CRS groups, we were limited by a small sample size. The high prevalence of CRS and sleep complaints in this population and the association of reduced sleep duration and increased morbidity and mortality highlights the importance of establishing if there is a shorter sleep duration in CRS+ patients through further investigation. Support (if any) NIOSH:U01OH011852, K24HL109156, NCATS:TL1TR004420