Effect of sinus opacification on the severity of obstructive sleep apnea

Purpose: The association between rhinosinusitis and obstructive sleep apnea (OSA) remains unclear. Here, we aimed to elucidate the association between sinus opacification and OSA severity. Methods: Patients with snoring problems who visited our clinic from April 2018 to December 2020 were retrospectively enrolled. Among these patients, we included those who underwent a physical examination, overnight polysomnography, and osteomeatal-unit computed tomography. We evaluated the association between apnea–hypopnea index (AHI) and Lund-Mackay score (LMS). LMS ≥ 5 was considered indicative of sinus opacification. Results: Among the 122 patients included in the study, LMS exhibited an increasing trend based on OSA severity. The LMS in the moderate OSA group was significantly higher than that in the no OSA group (P = 0.002), and the LMS in the severe OSA group was significantly higher than that in the no OSA (P < 0.001) and mild OSA (P = 0.006) groups. A correlation analysis revealed that AHI was significantly associated with body mass index (BMI) (r = 0.367, P < 0.001) and LMS (r = 0.255, P = 0.005). A multivariate analysis revealed that sinus opacification was associated with moderate and severe OSA [Adjusted odds ratio = 11.986 (P = 0.005) and 3.756 (P = 0.044), respectively] after adjusting for age, sex, BMI, smoking, hypertension, atopy, tonsil size, and palatal position. The effect of sinus opacification on OSA severity was comparable to that of overweight. Conclusion: Sinus opacification may increase OSA severity since moderate and severe OSA is independently associated with it.