Sleepless Nights? Could Be Sinus Trouble

The culprits, which include sinusitis and allergies, can be vanquished

Karen Pallarito

Karen Pallarito

Published on January 17, 2004

SATURDAY, Jan. 17, 2004 (HealthDayNews) -- Having trouble getting a good night's sleep? Are you rattling your spouse out of bed when you snore?

If so, those restless nights may be a sign of a sinus problem.

"It's more common than you think," says Dr. Keith Jay Wahl, an ear, nose and throat specialist and cosmetic surgeon in private practice in La Jolla, Calif.

Wahl sees a number of patients with snoring and sleep problems that he traces back to an underlying sinus condition.

Some patients come in with no obvious symptoms of a sinus disorder, such as thick mucus discharge or headache. If there's good reason to suspect sinus trouble, Wahl will order a CT scan. "And lo and behold, I'll pick up a lot of people who had a lot of underlying malady on X-ray," he says.

If you're snoring or unable to sleep soundly, an undiagnosed case of sinusitis may be the culprit, explains Wahl, who is also a clinical attending physician at the University of California, San Diego.

An estimated 37 million Americans each year suffer from sinusitis, an inflammation or infection of the sinus cavities that prevents mucus from draining properly. The blockage can cause headache; pain and pressure in the forehead, jaw, cheeks and teeth; swelling of the eyelids and tissues around the eyes; a loss of smell; and a stuffy nose. It can even cause earaches, neck pain and deep aching at the top of the head, according to the National Institute of Allergy and Infectious Diseases.

Other nasal obstructions that can contribute to so-called "sleep-disordered breathing" include allergic rhinitis, commonly known as hay fever, and polyps, which are small growths of inflamed mucus membrane.

Nearly 36 million people in the United States suffer from seasonal allergic rhinitis, the American Academy of Allergy, Asthma and Immunology says.

Nasal polyps are more common in people who have asthma or chronic sinus infections, experts say, although the exact cause of these protrusions is unknown.

It stands to reason that people who have sinus problems are sometimes sleep-deprived. Any airway obstruction can impede restful sleep.

"Patients who do have nasal obstruction are more likely to breathe through the mouth, for example," says Dr. Jerry Schreibstein, president of the Massachusetts Society of Otolaryngology-Head and Neck Surgery.

Researchers use the term "sleep-disordered breathing" to describe a group of disorders involving pauses in breathing or poor ventilation during sleep. The most common of these is sleep apnea, a potentially serious condition marked by intermittent periods during which a person's breathing actually stops or becomes very shallow due to a partial or complete closing of the upper airway. People with hay fever or allergies are more prone to experience sleep apnea.

An estimated 50 million to 70 million Americans have a sleep problem, says Dr. Carl Hunt, director of the National Heart, Lung, and Blood Institute's National Center on Sleep Disorders Research. They include people with allergies, allergic rhinitis or sinusitis, he says.

"Anybody who snores has some degree of narrowing of their upper airways during sleep," Hunt says. But it doesn't always mean a medical problem exists, he adds.

A simple sinus infection that's keeping you from getting the shuteye your body requires, for example, "would be considered a sleep problem, but it would not be classified as a sleep disorder," he explains.

Patients should consult their primary-care physician to determine whether an airway obstruction exists, Hunt says.

The type of treatment a patient receives depends on the problem, its cause and severity. Someone diagnosed with acute sinusitis, for instance, might get a prescription for an antibiotic to wipe out the infection and a decongestant to reduce congestion. Chronic sinusitis is often more difficult to treat and may require stronger oral antibiotics or intranasal nebulized treatments. If these fail or patients have underlying physiological conditions, surgery may be necessary.

Allergic rhinitis may be treated with medication or allergy shots. Surgery may be recommended to remove nasal polyps.

If those causes are ruled out, a patient with excessive daytime sleepiness or snoring that is interfering with a bed partner's sleep may be referred to a sleep specialist.

Rest assured that with appropriate treatment, you could be on your way to better slumber.

More information

To learn more about sleep problems, visit the National Center on Sleep Disorders Research. For more on sinusitis, check with the National Institute of Allergy and Infectious Diseases.

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