# Paranasal Sinus CT and Polysomnographic Findings in Adults with Cystic Fibrosis: Implications for Obstructive Sleep Apnea

## TL;DR

This study found that sinus CT scans in cystic fibrosis patients do not predict obstructive sleep apnea, suggesting sleep apnea screening is needed regardless of sinus health.

## Contribution

The study is the first to investigate the relationship between CT-based chronic rhinosinusitis severity and obstructive sleep apnea in adults with cystic fibrosis.

## Key findings

- Chronic rhinosinusitis severity scores did not correlate with obstructive sleep apnea in cystic fibrosis patients.
- Over 48% of cystic fibrosis patients had obstructive sleep apnea, regardless of sinus CT findings.
- Sinus CT scores had low discriminative ability for predicting obstructive sleep apnea (AUCs < 0.70).

## Abstract

Objective: To assess whether chronic rhinosinusitis (CRS) severity is associated with obstructive sleep apnea (OSA) in adult people with cystic fibrosis (pwCF). Methods: We conducted a retrospective single-center study of 44 adults with CF who underwent overnight polysomnography (PSG), Epworth Sleepiness Scale (ESS) assessment, and sinus computed tomography (CT). CRS severity was quantified using the Lund–Mackay score (LMS) and the main nasal cavity score (MNCS). OSA was defined by Apnea–Hypopnea Index (AHI) thresholds per American Academy of Sleep Medicine criteria. Results: Participants had a mean age of 31.1 ± 8.4 years and a mean percent predicted FEV1 of 51.8 ± 15.7. Sinus CT showed radiological evidence of CRS in all participants. Mean AHI was 5.3 ± 4.4/h; 48% had AHI ≥ 5/h. There were no significant differences between pwCF with and without OSA in age, sex, BMI, lung function, total sleep time, sleep efficiency, or ESS score (all p > 0.05). Mean LMS and MNCS did not differ between OSA and non-OSA groups (both p > 0.05), and neither score correlated with PSG parameters or ESS (all p > 0.05). Receiver operating characteristic (ROC) analysis demonstrated low discriminative ability of LMS and MNCS for predicting OSA (AUCs < 0.70, p < 0.05). Conclusions: In this cohort of adults with CF, CT-based CRS severity was not associated with OSA. Given the substantial prevalence of OSA observed, PSG screening should be considered irrespective of CRS severity.