To the Editor I read with interest the study by Kim et al,1 which assessed the association of chronic rhinosinusitis (CRS) with increased risk of depression and anxiety. In this retrospective nationwide cohort study, the overall incidences of both anxiety and depression during the 11-year follow-up were about 1.5-fold higher in the patients with CRS than in those without the disorder. Despite several reasons proposed by the authors including worse pain and energy levels, as well as difficulty with daily activities for developing depression and anxiety among patients with CRS, one of the important issues that appeared to be ignored in the conclusions is the role of impaired sleep quality in these patients.
Ghadami MR. Chronic Rhinosinusitis and Increased Risk of Depression and Anxiety: The Role of Impaired Sleep Quality . JAMA Otolaryngol Head Neck Surg. Published online May 23, 2019. doi:10.1001/jamaoto.2019.0916
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