Sinusitis and Sleep Apnea

There are several health problems that can significantly affect the quality of your sleep. Conditions that cause abnormal breathing or difficulty breathing are some primary causes of sleep disruptions. 

Being able to breathe normally while you are asleep is important, because breathing patterns have an impact on the heart rate and on the amount of oxygen that the brain and body receive. 

Sinusitis and sleep apnea are two conditions that can disrupt normal breathing and interfere with restful sleep. In this article, we look at the effects of these conditions and at the best ways of decreasing their impact on your sleep.

Sinusitis: Causes and Symptoms 

This is a respiratory condition whose main characteristic is inflammation of the sinuses. The sinuses are pyramid-shaped and frame the lower forehead, eyes, and nose. 

One of the roles of the sinuses is to keep the respiratory system free of bacteria and other harmful microorganisms, by trapping them in the cilia (very fine hairs that line the sinuses). 

To keep your respiratory system protected, the sinuses drain built-up bacteria and pollutants that have become trapped in the cilia. In a healthy person, this happens every 10 minutes or so. 

However, the sinuses can’t drain themselves normally if the nasal passage is blocked. This is what happens when you get a cold or other issues that cause a stuffy nose, such as allergies. 

If the blockage remains in place for a while, the accumulated pollutants and bacteria can’t be drained off the sinuses, and may cause further inflammation.

What are the main symptoms of sinusitis?

The main symptom is pain in the areas where the sinuses are located, so headaches and pain around the eyes and temples are common. In some cases, facial swelling may be visible. 

Nasal congestion is also common, which causes people to breathe through their mouth. When this happens at night, snoring is likely to happen. 

On the other hand, some people experience a runny nose or nasal discharge. A sore throat, bad breath, and a cough are other common symptoms.

What causes sinusitis?

In addition to allergies and the common cold, sinus inflammation can develop if:

  • You have a deviated septum
  • Your immune system is weak
  • You're a smoker
  • Your environment is polluted
  • You have nasal polyps (small growths on the inside of the nose).

Sleep apnea: Causes and Symptoms 

Obstructive sleep apnea or OSA is the most common form of sleep apnea, as it’s believed to affect one billion people worldwide. 

Although OSA is a sleep disorder, it has an impact on the respiratory system – just like sinusitis. People affected by OSA experience multiple sleep interruptions every night, since the muscles that keep the airways open relax too much and collapse, which blocks the normal flow of air into the lungs. 

Breathing interruptions usually last 10 seconds or more, after which the person experiences a sudden awakening, gasping for air, snorting, or choking. 

What are the main symptoms of obstructive sleep apnea?

People with OSA aren’t aware of the breathing interruptions, but the symptoms are usually evident while the person is awake. Common symptoms include:

  • Waking up feeling tired
  • A decrease in memory and concentration
  • Mood changes 
  • Frequent morning headaches
  • Waking up with a dry mouth or with a sore throat
  • Bed partners often report loud snoring

What causes obstructive sleep apnea?

The main cause of sleep apnea is poor muscle tone in the upper airways, but there are some factors that may increase the risk of developing this disorder. These include:

  • Smoking
  • Consuming alcohol
  • Taking certain narcotic drugs
  • Being obese or overweight

In addition, chronic nasal congestion is reported to cause obstructive sleep apnea. This type of obstruction causes mouth breathing, which over a period of time can impair muscle tone in the throat and upper airways.

So if a congested nose can cause OSA, could sinus inflammation be linked to this sleep disorder?

Are sleep apnea and sinusitis connected?

These two conditions are similar in that they cause disordered or abnormal breathing, as well as snoring. As to whether one causes the other, here’s what recent studies say:

In 2016, a study looked at whether people diagnosed with OSA were more likely to develop chronic sinus inflammation than those without OSA. The findings suggested that OSA patients had a higher chance of developing sinusitis, possibly because people with OSA frequently develop nasal and muscular inflammation. 

Another study examined the connection between chronic sinus inflammation and sleep disruption, and concluded that this condition increased the chances of experiencing sleep disturbances by up to 75%. However, these disturbances were mostly related to problems falling or staying asleep, and not to a physical blockage of the upper airways, as it happens during an OSA episode. 

How sinusitis and sleep apnea are treated 

Mild cases of sinus inflammation can be treated at home with decongestants, nasal sprays, antibiotics, or anti-inflammatory drugs. 

However, if the condition becomes chronic or happens several times per year, your physician may recommend other procedures to unblock or enlarge the passages inside the sinuses, so they can drain freely. This may involve surgery or an outpatient procedure called balloon sinuplasty.

And according to a 2015 study, people with both OSA and chronic sinus inflammation can benefit from sinus surgery, achieving better sleep quality and therefore increased psychological well-being.

Having said that, sinus surgery doesn’t eliminate the need for OSA treatment, which involves the use of a CPAP machine. CPAP therapy is the gold standard for obstructive sleep apnea, as it keeps the airways open during sleep and helps stabilize breathing. 

If you’ve started CPAP therapy and develop a sinus infection, contact your sleep specialist to discuss treatment while you’re ill.