{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T11:45:38Z","timestamp":1771674338525,"version":"3.50.1"},"reference-count":65,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,10,22]],"date-time":"2013-10-22T00:00:00Z","timestamp":1382400000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Sleep disturbance, reduced quality of life (QOL), and other components of \u201csickness behavior\u201d in patients with chronic rhinosinusitis (CRS) are poorly understood. These complex changes in central behavior are due to the effects of immune mediators acting in the brain. We hypothesized that immune mediators that have been associated with CRS are also associated with sickness behavior, somnifacient complaints, and CRS disease\u2010specific QOL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Pilot study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty patients with CRS were prospectively enrolled and completed the Pittsburgh Sleep Quality Index (PSQI), disease\u2010specific QOL, and olfactory instruments. Ethmoid mucosa was obtained and reverse transcription\u2010polymerase chain reaction was performed for the cytokines interleukin (IL)\u22124, \u221213, and transforming growth factor\u2010\u03b2 (TGF\u2010\u03b2). Average change in crossover threshold was calculated, and differences in gene expression were correlated with sleep quality, CRS\u2010specific QOL, and disease severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with CRS reported overall poor sleep quality and poor CRS\u2010specific QOL with significant correlations between them. Increased expression of TGF\u2010\u03b2 (<jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.443; <jats:italic>P<\/jats:italic>\u2009=\u2009.050) and IL\u20104 (<jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.548; <jats:italic>P<\/jats:italic>\u2009=\u2009.012) correlated with sleep dysfunction, whereas IL\u201013 expression was linearly associated with worse sleep quality (PSQI scores <jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.417; <jats:italic>P<\/jats:italic>\u2009=\u2009.075). IL\u20104 and TGF\u2010\u03b2 expression was not associated with CRS disease severity or QOL, whereas significantly higher levels of IL\u201013 expression correlated with worse CRS disease severity and QOL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with CRS exhibited behavioral changes commonly referred to as sickness behavior, which include poor sleep quality and reduced QOL. The upregulation of IL\u20104 and TGF\u2010\u03b2 may contribute to inflammatory brain\u2010mediated effects on sleep quality, whereas IL\u201013 may be a pleiotropic signaling molecule influencing sleep, QOL, and CRS disease severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2b. <jats:italic>Laryngoscope<\/jats:italic>, 124:E107\u2013E114, 2014<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.24412","type":"journal-article","created":{"date-parts":[[2013,10,12]],"date-time":"2013-10-12T01:38:16Z","timestamp":1381541896000},"source":"Crossref","is-referenced-by-count":34,"title":["Antisomnogenic cytokines, quality of life, and chronic rhinosinusitis: A pilot study"],"prefix":"10.1002","volume":"124","author":[{"given":"Jeremiah A.","family":"Alt","sequence":"first","affiliation":[{"name":"Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology\u2013Head and Neck Surgery Oregon Health and Science University Portland 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U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy L.","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology\u2013Head and Neck Surgery Oregon Health and Science University Portland Oregon 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