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Sinusitis (inflammation of the sinuses) and hay fever (allergic inflammation inside the nose) can certainly make you feel under the weather. But could these common maladies actually contribute to depression? As surprising as that might sound, several recent studies indicate that your psychological health and your sinus and nasal health are connected.

I first wrote about this unexpected link in a blog post nearly four years ago. Since then, the evidence for an association between sinusitis or hay fever and depression has only grown more compelling. In 2017 alone:

  • A study from Harvard Medical School found that a blocked-up nose was associated with an increased risk for depression in people with chronic sinus and nasal problems.
  • Research from the University of British Columbia found that about one-fifth of patients awaiting minimally invasive surgery for sinusitis also had signs of depression.
  • A study led by U.K. researchers at the County Durham and Darlington NHS Foundation Trust found that people with chronic sinus and nasal symptoms had a high rate of psychological distress. The more severe their physical symptoms, the greater the psychological burden tended to be.

Nosing around in nationwide data

Among the new publications, one stands out as the first to look at this issue across the entire U.S. population. Published in October 2017 in Laryngoscope Investigative Otolaryngology, this study looked at how sinusitis and hay fever affect depression, sleep, and work.

Recently, I chatted with study coauthor Kevin Hur, M.D., of the University of Southern California about what this research revealed. “Based on a recent national health survey, adults in the U.S. who reported having hay fever or sinusitis in the last 12 months were more likely to report having depressive symptoms as well,” Dr. Hur says.

Although this research didn’t explore physiological mechanisms, Dr. Hur believes that inflammation may play a role. “Elevated levels of pro-inflammatory cytokines—specifically, interleukin-1 (IL-1) and interleukin-6 (IL-6)—are found in patients with sinusitis as well as in patients with depression,” he says. “The significance of this similarity is still unclear, but the overlap in the pathophysiology of the two diseases may contribute to the overall association.”

Disturbed sleep and depressed mood

Poor sleep may be another important factor. “In our study, we found that adults who reported having sinusitis or hay fever slept fewer hours per night, on average, than those without these conditions,” says Dr. Hur. “Symptoms of sinus and nasal inflammation—such as a runny nose, nasal congestion, and sinus headaches—may greatly inhibit a person’s ability to get quality sleep at night. And that, in turn, affects the ability to function optimally during the day.”

Although your mood may suffer when you don’t sleep well, Dr. Hur points out that the relationship between sleep and full-fledged depression is complex. “Poor sleep can lead to depression, and depression can lead to poor sleep,” he says. “It’s a two-way street.”

Lost productivity at work or school

Sinusitis and hay fever may also get you down by sabotaging your success at work or school. It’s next to impossible to be at your best when you’re drowsy and dragging from lack of sleep. Plus, depression itself can sap your energy, drive, and concentration.

In a second study from the Harvard research team, depression symptoms were associated with missing days of work or school due to chronic sinusitis. In fact, the findings suggest that depression may be the biggest cause of lost productivity in sinusitis sufferers.

When quality of life takes a nosedive

A healthy sense of smell can help with savoring a meal, summoning up a memory, or, quite literally, stopping to smell the roses. Many people with chronic sinus and nasal problems find that their ability to smell is diminished. In recent research from the Medical University of South Carolina, depression was correlated with the negative effects of a decreased sense of smell.

The potential for misery doesn’t end there, unfortunately. “Symptoms of sinusitis and hay fever—such as a runny or stuffy nose, sneezing, and headaches—can all severely impact daily life and make social interactions very difficult,” says Dr. Hur.

So what should you do if you believe that your sinus and nasal problems are taking a toll on your well-being? “See a health care professional to be evaluated,” advises Dr. Hur. “There are several treatment options available to help improve your quality of life.”

References

Zhou, S., Hur, K., Shen, J., & Wrobel, B. (2017). Impact of sinonasal disease on depression, sleep duration, and productivity among adults in the United States. Laryngoscope Investigative Otolaryngology, 2, 288-294. http://dx.doi.org/10.1002/lio2.87

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