Pooled Analysis of Sleep Outcomes After Treatment With Temperature-Controlled Radiofrequency in Nasal Airway Obstruction Patients

Objective: To assess the long-term impact of temperature-controlled radiofrequency (TCRF) treatment on sleep-related symptoms in patients with nasal airway obstruction (NAO), including those with documented obstructive sleep apnea (OSA). Study Design: Pooled analysis of prospective multicenter studies. Setting: Seven academic and 25 private otolaryngology sites. Methods: A pooled analysis of 345 adults across four prospective multicenter studies (PIVOTAL, VATRAC, SWELL, and AERWAY) from 7 academic and 25 private otolaryngology sites was conducted. Participants had severe-to-extreme NAO and received a single, office-based TCRF treatment targeting the nasal valve or septal swell body (SSB). Outcomes included sleep-related components of the Nasal Obstruction Symptom Evaluation (NOSE) scale, 22-item Sino-Nasal Outcome Test (SNOT-22) sleep domain, and Epworth Sleepiness Scale (ESS). Analyses included stratification by the presence or absence of OSA and linear regression. Results: TCRF treatment was associated with significant, durable improvements in sleep-related symptoms through 24 months. At 24 months, the “Trouble Sleeping” subcomponent of the NOSE score improved by −1.9 (95% CI, −2.0 to −1.7) points, a 64% improvement. SNOT-22 sleep domain scores declined by −9.0 (95% CI, −10.5 to −7.6) points, with more than 80% of participants achieving clinical improvement. Among those with excessive daytime sleepiness (ESS ≥ 10), ESS dropped by −8.3 (95% CI, −9.7 to −6.9), and the prevalence of sleepiness fell from 53.8% to 9.8%. Improvements were consistent across the OSA+ subgroup. Conclusion: Office-based TCRF therapy targeting the nasal valve and/or SSB is associated with clinically meaningful, durable improvements in sleep-related symptoms and daytime somnolence in NAO patients, including a subset of those with documented OSA.