When sleep improves but AHI does not: comments on mepolizumab ± FESS in severe CRSwNP.

We read with great interest the randomized trial by Homoe et al. evaluating mepolizumab with or without functional endo-scopic sinus surgery (FESS) for severe uncontrolled CRSwNP (1), integrating patient-reported sleep outcomes (ESS, FOSQ-10, SNOT-22 sleep items) with WatchPAT-derived indices of sleep-disordered breathing (AHI/ODI). The study addresses a clinically frequent scenario in which patients report prominent fatigue and "poor sleep", while OSA may coexist and require indepen-dent management.