International Rhinologic Society Rhinology 0300-0729 2026 05 21 When sleep improves but AHI does not: comments on mepolizumab ± FESS in severe CRSwNP EN W-Z. Hong Department of Otorhinolaryngology Head and Neck Surgery, Zhongshan Hospital of Traditional Chinese Medicine, Affiliated to Guangzhou University of Chinese Medicine, Zhongshan, Guangdong, China Letter 3463 10.4193/Rhin26.159 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.