Iman Al Afifi

Dr. Iman Al Afifi


Research Focus & Metrics

Academic Career Length

1Year (2026-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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2 August 2026 in Journal of Clinical Medicine
Verified
Journal Article
Open access
PDF file
AMAntonio Moffa
Antonio Moffa
Eugenio De CorsoEugenio De Corso
Eugenio De Corso
DNDomiziana Nardelli
Domiziana Nardelli
ABahmed bahgat
ahmed bahgat
ALAntonella Loperfido
Antonella Loperfido
Manuele CasaleManuele Casale
Manuele Casale
Background/Objectives: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type 2 inflammatory condition that significantly impairs health-related quality of life (HRQoL), particularly sleep quality. Beyond mechanical nasal obstruction, type 2 cytokines (IL-4, IL-13) are thought to directly disrupt sleep architecture. Dupilumab, an IL-4Rα antagonist, is approved for severe CRSwNP, but its specific effect on sleep quality remains under investigation. This systematic review aims to evaluate the impact of dupilumab on sleep quality in patients with severe, uncontrolled CRSwNP. Methods: A comprehensive literature search was conducted in PubMed/MEDLINE, Google Scholar, and Web of Science up to June 2026. We included adult studies (≥1 month of dupilumab 300 mg every 15 days) reporting sleep outcomes using validated tools (Epworth Sleepiness Scale [ESS], Pittsburgh Sleep Quality Index [PSQI], Insomnia Severity Index [ISI], or the SNOT-22 sleep domain). Risk of bias was assessed using ROBINS-I and RoB 2 tools. Results: Seven studies (n = 2164 patients) met inclusion criteria. Across observational and post hoc RCT analyses, dupilumab consistently improved the SNOT-22 sleep domain (mean reduction up to −7.02 points at 24 weeks; p < 0.001), PSQI, ESS, and ISI scores. One study reported a decrease in poor global sleep quality from 88.9% at baseline to 5.7% at 12 months. However, most observational studies had a serious risk of bias due to unaddressed confounding and lack of blinding. No polysomnographic data were reported. Conclusions: Dupilumab was associated with significant improvements in patient-reported sleep quality in CRSwNP patients across seven included studies. However, the evidence is limited by the absence of objective sleep measures, the serious risk of bias in most observational studies, and the lack of comparative head-to-head data. High-quality randomized controlled trials with prespecified sleep endpoints and polysomnographic assessments are needed before definitive conclusions can be drawn.

15 March 2026 in European Archives of Oto-Rhino-Laryngology
Verified
Journal Article
Closed access
PDF file
DNDomiziana Nardelli
Domiziana Nardelli
FIFrancesco Iafrati
Francesco Iafrati
AMAntonio Moffa
Antonio Moffa
BCBenedetta Cristalli
Benedetta Cristalli
IAIman Al Afifi
Iman Al Afifi
Manuele CasaleManuele Casale
Manuele Casale