Acute impact of continuous positive airway pressure on nasal patency

Balsalobre, Leonardo; Pezato, Rogério; Gasparini, Hiran; Haddad, Fernanda Louise Martinho; Gregório, Luiz Carlos; Fujita, Reginaldo Raimundo

doi:10.1002/alr.21948

Cited by 12 publications

(7 citation statements)

References 25 publications

(24 reference statements)

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“…A small study by Iriz et al () showed a decrease in minimal cross‐section area after 1 month with PAP, while after 3 months on PAP the area was back to baseline values. Another study by Balsalobre et al () found more subjective and objective (AR) nasal obstruction immediately after 2 hr of PAP use in non‐OSA patients.…”

Section: Discussionmentioning

confidence: 93%

“…When focusing on the anatomical aspects, Iriz et al () demonstrated a decrease in nasal dimensions measured with acoustic rhinometry (AR) after 1 month of PAP use, and a return to baseline values after 3 months of PAP usage. Balsalobre et al () has described immediate subjective and objective nasal blockage after 2 hr of PAP use. To our knowledge, the long‐term effect of PAP on internal nasal dimensions has not been described, and no large, well‐defined, prospective study has investigated the nose, either objectively or subjectively.…”

Section: Introductionmentioning

confidence: 99%

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PAP treatment in patients with OSA does not induce long‐term nasal obstruction

Värendh

Andersson

Björnsdóttir

et al. 2018

Journal of Sleep Research

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We hypothesized that positive airway pressure treatment would induce nasal obstruction and decrease nasal cavity due to mucosal swelling. We further hypothesized that subjective and objective nasal obstruction at baseline would negatively affect positive airway pressure adherence. A total of 728 patients with sleep apnea were investigated in the Icelandic Sleep Apnea Cohort at baseline and 2 years after starting positive airway pressure. Patients underwent home sleep apnea testing at baseline. Questionnaires were answered and acoustic rhinometry was completed at baseline and follow‐up. The proportion of patients reporting subjective nocturnal nasal obstruction was reduced (baseline: 35% versus follow‐up: 24%; p < 0.001). Small interior nasal dimensions increased (p < 0.001) independent of adherence to treatment. Small nasal volume at baseline was a determinant for becoming a non‐user of positive airway pressure treatment (odds ratio 2.22, confidence interval 95% 1.35–3.67, p = 0.002). Subjective nasal obstruction decreased 2 years after initiating positive airway treatment in sleep apnea, and objectively small nasal dimensions increased. Small nasal volume at baseline was a negative predictor for positive airway pressure treatment adherence. Maybe most importantly, positive airway pressure treatment did not cause long‐term objective or subjective nasal obstruction.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

PAP treatment in patients with OSA does not induce long‐term nasal obstruction

Värendh

Andersson

Björnsdóttir

et al. 2018

Journal of Sleep Research

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show abstract

“…For example, while most of the studies have revealed an infiltration of neutrophils into inflamed nasal mucous membrane following CPAP treatment of OSAHS patients, 6 not all of the studies have observed the same rhinitis symptoms. 5 , 6 , 13 , 14 These differences may be due to the methodologies used. For the prospective studies that have been conducted, these have rarely extended over more than one year due to the difficulties associated with long-term follow-up studies.…”

Section: Discussionmentioning

confidence: 99%

Effect of continuous positive airway pressure on allergic rhinitis in patients with obstructive sleep apnea–hypopnea syndrome

Yang

et al. 2018

TCRM

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BackgroundThe effect of continuous positive airway pressure (CPAP) on nasal symptoms in patients with obstructive sleep apnea–hypopnea syndrome (OSAHS) remains controversial. In addition, possible mechanism(s) remains unclear.ObjectiveTo examine whether CPAP contributes to the onset and exacerbation of allergic rhinitis (AR) in OSAHS patients based on patient-reported changes in nasal symptoms with and without CPAP therapy and the detection of house dust mites (HDMs) in CPAP filters and household environments.Materials and methodsIn a cohort of OSAHS patients, 350 patients who were undergoing CPAP therapy and 100 patients who declined CPAP therapy were retrospectively analyzed. These patients were contacted by telephone and asked to compare their nasal symptoms before and after CPAP therapy. HDMs in air conditioner and CPAP device filters and in household dust samples were detected using enzyme-linked immunosorbent assays.ResultsThe prevalence of AR was higher in the CPAP group vs the non-CPAP group (15.8% vs 7.0%, respectively; P = 0.025). The onset of AR among the OSAHS patients with no previous history of AR significantly increased within the first year of CPAP therapy compared with the control group (5.7% vs 0%, respectively; P = 0.031). Meanwhile, the patients with a history of AR were more likely to experience exacerbated rhinitis symptoms within the second year of treatment compared with the control group (7.5% vs 0%, respectively; P = 0.005). There was no significant difference in HDM concentrations between the CPAP and air conditioner filters, yet the concentrations in both the filters were higher than the concentrations in the bedroom dust samples (all P < 0.05).ConclusionCPAP is associated with the onset and exacerbation of AR in OSAHS patients. Long-term exposure to high concentrations of HDM allergens may be a significant factor.

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“…Furthermore, in individuals with allergic nasal symptoms, said deterioration is more severe than in patients without these symptoms. 9 Thus, it is worth considering that baseline inflammation due to AR could increase or exacerbate the inflammatory effect of high airflow in the nasal cavity as the result of CPAP and lead to greater CPAP intolerance.…”

Section: Introductionmentioning

confidence: 99%

Effect of topical corticosteroids on nasal patency after acute positive airway pressure exposure

Balsalobre

Figueiredo

Pezato

et al. 2021

Brazilian Journal of Otorhinolaryngology

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Acute impact of continuous positive airway pressure on nasal patency

Abstract: Acute exposure to positive pressure via CPAP is associated with subjective and objective reductions in nasal patency. In individuals with allergic nasal symptoms, deterioration is even more severe than in patients without these symptoms.

Cited by 12 publications

References 25 publications

PAP treatment in patients with OSA does not induce long‐term nasal obstruction

PAP treatment in patients with OSA does not induce long‐term nasal obstruction

Effect of continuous positive airway pressure on allergic rhinitis in patients with obstructive sleep apnea–hypopnea syndrome

Effect of topical corticosteroids on nasal patency after acute positive airway pressure exposure

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Acute impact of continuous positive airway pressure on nasal patency

Abstract: Acute exposure to positive pressure via CPAP is associated with subjective and objective reductions in nasal patency. In individuals with allergic nasal symptoms, deterioration is even more severe than in patients without these symptoms.

Cited by 12 publications

References 25 publications

PAP treatment in patients with OSA does not induce long‐term nasal obstruction

PAP treatment in patients with OSA does not induce long‐term nasal obstruction

Effect of continuous positive airway pressure on allergic rhinitis in patients with obstructive sleep apnea&ndash;hypopnea syndrome

Effect of topical corticosteroids on nasal patency after acute positive airway pressure exposure

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Effect of continuous positive airway pressure on allergic rhinitis in patients with obstructive sleep apnea–hypopnea syndrome