Postural Variations of Nasal Patency

Rundcrantz, Hans

doi:10.3109/00016486909121582

Cited by 146 publications

(95 citation statements)

References 9 publications

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“…25 Nasal congestion increases in the supine position, thus worsening its effects during sleep. 35 In addition, nasal congestion, rhinorrhea, and sneezing exhibit circadian rhythms, with the greatest intensity in early morning, thus exacerbating their negative effects on sleep. 36,37 Allergic rhinitis-related inflammatory mediators also exhibit a circadian pattern, with levels peaking in early morning.…”

Section: Mechanisms Of Nasal Congestion: Impact On Sleep Quality and mentioning

confidence: 99%

Allergic rhinitis-induced nasal congestion: its impact on sleep quality

Storms¹

2008

Primary Care Respiratory Journal

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Allergic rhinitis (AR) is an extremely common health problem affecting 20 to 40 million Americans and between 10-25% of the world's population. Patients with AR suffer from both nasal symptoms (congestion, rhinorrhea, itching, and sneezing) and ocular symptoms (itching, redness, and tearing). The negative impact on sleep quality and quantity, and consequently on various aspects of the patient's life, is an under-recognised and under-treated component of AR morbidity. Nasal congestion, which is one of the most bothersome and prevalent symptoms of AR, is thought to be the leading symptom responsible for rhinitis-related sleep problems.In addition to reducing clinical symptoms, pharmacologic therapies for AR that specifically reduce inflammatory cells and mediators -and therefore nasal congestion and other symptoms -should also improve sleep quality and overall quality of life (QOL). Intranasal corticosteroids (INS) are the current mainstay of therapy for AR. Results of a number of clinical trials demonstrate that INS effectively reduce nasal congestion and ocular symptoms, improve sleep quality, and decrease daytime somnolence. Intranasal corticosteroids have also proved to be effective in reducing symptoms of acute rhinosinusitis and nasal polyposis, both of which also negatively impact on sleep quality. Intranasal corticosteroids are considered safe due to their low systemic bioavailability.

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Section: Mechanisms Of Nasal Congestion: Impact On Sleep Quality and mentioning

confidence: 99%

Allergic rhinitis-induced nasal congestion: its impact on sleep quality

Storms¹

2008

Primary Care Respiratory Journal

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“…In total, 10 patients were studied (nine males; mean¡SD (range) 46¡5 yrs ; body mass index 27¡1.5 kg?m -2 (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)). The inclusion criteria were as follows: 1) OSA syndrome [27] not yet receiving treatment; 2) clinically significant nasal obstruction (on the basis of clinical examination by M.F.…”

Section: Patientsmentioning

confidence: 99%

Effect of treating severe nasal obstruction on the severity of obstructive sleep apnoea

McLean

Urton²,

Driver³

et al. 2005

European Respiratory Journal

123

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An association between mouth breathing during sleep and increased propensity for upper airway collapse is well documented, but the effect of treatment for nasal obstruction on mouth breathing during sleep and simultaneous obstructive sleep apnoea (OSA) severity has not been described previously.A randomised single blind placebo-and sham-controlled crossover study of treatment (topical decongestant and external dilator strip) for nasal obstruction was carried out in 10 patients (nine males; mean¡SEM 46¡5 yrs) with nasal obstruction and OSA. All patients had normal acoustic pharyngometry. The effect of treatment on nasal resistance, mouth breathing during sleep and OSA severity was quantified.Treatment of nasal obstruction was associated with a dramatic and sustained reduction in nasal resistance and the oral fraction of ventilation during sleep (mean (95% confidence interval) absolute reduction in oral fraction 30% (12-49)). Improvements in sleep architecture were observed during active treatment, and there was a modest reduction in OSA severity (change in apnoea-hypopnoea index 12 (3-22)).In conclusion, treating nasal obstruction reduced mouth breathing during sleep and obstructive sleep apnoea severity, but did not effectively alleviate obstructive sleep apnoea.

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“…In the individual subject, nasal resistance can vary in relation to changes in nasal vascular congestion, posture, exercise, ambient air conditions, pharmacological agents, and disease [57]. A marked increase in nasal resistance is seen in patients with acute or chronic rhinitis when they become recumbent [58]. Unilateral nasal disease, such as polyps, can also cause increased nasal resistance in the lateral recumbent position if present in the uppermost nostril [59].…”

Section: Nasal Obstructionmentioning

confidence: 99%

Pathophysiology of obstructive sleep apnoea

Deegan¹,

McNicholas²

1995

Eur Respir J

263

183

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Arousal plays an important role in the termination of each apnoea, but may also contribute to the development of further apnoea, because of a reduction in respiratory drive related to the hypocapnia which results from postapnoeic hyperventilation. A cyclical pattern of repetitive obstructive apnoeas may result.A better understanding of the integrated pathophysiology of OSA should help in the development of new therapeutic techniques.

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Postural Variations of Nasal Patency

Cited by 146 publications

References 9 publications

Allergic rhinitis-induced nasal congestion: its impact on sleep quality

Allergic rhinitis-induced nasal congestion: its impact on sleep quality

Effect of treating severe nasal obstruction on the severity of obstructive sleep apnoea

Pathophysiology of obstructive sleep apnoea

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