The effect of unilateral and bilateral nasal obstruction on snoring and sleep apnea

Miljeteig, Harald; Hoffstein, V.; Cole, Philip

doi:10.1288/00005537-199210000-00009

Cited by 95 publications

(68 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Many studies show that, in the awake state, nasal obstruction is an independent risk factor for OSAS 4 . These results have been contradicted by other studies, which found differences between apnea and snoring patients with nasal resistance 5 . A similar study measuring supine nasal resistance failed to find any correlation with sleep disturbance indices.…”

Section: Introductioncontrasting

confidence: 68%

The value of posterior rhinomanometry in evaluating patients with snoring and obstructive sleep apnea syndrome

Stanciu¹,

Cirticioiu²,

Neagoş

2016

Romanian Journal of Rhinology

View full text Add to dashboard Cite

INTRODUCTIONThe most frequent and common respiratory sleep pathology encountered in medical practice is snoring associated or not with obstructive sleep apnea syndrome (OSAS). Obstructive sleep apnea is characterized by repetitive, partial or complete obstruction of the upper airway during sleep despite simultaneous respiratory effort, resulting in episodic hypoxemia and arousal. Respiratory disorders during sleep are very common in the general population and they are estimated to affect approximately 4% of men and 2% of women in the middle-aged workforce and laboratory investigations in sleepiness potentially increase day by day.It is well known that nasal breathing is the physiological one and that the nasal passages, by their complex structure and rich vascular, lymphatic, glandular and nervous formations, fulfil a very important physiological role. The calibre of the nasal passages, by their architectonic and morphofunctional integrity of the mucosa, help regulate the respiratory airflow, through its vascular-erectile function. The nasal mucosa, due to its morphological structure, ensures the inspired air conditioning function by the following three processes: heating, moistening and filtering. The ENT changes responsible for upper airway obstruction can be represented by nasal pathology, with or without oral and hypopharyngeal pathology. Multilevel obstruction is often present in snoring and ob-ABSTRACT BACKGROUND. Nowadays, snoring and obstructive sleep apnea are the most common sleep-related breathing disorders

show abstract

Section: Introductioncontrasting

confidence: 68%

The value of posterior rhinomanometry in evaluating patients with snoring and obstructive sleep apnea syndrome

Stanciu¹,

Cirticioiu²,

Neagoş

2016

Romanian Journal of Rhinology

View full text Add to dashboard Cite

show abstract

“…Using postnasal rhinomanometry in 683 patients, MILJETEIG et al [11] found no statistically significant relationships between nasal resistance and either snoring or OSAS. These findings are different from those in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…However, direct comparison of the two studies is difficult for several reasons. 1) MILJETEIG et al [11] compared only the snoring index and AHI between patients with normal and abnormal nasal resistance, without performing regression analysis. 2) The method for nasal resistance measurement was not the same in the two studies.…”

Section: Discussionmentioning

confidence: 99%

“…2) The method for nasal resistance measurement was not the same in the two studies. MILJETEIG et al [11] used postnasal rhinomanometry, in which pharynegeal pressure was recorded through a lidocaine gel-lubricated catheter inserted 8 cm along the floor of the wider nasal cavity. This catheter reduced the calibre of the nasal pathway and may have interfered with the normal physiology of the nasal mucosa, inducing nasal congestion.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Nasal obstruction as a risk factor for sleep apnoea syndrome

Lofaso¹,

Coste²,

d’Ortho³

et al. 2000

Eur Respir J

212

139

View full text Add to dashboard Cite

Nasal obstruction has frequently been mentioned as a possible risk factor in obstructive sleep apnoea syndrome (OSAS). Over a 2‐yr period, 541 unselected consecutive snorers referred for suspected breathing disorders during sleep were included to undergo posterior rhinomanometry. In addition cephalometric landmarks and body mass index (BMI) were obtained. Polysomnography was used to determine the number of abnormal respiratory events that occurred during sleep. OSAS was defined as 15 episodes, or more, of apnoea or hypopnoea per hour of sleep (AHI). Of the 541 consecutive snorers 528 underwent nasal resistance measurement by posterior rhinomanometry (failure rate: 2.4%). Patients with OSAS (259 patients) had higher nasal resistance than patients without OSAS (2.6±1.6 hPa·L·s‐1versus 2.2±1.0 hPa·L·s‐1, respectively, p<0.005). A stepwise multiple regression analysis showed that BMI, male sex, nasal resistance, and cephalometric parameters were contributing factors to the AHI. The r2‐value of the multiple regression analysis was 0.183. Nasal resistance contributed 2.3% of the variance (p<0.0001), whereas mandibular plane‐hyoid distance, BMI, male sex and age contributed 6.2%, 4.6%, 3% and 1.3% of the variance, respectively. To conclude, daytime nasal obstruction is an independent risk factor for OSAS.

show abstract

“…It may still help to relieve airway obstruction but usually has a very positive effect on improving the quality of life and CPAP tolerance in OSA patients (21,22). (13) reported on 14 patients with allergic rhinitis and 7 controls.…”

Section: Effects Of Nasal Anatomical Abnormalities On Osamentioning

confidence: 99%

Effects of Nasal Pathologies on Obstructive Sleep Apnea

Enöz

2007

Acta Med. (Hradec Kralove, Czech Repub.)

View full text Add to dashboard Cite

Many abnormalities of the nose and pharynx can cause or aggravate snoring and sleep apnea. Nasal septal deviation, nasal polyps, inferior turbinate hypertrophy and rhinitis can cause nasal airway obstructions. Adenoid hypertrophy, nasopharyngitis and nasopharyngeal tumors can cause nasopharyngeal airway narrowing (6).Epidemiological studies have found relationships between a history of nasal stuffiness and snoring (8) and between measured nasal airflow and a history of snoring (3), but attempts to find a linear correlation between nasal obstruction and sleep-disordered breathing have been less successful (2,30,34). However, a weak correlation between nasal resistance measured by means of posterior rhinomanometry and the severity of sleep apnea has recently been reported (15).Several studies have shown that increased nasal resistance may induce sleep-related breathing disorders (SRBD) and cause disturbed sleep (7, 8); however, contradictory results have also been obtained (12). PathophysiologyThree interacting factors play a critical role in obstruction of the upper airway in OSAS: the muscle activity of the dilators of the pharyngeal airway, the negative pressure generated during inspiration, which opposes the activity of the dilators, and the structural anatomy of the airway (7, 31).Mouth opening, independent of the breathing route, is believed to increase the collapsibility of the upper airways as a result of a decrease in the contractility of the upper airway muscles (20).The biologic basis for nasal obstruction as a cause of sleep-disordered breathing lies in the effect of nasal breathing on resistance and flow velocity, which affects the pressure differential between the atmosphere and the intrathoracic space (34). Partial or complete obstruction can occur when the intrathoracic negative pressure generated by the inspiratory muscles pulls on the compliant soft tissue in the upper airway, sucking the airway closed (26). It is worth pointing out that the nose accounts for half of the total respiratory system resistance (24). Nasal obstruction leads to various breathing disturbances, including an increase in sleep apnea-hypopnea and a reduced nocturnal lowest SpO 2 (23, 33).Although the primary site of obstruction in patients with OSAS is believed to be the oropharyngeal-hypopharyngeal region (Fig. 1), numerous studies examining the effects of experimentally-induced nasal obstruction on OSAS have indicated a positive and significant association (7,23,32,36). Therefore, nasal obstruction constitutes a predisposing factor for OSAS (1,3,23,32,36). Effects of nasal pathologies on OSA are summarized in Fig. 2. Effects of Allergic Rhinitis on OSAThe prevalence rate of allergic rhinitis is increasing by 3.5 % per decade and is estimated to be 15-25 % in Europe (29).In general, allergic rhinitis constitutes a pathologic condition characterized by a transient increase in nasal airway resistance due to mucosal swelling (16,18,22,25) and therefore theoretically constitutes a risk factor for OSAS.Several reports in which ...

show abstract

The effect of unilateral and bilateral nasal obstruction on snoring and sleep apnea

Cited by 95 publications

References 11 publications

The value of posterior rhinomanometry in evaluating patients with snoring and obstructive sleep apnea syndrome

The value of posterior rhinomanometry in evaluating patients with snoring and obstructive sleep apnea syndrome

Nasal obstruction as a risk factor for sleep apnoea syndrome

Effects of Nasal Pathologies on Obstructive Sleep Apnea

Contact Info

Product

Resources

About