The Effect of Nasal Obstruction on Sleep Apnea

Roh, Hwan Jung; Koo, Han Eol; Jeong, Hyang Sook; Koo, Soo Kweon; Lee, Sang Hwa

Abstract

BACKGROUND AND OBJECTIVES: Although it is widely accepted that nasal obstruction leads to snoring and sleep apnea, the relationship between these variable factors is not clear. Moreover, while nasal blockage in human is known to produce sleep- disordered breathing, it is controversial whether nasal obstruction itself produces obstructive apnea and whether it causes changes in the sleep stages. The purpose of this study is to measure changes in sleep physiology by nasal blockage alone and to evaluate whether the nasal blockage itself ca>i produce the sleep apnea syndrorm or not. MATERIAL AND METHOD: Normal thirty subjects, 15 males and 15 females, who had sleep apnea episodes <2 by polysomnography during sleep, were evaluated using Alice III polysomnography after both nostrils opened, unilateral nostril blockage, and bilateral nostril blockage. The parameters of measurement were hypopnea and apnea episodes and apnea type, apnea index (AI), respiratory disturbance index (RDI), SO and sleep stages. A statistical analysis was performed using a wicoxon signed rank test.
RESULTS
Bilateral nasal blockage induces significantly increased apnea and hypopnea episodes, AI, and RDI but induces significantly decreased mean and lowest O. saturation. Also, bilateral nasal blockage significantly prolonged S,-NREM sleep and decreased REM sleep (p(0.05). However, these changes did not correspond with the criteria of the sleep apnea syndrome.
CONCLUSION
Unilateral nasal obstruction does not cause any significant changes in the measured parameters compared to the normal nose of unblocked state. Bilateral nasal obstruction does not induce the obstructive sleep apnea syndrome by itself. However, it causes changes in the sleep stages and increases sleep apnea episodes significantly.