Clin Exp Otorhinolaryngol.  2017 Mar;10(1):71-76. 10.21053/ceo.2015.01438.

The Effect of Sleep Disordered Breathing on Olfactory Functions: Analysis by Apnea-Hypopnea Index

• Shin DH
• Ahn SH
• Yang Y
• Choi S
• Cho JH
• Hong SC
• Kim JK

• KMID: 2376411
• DOI: http://doi.org/10.21053/ceo.2015.01438

Abstract

OBJECTIVES
One hypothesis of obstructive sleep apnea syndrome (OSAS) is that long-standing snoring vibrations and hypoxia of the nerves cause a local neuropathy in the upper airway during sleep. The aim of this study was to investigate olfactory function in subjects comprising snorers and untreated subjects with OSAS, and to correlate data with polysomnographic parameters.
METHODS
Sixty-nine patients were evaluated for snoring from January 2010 to December 2013. The mild group (apneahypopnea index [AHI]<15) consisted of 19 subjects, and the moderate-severe group (AHI≥15) consisted of 50 subjects. Exclusion criteria were conductive olfactory dysfunction, previous tonsil or soft palatal surgery, central sleep apnea, and medications that are known to affect peripheral nerves. Nocturnal polysomnography and olfactory function test such as Korean version of Sniffin's stick test I, II (KVSS I, II) were performed.
RESULTS
There was a significant difference in body mass index, average oxygen saturation (SaO2), lowest SaO2, average snoring duration, and KVSS I, II between the two groups. AHI was related to odor threshold score, and average SaO2 was related to odor discrimination score. But, odor identification score showed no relation with AHI and average SaO2 except for age. Average SaO2 and AHI were closely related to the function of smell.
CONCLUSION
Hypoxia and low nasal airflow caused by OSAS may have an effect on the olfactory function. On comparison between the two groups, patients with a high AHI, especially those with OSAS, had an olfactory dysfunction. Also, low average oxygen is the main risk factor in determining the olfactory function. In people with OSAS, the possibility of olfactory dysfunction should be considered and an olfactory function test should be performed.

Keyword

Obstructive Sleep Apnea; Polysomnography; Smell; Olfaction Disorders

MeSH Terms

Anoxia
Body Mass Index
Discrimination (Psychology)
Humans
Odors
Olfaction Disorders
Oxygen
Palatine Tonsil
Peripheral Nerves
Polysomnography
Risk Factors
Sleep Apnea Syndromes*
Sleep Apnea, Central
Sleep Apnea, Obstructive
Smell
Snoring
Vibration
Oxygen

Figure

• 

  Fig. 1. (A) Scatter plot showing a significant negative association of apnea-hypopnea index (AHI) with Korean version of Sniffin’s stick test II (KVSS II) score (Spearman rank correlation, –0.275; P=0.022). Regression line and lines for the 95% confidence interval (CI) are shown. (B) Scatter plot showing a significant positive association of average oxygen saturation with KVSS II score (Spearman rank correlation, 0.271; P=0.024). Regression line and lines for the 95% CI are shown.

• 

  Fig. 2. (A) Scatter plot showing a significant negative association of apnea-hypopnea index (AHI) with threshold test score (Spearman rank correlation, –0.336; P<0.01). Regression line and lines for the 95% confidence interval (CI) are shown. (B) Scatter plot showing a significant positive association of average oxygen saturation with discrimination test score (Spearman rank correlation, 0.246; P=0.042). Regression line and lines for the 95% CI are shown.

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