Role of nasal problems on positional and nonpositional obstructive sleep apnea

Area of Science:

• Otorhinolaryngology
• Sleep Medicine
• Pulmonology

Background:

• Nasal pathologies are common in patients with obstructive sleep apnea (OSA).
• The influence of nasal obstruction on the classification of OSA (positional vs. nonpositional) requires further investigation.
• Allergic rhinitis (AR) is a prevalent nasal condition that may impact OSA severity and type.

Purpose of the Study:

• To investigate the association between nasal pathologies, specifically allergic rhinitis, and the classification of obstructive sleep apnea (OSA) into positional (PP) and nonpositional (NPP) types.
• To determine if specific nasal obstruction parameters correlate with the presence of PP-OSA or NPP-OSA.

Main Methods:

• Retrospective analysis of 44 male OSA patients with nasal obstruction.
• Assessment of nasal obstruction scores, apnea-hypopnea index (AHI) in different positions, daytime sleepiness, and BMI.
• Correlation of snoring severity, clinical nasal obstruction, septal deviation, conchal hypertrophy, and AR scores with OSA type (PP vs. NPP).

Main Results:

• The apnea-hypopnea index (AHI) was significantly lower in the positional OSA (PP-OSA) group compared to the nonpositional OSA (NPP-OSA) group (p<0.03).
• A significant negative correlation was found between allergic rhinitis (AR) score and PP-OSA (r=-0.40, p<0.0001).
• A significant positive correlation was observed between AHI and body mass index (BMI) (r=0.32, p<0.05).

Conclusions:

• Allergic rhinitis (AR) is identified as a significant risk factor for obstructive sleep apnea (OSA).
• Patients with AR appear more likely to have nonpositional OSA (NPP-OSA) due to severe nasal obstruction increasing nasal resistance or pharyngeal collapsibility.