Acute impact of continuous positive airway pressure on nasal patency

Continuous airflow in the upper airway can cause discomfort, leading to nasopharyngeal complaints. The aim of the present study is to evaluate the acute effects of continuous positive upper-airway pressure on nasal patency in awake normal subjects.

Twenty-seven adults (17 men; 10 women; age range, 18 to 43 years) were exposed to continuous airway pressure (20 cmH₂ O) in the nasal cavity, delivered by a continuous positive airway pressure (CPAP) device through a nasal mask for 2 hours. Visual analogue scale (VAS) of nasal obstruction, Nasal Obstruction Symptom Evaluation (NOSE) modified scale, acoustic rhinometry (AR), and peak nasal inspiratory flow (PF) were measured before and after the use of CPAP.

There was an increase in nasal obstruction scores both on the VAS (p < 0.05) and on the NOSE scale (p < 0.05), as well as a reduction in nasal cavity volume on AR (p < 0.05) and a decline in PF (p < 0.05). Subjects were stratified into 2 groups: with and without symptoms of allergic rhinitis. Nasal parameters were significantly worse in the rhinitis group, with higher nasal obstruction scores on the VAS (p = 0.001) and NOSE scale (p < 0.001) and decreased PF (p < 0.001).

Acute exposure to positive pressure via CPAP is associated with subjective and objective reductions in nasal patency. In individuals with allergic nasal symptoms, deterioration is even more severe than in patients without these symptoms.