Sleep disorders in patients with severe nasal obstruction due to septal deviation

The role of nasal obstruction in etiology of the sleep apnea disease is controversial in literature. Forty-six subjects (3 women, 43 men) with severe nasal obstruction due to septal deviation were evaluated. The examination included case history, clinical ORL examination by ENT specialist, rhinomanometry and whole night sleep recording (SCSB, oximetry, EKG). Mean age of the patients was 40.0 years (from 17 to 68 years) and body mass index 26.0 kg/m2 (from 20.3 to 34.6 kg/m2). The chief complaint of the patients was a severe nasal obstruction. Thirty-one patients (67%) had also heavy disturbing snoring, and apnea periods during sleep were reported by 10 cases. The evaluation of the sleep recordings revealed 12 cases with partial upper airway obstruction (26%), 1 case with severe airway obstruction, 1 case with mixed type of obstructive apnea and 3 cases with periodic limb movements. Evaluation of the oxygen desaturation of the blood revealed only 6 cases with significant disturbance (pO2 below 90% level). As a final result we conclude that severe nasal obstruction can lead to breathing disturbance during sleep.