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[Obstructive sleep apnea and obstructing nasal polyps]

T Verse1, W Pirsig, B Kroker

  • 1Universitäts-Hals-Nasen-Ohren-Klinik Ulm.

Laryngo- Rhino- Otologie
|May 13, 1998
PubMed
Summary
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Nasal polyps surgery unexpectedly worsened sleep apnea in two patients, increasing their apnea-hypopnea index (AHI) and causing daytime sleepiness. This highlights potential risks of nasal surgery for sleep-related breathing disorders.

Area of Science:

  • Otolaryngology
  • Sleep Medicine
  • Respiratory Physiology

Background:

  • Nasal obstruction is a potential factor in obstructive sleep apnea (OSA).
  • The specific role of nasal polyps in OSA has not been previously studied.
  • This study investigates the impact of nasal polyp treatment on sleep apnea.

Observation:

  • Two male patients with nasal polyps causing significant obstruction and hyposmia underwent endonasal sinus surgery.
  • Pre- and post-operative polysomnography (PSG) and nasal endoscopy were performed.
  • Patients reported relief of nasal obstruction but not sleep-related symptoms pre-operatively.

Findings:

  • Post-surgery, both patients experienced a significant increase in their apnea-hypopnea index (AHI).
  • Excessive daytime sleepiness (EDS) emerged, and REM sleep duration decreased post-operatively.

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  • Nasal CPAP therapy was recommended for both patients after surgery.

    • Implications:

    • Surgical intervention for nasal polyps may paradoxically worsen sleep apnea.
    • Changes in nasal airflow dynamics or sensory receptor function post-surgery could influence breathing patterns.
    • Further research is needed to understand the complex relationship between nasal surgery, nasal breathing, and sleep apnea severity.