0851 Evaluation of a new sleep focused nasal obstruction symptom evaluation (NOSE) tool

Abstract

Abstract Introduction Nasal obstruction is a common patient complaint in the sleep clinic. The nasal obstruction symptom evaluation (NOSE) scale is a validated questionnaire to assess symptoms and quality of life. However, it has weaknesses when evaluating patients in the sleep clinic because it does not differentiate awake and sleep related nasal obstruction. Our primary goal was to compare the old NOSE scale to a new sleep NOSE scale that separates awake and sleep related nasal obstruction. Methods A retrospective study was completed to compare the known NOSE scale (old NOSE) with a revised clinical scale more relevant to the sleep clinic (new sleep NOSE and new awake NOSE). 169 adult participants completed the 3 scales in a sleep clinic specializing in otolaryngologic interventions. The collected data compared median scores (Wilcoxon’s signed rank test), agreement (Cohen’s kappa), and correlation (Spearman correlation). Wald’s test was also used to compare the scores between subgroups of insomnia and obstructive sleep apnea (OSA). Results The old NOSE scale scores were not significantly different from the sleep NOSE score (p=0.4) but was significantly different from the awake NOSE scale (p< 0.001). The new sleep NOSE scores were also significantly higher than then awake NOSE scores (p<.001). Patients with insomnia tended to score higher on the sleep NOSE scale than the awake NOSE scale. Conclusion This study suggests that in the sleep clinic setting, patients score the NOSE scale according to sleep related obstruction. In addition, insomnia patients relate more nighttime than daytime nasal obstruction. Further studies are needed to determine if the NOSE scale needs to be revised to better encompass nasal complaints related to sleep. Support (if any)