Assessment of Screening for Nasal Obstruction among Sleep Dentistry Outpatients with Obstructive Sleep Apnea.

Arisa Sawa,Hiroshi Suzuki,Yoshihiro Iwata,Yasuhide Makiyama,Hideo Niwa,Sumito Oguchi,Chin Moi Chow,Tatsuo Yagi,Osamu Komiyama

doi:10.3390/dj8040119

Arisa Sawa, Hiroshi Suzuki + Show 7 more

Open Access

https://doi.org/10.3390/dj8040119

Copy DOI

Abstract

Oral appliances (OA), a common treatment modality for obstructive sleep apnea (OSA), are not suitable for patients with nasal obstruction. Rhinomanometry, the gold standard technique to assess nasal airway resistance, is not readily available in sleep dentistry clinics. We demonstrate the use of a portable lightweight peak nasal inspiratory flow (PNIF) rate meter to objectively assess nasal airflow and utilized the Nasal Obstruction Symptom Evaluation (NOSE) scale to subjectively assess nasal obstruction in 97 patients with OSA and 105 healthy controls. We examined the correlations between the following variables between the groups: demographics, body mass index, PNIF, NOSE scale scores, apnea–hypopnea index (AHI), minimum SpO2 (SpO2min), Mallampati classification, and Epworth Sleepiness Scale (ESS) scores. Patients with OSA had significantly lower PNIF values and higher NOSE scores than controls. In the patient group, PNIF was not significantly correlated with AHI, SpO2min, Mallampati classification, or NOSE or ESS scores. Lower PNIF values and higher NOSE scores suggested impaired nasal airflow in the OSA group. As daytime PNIF measurement bears no relationship to AHI, this cannot be used alone in predicting the suitability of treatment for OSA with OA but can be used as an adjunct for making clinical decisions.

Highlights

Obstructive sleep apnea (OSA) is a condition in which oxygen levels in the brain are reduced by the cessation of breathing during sleep, resulting in sleep disturbances [1]
Data on apnea–hypopnea index (AHI), SpO2 min (%), and the Epworth Sleepiness Scale (ESS) scores were collected for the obstructive sleep apnea (OSA) group (Table 1)
The mean peak nasal inspiratory flow (PNIF) values were significantly lower in the OSA group (101.3 ± 44.4 L/min) than in the control group (134.2 ± 31.5 L/min) (p < 0.001)

Summary

Introduction

Obstructive sleep apnea (OSA) is a condition in which oxygen levels in the brain are reduced by the cessation of breathing during sleep, resulting in sleep disturbances [1]. OSA has been associated with the onset and worsening of lifestyle-related diseases such as hypertension, myocardial infarction, and diabetes. OSA can lead to excessive daytime sleepiness, significantly increasing the risk of accidents [2]. Continuous positive airway pressure (CPAP) therapy remains the gold standard for the. J. 2020, 8, 0119 treatment of OSA in Europe and the United States. Patients with mild-to-moderate OSA can be treated using oral appliances (OA) [3]

Methods

Results

Discussion

Conclusion