Effect of Nasal Continuous Positive Pressure on the Nostrils of Patients with Sleep Apnea Syndrome and no Previous Nasal Pathology. Predictive Factors for Compliance

Abstract

ObjectiveTo evaluate the effect of continuous positive airway pressure (CPAP) on the nostrils of patients with sleep apnea–hypopnea syndrome and its impact on quality of life, and to identify predictive factors for compliance. MethodsLongitudinal prospective study. Thirty-six consecutive patients evaluated before and 2 months after CPAP using the following variables: clinical (eye, nose and throat [ENT] symptoms, Epworth test, anxiety/depression scales, general and rhinoconjunctivitis-specific quality of life); anatomical (ENT examination, computed tomography); functional (auditive and Eustachian tube function, nasal flow, mucociliary transport); biological (nasal cytology); and polisomnographics. The sample was divided into partients with good adherence (≥4h/d) and patients with bad adherence (<4h/d). ResultsA significant improvement was observed in daytime sleepiness (P=.000), anxiety (P=.006), and depression (P=.023). Nasal dryness (P=.000), increased neutrophils in nasal cytology (P=.000), and deteriorating ciliary function were evidenced, particularly in partients with good adherence. No significant differences were observed in the other variables. Baseline sleepiness was the only factor predictive of compliance. ConclusionsCPAP in patients without previous nasal pathology leads to an improvement in a series of clinical parameters and causes rhinitis and airway dryness. Some ENT variables worsened in partients with good adherence. Sleepiness was the only prognostic factor for poor tolerance.