Nasal Symptoms in Patients with Obstructive Sleep Apnoea and Their Association with Continuous Positive Airway Pressure Usage.

Konstantinos Chaidas,Kallirroi Lamprou,Annabel H Nickol,John R Stradling,Amberley Munnings

doi:10.3390/life12020305

Konstantinos Chaidas, Kallirroi Lamprou + Show 3 more

Open Access

https://doi.org/10.3390/life12020305

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Journal: Life	Publication Date: Feb 17, 2022
Citations: 1	License type: CC BY 4.0

Affiliation: Oxford University Hospitals NHS Trust

Abstract

The role of nasal symptoms in continuous positive airway pressure (CPAP) tolerance is not completely clear. This study aimed to investigate the association between CPAP usage and nasal symptoms, either prior to, or developing during, CPAP use in patients with obstructive sleep apnoea (OSA). Two hundred thirty patients were studied and divided into high-, low-, and non-CPAP users. Nasal symptoms and related quality of life parameters were evaluated prior to CPAP initiation and after three months. We also investigated predictive factors for CPAP usage. Non-CPAP users had significantly worse baseline scores for runny nose compared with high and low users (1.34 vs. 0.68 and 0.75, respectively, p = 0.006). There were no other significant differences between the groups. Runny nose was an independent predictive factor for lower CPAP usage (p = 0.036). An evaluation after three months showed worsening in runny nose score in high-CPAP users (p = 0.025) but not in low- and non-users. There were no significant changes in other nasal symptoms. Our study demonstrates that nasal symptoms were very common in this population but rhinorrhoea was the only symptom associated with poorer CPAP adherence. Moreover, rhinorrhoea worsened after a three-month trial of high-CPAP usage.

Highlights

Published: 17 February 2022Obstructive sleep apnoea (OSA) is a common respiratory disorder affecting 9–38% of the adult population [1] and is associated with daytime sleepiness, impaired cognitive ability, and serious sequelae such as road traffic accidents, cardiovascular morbidity, and all-cause mortality [2]
The percentage of study participants with nasal obstruction prior to Continuous positive airway pressure (CPAP) initiation was 57.9%, of whom it was mild in 37%
There was a significant difference in the baseline score for runny nose between CPAP users and non-users and our model shows that rhinorrhoea is an independent predictive factor for low-CPAP usage

Summary

Introduction

Published: 17 February 2022Obstructive sleep apnoea (OSA) is a common respiratory disorder affecting 9–38% of the adult population [1] and is associated with daytime sleepiness, impaired cognitive ability, and serious sequelae such as road traffic accidents, cardiovascular morbidity, and all-cause mortality [2]. Continuous positive airway pressure (CPAP) is considered as the gold-standard treatment, especially in moderate and severe cases. CPAP is highly efficacious for the majority of patients, with good long-term adherence up to 80% and. 71% at 5 and 10 years, respectively [3]. This still leaves a substantial minority of patients poorly tolerant of CPAP. Many factors, such as OSA severity, have been identified as influencing CPAP usage but much of the variance is left unexplained [3]. Side effects of CPAP are present in 15% to

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