Abstract
Background. The difference in nasal obstruction between OSA patients and healthy individuals is not adequately documented. Our aim was to describe the sinonasal quality of life and nasal function in OSA patients and healthy controls using the sinonasal outcome test-20 (SNOT-20), nasal obstruction visual analog scale (NO-VAS), and peak nasal inspiratory flow (PNIF). Methodology and Principal. Ninety-three OSA patients and 92 controls were included in a case-control study from 2010 to 2015. Results. Mean SNOT-20 score in the OSA group was 1.69 (SD 0.84) compared to 0.55 (SD 0.69) in controls (p < 0.001, 95% CI [0.9, 1.4]). The mean NO-VAS score was 41.3 (SD 12.8) and 14.7 (SD 14.4) in the OSA group and controls, respectively, (p < 0.001, 95% CI [22.7, 30.6]). PNIF measured 105 litres/minute in the OSA group and 117 litres/minute in controls (p < 0.01, 95% CI [−21.8, −3.71]). There was a positive correlation between subjective nasal obstruction and change in PNIF after decongestion in the control group alone. Conclusions. OSA patients have a reduced sinonasal QoL and lower peak nasal inspiratory flow compared to controls. Treatment of nasal obstruction in OSA patients should be made a priority along with treatment of the ailment itself.
Highlights
Sinonasal complaints are associated with obstructive sleep apnea (OSA) [1], and the relief of sinonasal obstruction has been shown to reduce subjective complaints of daytime sleepiness [2]
The groups were matched in age, gender distribution, and educational level but there was a significant difference between the groups regarding weight and BMI as expected since weight is strongly associated with development of OSA [9]
Despite the obvious effect of restoring nasal function on positive airway pressure treatment and subjective daytime sleepiness in patients, the effect on objective measures of obstructive sleep apnea keeps eluding us. These conflicting results raise more questions: Should we believe in quality of life (QoL) measures and postulate that the diagnostic tools we use today does not quite give a good enough measure of the daytime sleepiness associated with OSA? This view is supported by the increasing tendency to see obstructive sleep apnea as a result of a combination of the number of apneas and hypopneas, and the nocturnal hypoxemia and respiratory disturbance index [16]
Summary
Sinonasal complaints are associated with obstructive sleep apnea (OSA) [1], and the relief of sinonasal obstruction has been shown to reduce subjective complaints of daytime sleepiness [2]. The primary goal of this study was to compare sinonasal quality of life (QoL) in OSA patients with a group of healthy controls. Our aim was to describe the sinonasal quality of life and nasal function in OSA patients and healthy controls using the sinonasal outcome test-20 (SNOT-20), nasal obstruction visual analog scale (NO-VAS), and peak nasal inspiratory flow (PNIF). Mean SNOT-20 score in the OSA group was 1.69 (SD 0.84) compared to 0.55 (SD 0.69) in controls (p < 0.001, 95% CI [0.9, 1.4]). OSA patients have a reduced sinonasal QoL and lower peak nasal inspiratory flow compared to controls. Treatment of nasal obstruction in OSA patients should be made a priority along with treatment of the ailment itself
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