Nasal Obstruction, Nasal Airway Resistance and Sleep Disturbance
Dr Liam Grouse, RMO, St George Hospital, Sydney, Australia
Authors List
Grouse, L., Haghigi, M., Liang, K., Choy, C,. Hua, R,. Alvarado, R,. Campbell, R,. Kalish, R,. Harvey, R,.
Rhinology and Endoscopic Skull Base Surgery Department of Otolaryngology, St Vincent’s Hospital Sydney and the University of New South Wales & Macquarie University, Australia
Background: The detrimental effects of nasal obstruction are well-documented, yet its impact on sleep remains unclear. While nasal obstruction may affect sleep induction, it is increased airway resistance that contributes to sleep-disordered breathing. This study aims to define the relationship of patient-reported sleep (termed ‘sleep function’) with perceived nasal obstruction, overall nasal function, and nasal airway resistance (NAR).
Methods: Patients presenting to a tertiary rhinology clinic with any complaint were included. Sleep function was recorded as a 4-item questionnaire (0-20). Perceived nasal obstruction was rated on a 6-point ordinal score from “no problem” to “problem as bad as it could be,” and overall nasal function was rated on a 13-point ordinal score from “terrible” to “excellent.” Total NAR (Pa/cm3/s at a reference pressure of 150 Pa) was determined via active anterior rhinomanometry, under controlled conditions, and prior to any decongestants. Spearman’s rank correlation coefficient was used to evaluate the relationship between sleep function and perceived nasal obstruction, overall nasal function, and NAR.
Results: 2039 patients were assessed (44.0 ± 17.5 years, 49.6% female). Sleep function was reported as 8.34 ± 5.9. Sleep function was only weakly correlated with nasal obstruction (rs 0.394, P < 0.01) and moderately correlated with overall nasal function (rs -0.415 P < 0.01). However, sleep function showed only a very weak correlation with NAR (rs 0.063 P = 0.01). Among the four individual sleep function items, only three were correlated with NAR (Difficulty falling asleep rs 0.089, P < 0.01; Lack of a good night's sleep rs 0.057, P = 0.02; Wake up tired rs 0.073, P < 0.01).
Conclusion: Patients may over attribute sleep difficulties to nasal function. Given the limited correlation between nasal airway resistance and sleep function, surgeons should exercise caution when patients report sleep dysfunction but show minimal objective evidence of nasal airway obstruction.
Grouse, L., Haghigi, M., Liang, K., Choy, C,. Hua, R,. Alvarado, R,. Campbell, R,. Kalish, R,. Harvey, R,.
Rhinology and Endoscopic Skull Base Surgery Department of Otolaryngology, St Vincent’s Hospital Sydney and the University of New South Wales & Macquarie University, Australia
Background: The detrimental effects of nasal obstruction are well-documented, yet its impact on sleep remains unclear. While nasal obstruction may affect sleep induction, it is increased airway resistance that contributes to sleep-disordered breathing. This study aims to define the relationship of patient-reported sleep (termed ‘sleep function’) with perceived nasal obstruction, overall nasal function, and nasal airway resistance (NAR).
Methods: Patients presenting to a tertiary rhinology clinic with any complaint were included. Sleep function was recorded as a 4-item questionnaire (0-20). Perceived nasal obstruction was rated on a 6-point ordinal score from “no problem” to “problem as bad as it could be,” and overall nasal function was rated on a 13-point ordinal score from “terrible” to “excellent.” Total NAR (Pa/cm3/s at a reference pressure of 150 Pa) was determined via active anterior rhinomanometry, under controlled conditions, and prior to any decongestants. Spearman’s rank correlation coefficient was used to evaluate the relationship between sleep function and perceived nasal obstruction, overall nasal function, and NAR.
Results: 2039 patients were assessed (44.0 ± 17.5 years, 49.6% female). Sleep function was reported as 8.34 ± 5.9. Sleep function was only weakly correlated with nasal obstruction (rs 0.394, P < 0.01) and moderately correlated with overall nasal function (rs -0.415 P < 0.01). However, sleep function showed only a very weak correlation with NAR (rs 0.063 P = 0.01). Among the four individual sleep function items, only three were correlated with NAR (Difficulty falling asleep rs 0.089, P < 0.01; Lack of a good night's sleep rs 0.057, P = 0.02; Wake up tired rs 0.073, P < 0.01).
Conclusion: Patients may over attribute sleep difficulties to nasal function. Given the limited correlation between nasal airway resistance and sleep function, surgeons should exercise caution when patients report sleep dysfunction but show minimal objective evidence of nasal airway obstruction.
