Sleep Apnea and Nasal Patency

1988 ◽  
Vol 2 (4) ◽  
pp. 177-182 ◽  
Author(s):  
Richard P. Millman
Keyword(s):  
Allergic Rhinitis ◽  
Sleep Apnea ◽  
Nasal Obstruction ◽  
Successful Treatment ◽  
Normal Subjects ◽  
Sleep Disruption ◽  
Nasal Patency ◽  
Daytime Drowsiness ◽  
Clinical Investigations ◽  
Nasal Passages

Clinical investigations over the last decade have revealed that sleep may not be the benign rejuvenating state it was once considered. Sleep apnea is now frequently recognized, and it is clear that patency of the nasal passages and the nasopharynx is crucial for successful treatment of the syndrome. Furthermore, partial or complete nasal obstruction even in normal subjects can cause sleep disruption, hypopneas, and apneas. This may partially explain some of the daytime drowsiness seen in patients with conditions such as allergic rhinitis.

Intranasal budesonide in children affected by persistent allergic rhinitis and its effect on nasal patency and Nasal Obstruction Symptom Evaluation (NOSE) score

2015 ◽  
Vol 31 (3) ◽  
pp. 391-396 ◽  
Author(s):  
Anna Maria Zicari ◽  
Francesca Occasi ◽  
Montanari Giulia ◽  
Luciana Indinnimeo ◽  
Giovanna De Castro ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Nasal Obstruction ◽  
Nasal Patency ◽  
Persistent Allergic Rhinitis ◽  
Symptom Evaluation

scholarly journals Primary school children often underestimate their nasal obstruction

2016 ◽  
Vol 54 (2) ◽  
pp. 164-169
Author(s):  
Francesca Occasi ◽  
Marzia Duse ◽  
Tommaso Vittori ◽  
Anna Rugiano ◽  
Giancarlo Tancredi ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Secondary School ◽  
Primary School ◽  
Nasal Obstruction ◽  
School Children ◽  
Primary School Children ◽  
Nasal Resistance ◽  
Nasal Patency ◽  
School Aged Children ◽  
Subjective Sensation

Background: No consensus has ever been reached about the correlation between nasal resistance and the subjective sensation of nasal patency. The aim of the present study was to better de ne whether primary school and secondary school aged children correctly estimate their nasal obstruction. Materials and methods: Two hundred eighty four children (168 males and 116 female) aged between 6 and 14 years (9.5+2.9 years) affected by Pediatric Allergic Rhinitis underwent Rhinomanometry and they were considered as correctly estimating their nasal obstruction when the grade of nasal patency corresponded to the severity of the NOSE score, overestimating when the grade of nasal patency was <1 when compared to the severity of the score, underestimating when the grade of nasal patency was >1 when compared to the severity of the score. Results: Correlation between NOSE score and nasal patency was statistically significant (r -0.74; p<0.001). Children between 6 and 9 years of age underestimate (43.7%) and children >12 overestimate (34.7%) their symptoms more frequently than children among other age ranges (p<0.001). Conclusion: Although NOSE score approximately allow to quantify nasal obstruction, in children, especially between 6 and 9 years of age, an objective measurement of nasal patency should be performed to better define the therapeutic approach.

Exercise-Induced Nasal Obstruction in Patients with Allergic Rhinitis

1989 ◽  
Vol 3 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Motofumi Ohki ◽  
Makoto Hasegawa ◽  
Akira Sakuma
Keyword(s):  
Allergic Rhinitis ◽  
Nasal Obstruction ◽  
Normal Subjects ◽  
Nasal Resistance ◽  
Post Exercise ◽  
Nasal Cycle ◽  
Exercise Period ◽  
Capacitance Vessels ◽  
Exercise Induced

Exercise-induced nasal obstruction was studied in 90 patients with allergic rhinitis and 26 normal subjects. Allergic patients as well as normal subjects showed marked decreases of nasal resistance immediately after exercise. In allergic patients, however, the total nasal resistance returned to the pre-exercise level quickly after exercise and surpassed it. Meanwhile, the total nasal resistance gradually returned to the pre-exercise level in the post-exercise period in normal subjects. The profile of the total nasal resistance changes in the allergic patients was statistically different from that in the normal subjects. As far as unilateral nasal resistance is concerned, marked increases of nasal resistance appeared 10–30 minutes after exercise in 20 of 90 allergic patients. On the contrary, this phenomenon was not found in any normal subject. This unilateral nasal obstruction, which appeared only in allergic patients, is probably due to excessive dilatation of the capacitance vessels in the nasal mucosa and considered to appear as an enhancement of the nasal cycle. In this paper, the role of the nasal cycle is discussed in relation to exercise-induced nasal obstruction.

Effects of Acute Alcohol Intake on Nasal Patency

2021 ◽  
pp. 194589242110623
Author(s):  
Yuzhoujia Deng ◽  
Chengshuo Wang ◽  
Shen Shen ◽  
Xiaozhe Yang ◽  
Hongfei Lou ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Alcohol Consumption ◽  
Nasal Obstruction ◽  
Alcohol Intake ◽  
Blood Alcohol Concentration ◽  
Heavy Drinking ◽  
Nasal Patency ◽  
Objective Evidence ◽  
Heavy Drinkers ◽  
Baseline Values

Background Acute alcohol intake may influence nasal patency; however, there is lack of objective evidence. Objective The aim of this study was to evaluate the effects of acute alcohol intake on nasal patency employing both subjective and objective measures. Methods A total of 31 participants were classified into 2 groups of non-heavy drinkers (n = 17) and heavy drinkers (n = 14). Both groups consumed wine in 1 h and were assessed for subjective nasal symptoms and objective nasal patency, using rhinomanometry and acoustic rhinometry, at baseline and at 0.5, 2, and 6 h post-alcohol consumption. Results Alcohol consumption significantly increased nasal obstruction from baseline values in both heavy and non-heavy drinking groups. Total nasal volume (TNV) and the minimal cross-sectional area (MCA) were significantly decreased and nasal airway resistance (NAR) significantly increased from baseline values by 2 h post-alcohol consumption for both heavy and non-heavy drinking groups ( P < .05). Significant differences were found in TNV, MCA, and NAR between baseline and post-drinking in allergic rhinitis subjects; with no significant differences in MCA and NAR in subjects without allergic rhinitis. Pulse rate (PR) and temperature (T) were elevated, and blood pressure (BP) was decreased after alcohol consumption ( P < .05). Blood alcohol concentration (BAC) was not significantly correlated with nasal patency with regard to any subjective or objective measurement. Conclusion Acute alcohol consumption may impair nasal patency, independent of the amount consumed. Individuals with allergic rhinitis may be more prone to nasal obstruction after alcohol consumption than those without allergic rhinitis.

Acoustic Rhinometry Findings in Patients with Mild Sleep Apnea

2002 ◽  
Vol 126 (5) ◽  
pp. 475-480 ◽  
Author(s):  
Steven M. Houser ◽  
Bulent Mamikoglu ◽  
Benjamin F. Aquino ◽  
Rizwan Moinuddin ◽  
Jacquelynne P. Corey
Keyword(s):  
Allergic Rhinitis ◽  
Sleep Apnea ◽  
Nasal Obstruction ◽  
Nasal Congestion ◽  
Acoustic Rhinometry ◽  
Cross Sectional ◽  
Tertiary Referral Center ◽  
Retrospective Data Analysis ◽  
Obstructive Sleep

BACKGROUND: Nasal obstruction may contribute to the development of obstructive sleep apnea (OSA). Acoustic rhinometry (AR) measures nasal patency and congestion, which are useful parameters in objectively evaluating nasal obstruction. The nasal obstruction produced by allergic rhinitis may contribute to the development of OSA and can be easily assessed with AR. OBJECTIVE: This study was undertaken to assess the degree of nasal obstruction seen in allergic patients with and without OSA. STUDY DESIGN AND SETTING: This study was a retrospective data analysis from a tertiary referral center. The AR data from 10 patients with and 40 patients without mild OSA were compared. RESULTS: The mean congestion factors at the first cross-sectional area (CSA1) on the AR graph were found to be significantly higher in the OSA group than in the non-OSA group ( P = 0.03). The classification of change in congestion factors demonstrated significant differences at CSA1, CSA2, and CSA3 and in volume (***t distributions <0.001, 0.0312, <0.001, and <0.001, respectively). The non-OSA patients noted a significant subjective improvement in nasal congestion after topical nasal decongestion, whereas the OSA patients did not ( P < 0.0001 and 0.064, respectively). CONCLUSION: Although the role of nasal obstruction in OSA is controversial, our study lends evidence to the thought that the nasal obstruction associated with allergic rhinitis is associated with the presence of mild OSA. SIGNIFICANCE: Whether allergic rhinitis is a direct cause of OSA is debatable, but we have shown that greater nasal congestion is related to the presence of OSA in a population of patients with allergic rhinitis.

scholarly journals Evaluating the Impacts of Methylsulfonylmethane on Allergic Rhinitis After a Standard Allergen Challenge: Randomized Double-Blind Exploratory Study (Preprint)

2018 ◽  
Author(s):  
Susan Hewlings ◽  
Douglas S Kalman
Keyword(s):  
Allergic Rhinitis ◽  
Nasal Obstruction ◽  
Visual Analog Scale ◽  
Adaptive Design ◽  
High Dose ◽  
Nasal Patency ◽  
Analog Scale ◽  
Double Blind ◽  
Nasal Symptoms ◽  
Study Product

BACKGROUND The sulfur-containing compound methylsulfonylmethane (MSM) has been used as a dietary supplement for a variety of reported health benefits. Clinical observations and case studies have indicated that MSM may help alleviate allergic rhinitis; however, this effect has not been evaluated under controlled conditions. OBJECTIVE This study aimed to determine the effects of MSM consumption on allergic rhinitis symptoms after provocation with a standardized allergen. METHODS We recruited healthy participants with a history of allergic nasal congestion to participate in a randomized, double-blind, adaptive-design study. Participants were administered a standardized allergen in clinic to determine the presence or absence of an allergic response. Participant responses were recorded using a recognized measure of nasal patency, peak nasal inspiratory flow (PNIF), and by a visual analog scale to score the severity of their allergy-related nasal symptoms. After we collected baseline nasal responses to allergen, followed by a 1-week washout period, participants returned to the clinic and were exposed to allergen after taking an acute high dose of 12 g of MSM. We then randomly assigned participants to a lower dose of MSM (1 g, 3 g, or 6 g), which they consumed once a day for 14 days. Participants returned to the clinic for repeat assessments while again taking their assigned daily dose of MSM. RESULTS All MSM treatment courses significantly reduced visual analog scale average nasal symptoms in a longitudinal comparison across all participants, with low-dose treatments decreasing symptoms by 53.72% (P=.001), and an acute 12-g dose decreasing symptoms by 22.49% (P=.03). Although the acute dose of MSM did not yield significant changes in nasal patency, low “everyday” doses significantly relieved nasal obstruction as indicated by a 17.32% (P=.02) increase in PNIF across all participants. The most effective dose across all measurements was daily consumption of 3 g of MSM, which significantly decreased all nasal symptoms (nasal obstruction, rhinorrhea, watery or itchy eyes and nose, and sneezing) and further was found to significantly (P=.01) increase PNIF. CONCLUSIONS The MSM study product provided significant relief of allergic rhinitis symptoms and objective nasal obstruction measurements without the occurrence of adverse events. Oral consumption of the study product may reduce the symptoms and onset of allergic rhinitis without the side effects associated with standard-care medication. CLINICALTRIAL ClinicalTrials.gov NCT02342483; https://clinicaltrials.gov/ct2/show/NCT02342483 (Archived by WebCite at http://www.webcitation.org/73vLKNvAp) INTERNATIONAL REGISTERED REPOR RR1-10.2196/11139

Aerodynamics Analysis of the Impact of Nasal Surgery on Patients with Obstructive Sleep Apnea and Nasal Obstruction

ORL ◽  
2021 ◽  
pp. 1-8
Author(s):  
Lifeng Li ◽  
Demin Han ◽  
Hongrui Zang ◽  
Nyall R. London
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Nasal Obstruction ◽  
Upper Airway ◽  
Apnea Hypopnea Index ◽  
Nasal Surgery ◽  
Subjective Sleep Quality ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
The Impact

<b><i>Objective:</i></b> The purpose of this study was to evaluate the effects of nasal surgery on airflow characteristics in patients with obstructive sleep apnea (OSA) by comparing the alterations of airflow characteristics within the nasal and palatopharyngeal cavities. <b><i>Methods:</i></b> Thirty patients with OSA and nasal obstruction who underwent nasal surgery were enrolled. A pre- and postoperative 3-dimensional model was constructed, and alterations of airflow characteristics were assessed using the method of computational fluid dynamics. The other subjective and objective clinical indices were also assessed. <b><i>Results:</i></b> By comparison with the preoperative value, all postoperative subjective symptoms statistically improved (<i>p</i> &#x3c; 0.05), while the Apnea-Hypopnea Index (AHI) changed little (<i>p</i> = 0.492); the postoperative airflow velocity and pressure in both nasal and palatopharyngeal cavities, nasal and palatopharyngeal pressure differences, and total upper airway resistance statistically decreased (all <i>p</i> &#x3c; 0.01). A significant difference was derived for correlation between the alteration of simulation metrics with subjective improvements (<i>p</i> &#x3c; 0.05), except with the AHI (<i>p</i> &#x3e; 0.05). <b><i>Conclusion:</i></b> Nasal surgery can decrease the total resistance of the upper airway and increase the nasal airflow volume and subjective sleep quality in patients with OSA and nasal obstruction. The altered airflow characteristics might contribute to the postoperative reduction of pharyngeal collapse in a subset of OSA patients.

Nasal Cytology in Radiofrequency Turbinate Volume Reduction

ORL ◽  
2021 ◽  
pp. 1-6
Author(s):  
Giancarlo Pecorari ◽  
Giuseppe Riva ◽  
Claudia Bartoli ◽  
Mattia Ravera ◽  
Valeria Dell’Era ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Effective Treatment ◽  
Nasal Obstruction ◽  
Nasal Mucosa ◽  
Inferior Turbinate ◽  
Volume Reduction ◽  
Nonallergic Rhinitis ◽  
Turbinate Hypertrophy ◽  
Nasal Cytology ◽  
Rhinitis Medicamentosa

Introduction: Radiofrequency turbinate volume reduction (RFTVR) is an effective treatment of inferior turbinate hypertrophy. RFTVR can reduce epithelial cell alterations in nasal mucosa. The aim of this observational study was to evaluate the effects of RFTVR on nasal obstruction and cytology, stratifying for different types of rhinitis. Methods: Nasal cytology and subjective nasal obstruction were evaluated on 113 patients before RFTVR (T0) and after 3 months (T1). The patients were divided into groups on the basis of the underlying disease: allergic rhinitis, nonallergic rhinitis, rhinitis medicamentosa, and other diseases (e.g., hormonal-based turbinate hypertrophy). Results: Nasal cytology at T0 identified 42 patients with allergic rhinitis, 40 with nonallergic rhinitis, 19 with rhinitis medicamentosa, and 12 with other diseases. An improvement of nasal cytology at T1 was observed in 29.2% of cases. They mainly consisted of patients with nonallergic rhinitis with neutrophils, whose neutrophil infiltrate decreased. Only 2 cases (1.7%) showed a worsening of nasal cytology at T1. A statistically significant decrease in subjective nasal obstruction was observed for every group (p < 0.05). Higher differences of nasal obstruction between T0 and T1 were found in patients with rhinitis medicamentosa or other diseases. Conclusion: RFTVR represents a safe and effective treatment for turbinate hypertrophy of various etiology. It is not responsible for a worsening of inflammatory infiltrate of the nasal mucosa.

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