Nasal obstruction as a risk factor for sleep-disordered breathing☆,☆☆,★
Section snippets
Methods
All men and women 30 to 60 years of age employed at one of five large state agencies in south central Wisconsin were surveyed about sociodemographic factors, sleep characteristics, brief medical history, and potential risk factors for sleep-disordered breathing. The job categories ranged from unskilled labor to professional at each agency. A total of 4927 questionnaires were completed, for a response rate of 75%. Of particular relevance to this investigation, questions were asked about the
Data analysis
Data were analyzed with software modules for descriptive statistics, contingency tables, multiple linear regression, and logistic regression. Mean airflow was adjusted for confounding factors, including age, sex, and BMI, by means of the general linear models procedure. Multiple regression modeling was used to estimate differences in AHI which may be due to nasal congestion and decreased airflow. For categorical outcome variables of hypersomnolence, snoring, and sleep-disordered breathing
Results
Characteristics of the survey sample (n = 4927) are shown in Table I and those of the cohort sample (n = 911) in Table II.
Characteristic Finding Mean age (yr) 45 (7.8) Mean body mass index (kg/m2) 29 (6.4) Male (percentage of participants) 59 Snoring status (percentage of participants)
Occasional (1–3 nights per week) 31
Habitual (>3 nights per week) 26 Allergies as cause of nasal congestion (percentage of participants)
Medicate 13
Do not medicate 22
Total 35 Rhinitis
Discussion
Indicators of nasal obstruction, including self-reported congestion and objectively measured flow, were associated with sleep-disordered breathing as evidenced by habitual snoring or worse sleep-disordered breathing. Although a linear trend between decreased nasal airflow and greater AHI was not observed, habitual snoring was consistently associated with decreased nasal airflow, self-reported stuffiness attributed to allergy, and self-reported nighttime nasal congestion or discharge. The lack
Conclusions
Sleep-disordered breathing, particularly simple snoring, which represents the mildest form, has a high prevalence among adults.18 Our analysis showed that in a population-based sample, middle-aged men and women with nasal obstruction, particularly those with chronic nighttime symptoms of rhinitis, are significantly more likely to be habitual snorers. A proportion of these patients also may have more severe sleep-disordered breathing with frequent episodes of apnea and hypopnea. The findings
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2022, Brazilian Journal of OtorhinolaryngologyCitation Excerpt :Patients with nasal obstruction are more exposed to upper airway collapse by increasing negative pressure on the lumen of the pharynx.14 Studies have shown that nasal obstruction is a risk factor for OSA but there is no linear association between obstruction and severity of sleep-disordered breathing.1 Approximately 15% of patients with sleep-disordered breathing also have nasal obstruction.20
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From the Department of Preventive Medicine, University of Wisconsin aMari Palta, PhD, Jerome Dempsey, PhD, James Skatrud, MD, Safwan Badr, MD, Steven Weber, PhD, William Busse, MD, Anthony Jacques, MS, and Linda Evans.
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Reprint requests: Dr. Terry Young, Professor, Department of Preventive Medicine, University of Wisconsin, 504 North Walnut St., Madison, WI 53705
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