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Cited by 142Obstructive Sleep Apnea ResearchNasal Surgery and Airway StudiesSleep and related disorders

Effect of treating severe nasal obstruction on the severity of obstructive sleep apnoea

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McLean, H. A., Urton, A. M., Driver, H. S., Tan, A. K. W., Day, A. G., Munt, P. W., Fitzpatrick, M. F.·2005·European Respiratory Journal
DOI 10.1183/09031936.05.00045004
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Abstract

An association between mouth breathing during sleep and increased propensity for upper airway collapse is well documented, but the effect of treatment for nasal obstruction on mouth breathing during sleep and simultaneous obstructive sleep apnoea (OSA) severity has not been described previously. A randomised single blind placebo- and sham-controlled crossover study of treatment (topical decongestant and external dilator strip) for nasal obstruction was carried out in 10 patients (nine males; mean±sem 46±5 yrs) with nasal obstruction and OSA. All patients had normal acoustic pharyngometry. The effect of treatment on nasal resistance, mouth breathing during sleep and OSA severity was quantified. Treatment of nasal obstruction was associated with a dramatic and sustained reduction in nasal resistance and the oral fraction of ventilation during sleep (mean (95% confidence interval) absolute reduction in oral fraction 30% (12–49)). Improvements in sleep architecture were observed during active treatment, and there was a modest reduction in OSA severity (change in apnoea–hypopnoea index 12 (3–22)). In conclusion, treating nasal obstruction reduced mouth breathing during sleep and obstructive sleep apnoea severity, but did not effectively alleviate obstructive sleep apnoea.

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Crossref · 10.1183/09031936.05.00045004

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  • These treatments have not demonstrated a significant, persistent change in apnea-hypopnea index or improvement in sleep quality.

    “but has not demonstrated a significant, persistent change in AHI or improvement in sleep quality.”

    From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [903]

    The Sleep apnoea severity results report a statistically significant reduction in AHI on the active-treatment night. The Sleep stage architecture results and Discussion report improved sleep architecture and subjective sleep quality. The study lasted only one night, so it cannot establish whether the AHI change persisted. (LLM, conf=0.89)

    Checked by a reasoning model — may be wrong.

    Experimental — accuracy not yet measured

  • Topical nasal decongestion and/or external dilator strips for chronic nasal obstruction have been shown to decrease snoring.

    “Topical nasal decongestion and/or external dilator strip for chronic nasal obstruction has been shown to decrease snoring”

    From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [903]

    The introductory passage (section U; page not provided) reports reduced snoring frequency and/or intensity with nasal splints in three cited studies, supporting the external-dilator-strip part of the claim. It does not report that topical nasal decongestion decreases snoring, and this paper’s treatment study reports other outcomes rather than a reduction in snoring. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Nasal dilation increases nasal cross section by 14-25% and is associated with a distinctive and sustained reduction in nasal resistance and the oral fraction of ventilation during sleep.

    “Nasal dilation increases nasal cross section by 14–25% and is associated with a distinctive and sustained reduction in nasal resistance and the oral fraction of ventilation during sleep 146.”

    From Non-CPAP therapies in obstructive sleep apnoea (2011) · cites this paper as [146]

    The Discussion reports that relieving severe nasal obstruction reduced the oral fraction of ventilation during sleep from a mean of 39% to 8%, alongside a fall in nasal resistance. The Design section shows that treatment combined a decongestant with a nasal dilator strip. Our copy does not report a 14–25% increase in nasal cross-sectional area or establish the effect of dilation alone. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • OSA severity was reduced in one study with 10 patients with OSA and nasal obstruction.

    “OSA severity was reduced in one study with 10 patients with OSA and nasal obstruction 146”

    From Non-CPAP therapies in obstructive sleep apnoea (2011) · cites this paper as [146]

  • Sleep architecture is improved slightly in patients with OSA.

    “and is improved slightly in patients with OSA 146.”

    From Non-CPAP therapies in obstructive sleep apnoea (2011) · cites this paper as [146]

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Authors
McLean, H. A., Urton, A. M., Driver, H. S., Tan, A. K. W., Day, A. G., Munt, P. W., & Fitzpatrick, M. F.
Affiliations
  • Queen's University (CA)
  • Kingston General Hospital (CA)
Corresponding author
McLean, H. A.
Venue
European Respiratory Journal
Publisher
European Respiratory Society (ERS)
Published
2005-03
Volume
25
Issue
3
Pages
521-527
ISSN
  • 0903-1936 (ISSN-L)
  • 1399-3003
DOI
10.1183/09031936.05.00045004
OpenAlex
W2151560436
Cited by
142
References
47
Citations by year
2026: 6 · 2025: 2 · 2024: 3 · 2023: 5 · 2022: 7 · 2021: 6 · 2020: 8 · 2019: 4 · 2018: 6 · 2017: 5 · 2016: 10 · 2015: 7 · 2014: 12 · 2013: 10 · 2012: 7
FWCI
3.80
Type
journal article
Language
en
Open access
Locations
  • European Respiratory Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Keywords
nasal obstruction, obstructive sleep apnea, nasal resistance, topical decongestants, upper airway collapse, apnea-hypopnea index, sleep architecture
MeSH terms
Administration, Intranasal, Adolescent, Adult, Dilatation, Female, Humans, Male, Middle Aged, Mouth Breathing, Nasal Decongestants, Nasal Obstruction, Treatment Outcome, Polysomnography, Cross-Over Studies, Sleep Apnea, Obstructive

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