The effect of nasal obstruction on treatment TYPE and adherence in obstructive sleep apnea patients

Objective: Nasal obstruction has been considered to be an etiologic factor for obstructive sleep apnea syndrome, however the role of the obstruction has not be elucidated. This study is performed to evaluate if a correlation exists between objective nasal pathologies and subjective symptoms of nasal obstruction, to determine the effect of nasal obstruction on therapeutic level of positive airway pressure, the type of PAP device, mask type and treatment adherence in obstructive sleep apnea patients. Methods: Eighty six patients, diagnosed with OUAS were enrolled in the study, prospectively. All patients underwent a detailed nasal and faringeal examination and completed Nasal Obstruction Symptom Evaluation (NOSE ) Scale and Sinonasal Outcome Test, prior to PAP treatment. Three months after initiating PAP therapy, telephone calls were performed and PAP compliance were asssessed by patients' self report. Results: This study demonstrated a significant correlation between objective nasal pathologies and subjective symptoms of nasal obstruction.. Significant relationship were found between septal deviation and disease severity quantified by apnea- hypopne index and minimum O2 saturation.. Objective and subjective findings were not found to be associated with theraupatic PAP pressure, mask type and decongestant medication,. However the auto-CPAP treatment was statistically higher in patients with turbinate hipertrophy. SNOT-22 test score was stastistically higher in the nonadherent group. Conclusion: Subjective evaluation methods can be effective to evaluate nasal obstruction . Using both of objective and subjective methods for nasal obstruction, can help to define the most accurate PAP therapy and can identify the patients who are at risk of drop-out therapy or risk of poor adherence