Impact of impaired nasal breathing on sleep-disordered breathing.
OBJECTIVE
The role of the nose and its importance in the development and severity of sleep-disordered breathing (SDB) is still a matter of discussion. In the first part of this study, often-controversial data and theories about the nose are reviewed concerning its influence on the pathophysiology of SDB and to interpret certain clinical findings connected with impaired nasal breathing. In the second part, the effectiveness of some nonsurgical and surgical therapies is evaluated.


METHODS
A worldwide literature research (Medline) was the basis for this review.


RESULTS
The study of the literature on nasal resistance and clinical findings about the effects of incomplete or complete nasal blockage, particularly in comparison of healthy persons and persons with SDB, allows the assumption of the existence of two different groups of responders: a larger group where the importance of the nose for SDB is negligible and a smaller group where the influence of the nose on SDB is crucial. The same seems to hold true for the responses to nonsurgical and surgical treatments with only a few surgical results available in the literature. While the success rate of nasal surgery for patients with obstructive sleep apnea, for instance, seems to be less than 20%, the normalization of nasal resistance often leads to a positive impact on the well-being and the sleep quality of these patients. However, because criteria to identify responders are lacking, the prediction of success of any treatment for the individual with SDB is not possible.
Verse
Thomas
T
University ENT Clinic Mannheim, Mannheim, Germany. thomas.verse@hno.ma.uni-heidelberg.de
Pirsig
Wolfgang
W
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D006801:Humans; D015508:Nasal Obstruction / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000209:etiology*; D013256:Steroids
D000893:Anti-Inflammatory Agents; D013256:Steroids