title: Chronic nasal obstruction causes daytime sleepiness and decreased quality of life even in the absence of snoring.
abstract: BACKGROUND
  There has been a growing awareness that nasal obstruction may impair various daily and social activities. We performed a questionnaire survey in a working population to clarify the contribution made by snoring concomitant with nasal obstruction to daytime sleepiness and quality of life (QOL).
  
  
  METHODS
  Seven thousand nine hundred eighty daytime workers were asked to complete questionnaires, 7702 responded, and the data from 3442 subjects were finally analyzed. Nasal obstruction and snoring were graded into three and four categories, respectively. Daytime sleepiness and QOL were assessed by the Epworth Sleepiness Scale (ESS) and the Medical Outcomes Study 36-Item Short-Form Health Survey, respectively.
  
  
  RESULTS
  Subjects with chronic nasal obstruction, even if snoring was absent, reported significantly higher ESS scores and lower QOL scores than control subjects, and the presence of habitual snoring had an additive influence on these changes. The ESS and mental QOL scores adjusted for age, sex, and body mass index showed the same tendency.
  
  
  CONCLUSIONS
  Induction of sleep-disordered breathing (SDB) is a possible cause of excessive daytime sleepiness and impaired QOL in subjects with nasal obstruction. A variant of SDB such as silent upper respiratory resistance syndrome may participate in this phenomenon in the absence of snoring.
authors.affiliation: Department of Otorhinolaryngology, University of Occupational and Environmental Health, Kitakyushu, Japan. udaka@med.uoeh-u.ac.jp
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Udaka
authors.forename: Hideaki
authors.initials: H
authors.lastname: Suzuki
authors.forename: Takeyuki
authors.initials: T
authors.lastname: Fujimura
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Hiraki
authors.forename: Junichi
authors.initials: J
authors.lastname: Ohkubo
authors.forename: Teruo
authors.initials: T
authors.lastname: Shiomori
authors.forename: Narihisa
authors.initials: N
authors.lastname: Ueda
authors.forename: Koichi
authors.initials: K
authors.lastname: Hashida
authors.forename: Takanori
authors.initials: T
authors.lastname: Mori
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Fujino
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005221:Fatigue; D005260:Female; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000453:epidemiology / Q000503:physiopathology*; D015995:Prevalence; D011788:Quality of Life; D012220:Rhinitis / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D012893:Sleep Wake Disorders / Q000150:complications; D012913:Snoring / Q000453:epidemiology; D011795:Surveys and Questionnaires