Short-term CPAP treatment induces a mild increase in inflammatory cells in patients with sleep apnoea syndrome.
BACKGROUND
Nasal CPAP has been proven to be an efficient method of treating SAS patients without facial dysmorphism. However, it still remains a matter of debate why it is not universally well tolerated. The AIM OF THE STUDY was to evaluate the influence of initial CPAP treatment on nasal function in SAS patients.


METHODS
Forty-two patients were consecutively included in a prospective clinical study and divided into the three following groups: 1) SAS subjects (26 patients qualifying for CPAP treatment), 2) First control group (C1) (9 patients with mild or moderate SAS, not willing to be treated with CPAP, AHI > 5 [n/h]), 3) Second control group (C2) (7 healthy subjects, AHI < or = 5). Nasal patency was measured by active anterior rhinomanometry (AAR) at recruitment and after a three-day CPAP treatment. After each AAR nasal lavage was obtained from both nostrils. Total inflammatory cell count (TCC) in each nasal lavage was then calculated in a Neubauer's chamber.


RESULTS
Initial CPAP treatment caused a statistically significant rise of TCC in nasal lavage of SAS patients, when compared with initial values [n*10(5)/ml] (pre: 1.30, post: 1.92, p = 0.009). No significant differences (p > 0.05) were found both in initial TCC and nasal patency values among the three studied groups.


CONCLUSIONS
SAS subjects present an unchanged nasal patency when compared to control subjects. Initial CPAP therapy might be responsible for evoking local nasal inflammation.
Department of Pulmonology, Medical University of Silesia, Katowice, Poland. simon.mds@poczta.fm
Szymon
S
Skoczyński
Mariola
M
Ograbek-Król
Maciej
M
Tazbirek
Aleksandra
A
Semik-Orzech
Władysław
W
Pierzchała
D000328:Adult; D000368:Aged; D045422:Continuous Positive Airway Pressure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017817:Nasal Lavage Fluid / Q000166:cytology; D010349:Patient Compliance; D012220:Rhinitis / Q000209:etiology* / Q000473:pathology*; D025363:Rhinomanometry; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D013997:Time Factors; D016312:Treatment Refusal