title: Impact of nasal obstruction on obstructive sleep apnea.
abstract: OBJECTIVE
  The purpose of this study was to investigate the relationship between nasal obstruction and sleep-disordered breathing. The effect of postoperative nasal packing on sleep parameters was compared between patients with mild obstructive sleep apnea (OSA) and those with moderate/severe OSA.
  
  
  METHODS
  A prospective, nonrandomized controlled study.
  
  
  METHODS
  Tertiary care center.
  
  
  METHODS
  Participants were recruited among adult patients with a history of snoring scheduled to undergo nasal surgery from November 2009 to February 2010. All subjects underwent polysomnogram (PSG) testing within 30 days prior to surgery. Patients underwent nasal surgery and received postoperative nasal packing, and a PSG was repeated on the first postoperative night with nasal packing in place. Outcome measures included a change in respiratory disturbance index (RDI), minimum oxygen saturation, oxygen desaturation index (ODI), and duration of snoring.
  
  
  RESULTS
  Forty-nine patients were included in the study. Patients were stratified into 2 groups: those with RDI ≥15 (n = 23) and those with RDI <15 (n = 26). Nasal packing was found to significantly increase RDI (5.2 ± 4.0 vs 10.4 ± 10.0; P = .0001), duration of snoring (86.5% ± 13.1% vs 79.3% ± 15.3%; P = .008), and ODI (7.6 ± 7.1 vs 9.9 ± 7.4; P = .001) in patients with mild OSA but not in patients with moderate/severe OSA. Mean minimum arterial oxygen saturation was unchanged in both groups.
  
  
  CONCLUSIONS
  Postoperative nasal packing aggravated measures of OSA in patients with mild OSA but not in patients with moderate/severe OSA.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA. hednnek@aol.com
authors.forename: Michael
authors.initials: M
authors.lastname: Friedman
authors.forename: Alexander
authors.initials: A
authors.lastname: Maley
authors.forename: Kanwar
authors.initials: K
authors.lastname: Kelley
authors.forename: Chris
authors.initials: C
authors.lastname: Leesman
authors.forename: Akshay
authors.initials: A
authors.lastname: Patel
authors.forename: Tanya
authors.initials: T
authors.lastname: Pulver
authors.forename: Ninos
authors.initials: N
authors.lastname: Joseph
authors.forename: Tolgahan
authors.initials: T
authors.lastname: Catli
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015508:Nasal Obstruction / Q000150:complications / Q000503:physiopathology*; D017286:Polysomnography; D011446:Prospective Studies; D012720:Severity of Illness Index; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000503:physiopathology*; D012913:Snoring / Q000209:etiology / Q000503:physiopathology*