title: The influence of nasal abnormalities in adherence to continuous positive airway pressure device therapy in obstructive sleep apnea patients.
abstract: BACKGROUND
  The few studies that examine the effect of nasal abnormalities on continuous positive airway pressure device (CPAP) adherence are controversial. The aim of this study was to evaluate the contribution of nasal abnormalities in CPAP adherence.
  
  
  METHODS
  We included patients with moderate to severe OSA. The patients were submitted to rhinoscopy, nasofibroscopy, nasal inspiratory peak flow, and acoustic rhinometry. The patients who used a CPAP for 4 h or more per night for at least 70 % of the nights over a 6-month period were considered to have good adherence.
  
  
  RESULTS
  Thirty-four patients finished the study. Eleven (33.4 %) were female and 23 (67.6 %) were male. Sixteen (47.1 %) patients had good adherence. The body mass index (p = 0.030), neck circumference (p = 0.006), and apnea-hypopnea index (p = 0.032) were higher, and the oxyhemoglobin saturation minimum was lower (p = 0.041) in the good adherence group. Nasal parameters showed no differences between good and poor adherence groups. In Spearman's correlation, surprisingly, there was a negative correlation between the highest number of hours of CPAP use with smaller values of nasal minimal cross-sectional areas in the supine position (r, 0.375; p = 0.029). In the linear regression model, the nasal findings that predicted increased of the CPAP use were the following: lower scores of nasal symptoms (p = 0.007) and lower nasal volume in supine position (p = 0.001).
  
  
  CONCLUSIONS
  The majority of the nasal parameters evaluated in this study did not influence CPAP adherence.
authors: Disciplina de Medicina e Biologia do Sono-Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleao de Barros, 925, Vila Clementino, São Paulo, SP, Brazil, 04024-002, femartinho@uol.com.br.
authors: Fernanda Louise Martinho
authors: FL
authors: Haddad
authors: Tatiana de Aguiar
authors: Tde A
authors: Vidigal
authors: Luciane
authors: L
authors: Mello-Fujita
authors: Fátima Dumas
authors: FD
authors: Cintra
authors: Luiz Carlos
authors: LC
authors: Gregório
authors: Sérgio
authors: S
authors: Tufik
authors: Lia
authors: L
authors: Bittencourt
mesh_terms: D000328:Adult; D000368:Aged; D000403:Airway Resistance; D045422:Continuous Positive Airway Pressure / Q000523:psychology*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D009666:Nose / Q000002:abnormalities*; D010349:Patient Compliance / Q000523:psychology*; D017286:Polysomnography; D023842:Rhinometry, Acoustic; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy