title: The effect of nasal surgery on nasal continuous positive airway pressure compliance.
abstract: OBJECTIVE
  Nasal continuous positive airway pressure (CPAP) is the standard therapy for sleep apnea; however, compliance rates are historically poor. Among the most commonly cited reasons for nonadherence is nasal obstruction. Our study sought to examine if nasal surgery actually increases CPAP compliance.
  
  
  METHODS
  Prospective case series.
  
  
  METHODS
  Nasal CPAP-intolerant obstructive sleep apnea (OSA) patients, with documented nasal obstruction, underwent septoplasty plus inferior turbinoplasty. Preoperative and postoperative data were collected on CPAP usage per night and subjective nasal obstruction with the Nasal Obstruction Symptom Evaluation (NOSE) Scale questionnaire.
  
  
  RESULTS
  Eighteen patients met inclusion criteria and underwent septoplasty. CPAP usage increased significantly from 0.5 hours per night preoperatively to 5 hours per night postoperatively (P < .05). Subjective nasal obstruction on the NOSE Scale decreased from 16.1 preoperatively to 5.4 following surgical intervention (P < .05). CPAP pressure decreased from 11.9 preoperatively to 9.2 after surgery, with a trend toward significance (P = .062).
  
  
  CONCLUSIONS
  This study demonstrates improved CPAP compliance rates following septoplasty in OSA patients with nasal obstruction. Correction of nasal obstruction should be offered in nasal CPAP-intolerant individuals to improve CPAP compliance.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors.forename: Justin
authors.initials: J
authors.lastname: Poirier
authors.forename: Charles
authors.initials: C
authors.lastname: George
authors.forename: Brian
authors.initials: B
authors.lastname: Rotenberg
mesh_terms: D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000601:surgery*; D059747:Nasal Surgical Procedures; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000628:therapy*
keywords: Obstructive sleep apnea; continuous positive airway pressure; nasal surgery; septoplasty