title: Provent therapy for obstructive sleep apnea: Impact of nasal obstruction.
abstract: OBJECTIVE
  Determine the impact of nasal obstruction on efficacy, success, and adherence of Provent therapy in patients with obstructive sleep apnea (OSA).
  
  
  METHODS
  Prospective, two-arm, clinical pilot study at a single clinical site.
  
  
  METHODS
  Patients with OSA who failed continuous positive airway pressure therapy were divided into two treatment arms: arm 1 were patients with no complaints of nasal obstruction and <50% nasal obstruction on exam, and arm 2 were patients with occasional complaints of nasal obstruction and 50% to 80% nasal obstruction on exam. Sleep testing at home was performed prior to the trial and on day 10 of the study with the use of Provent.
  
  
  RESULTS
  Apnea-hypopnea index (AHI) decreased significantly from 20.5 ± 14.8 to 11.5 ± 16.6 (P < .001) in our total patient population. Patients in arm 1 had statistically significant improvement in their AHI (18.1 ± 13.0 to 7.4 ± 10.1, P < .001), oxygen desaturation index (ODI) (16.3 ± 10.8 to 8.2 ± 9.0, P < .001), and minimum oxygen saturation (81.3% ± 6.7% to 86.9% ± 5.6%, P = 0.008) from baseline sleep study to sleep study 2. Patients in arm 2 had improvements in their AHI (23.4 ± 16.6 to 16.5 ± 21.4), ODI (21.5 ± 14.8 to 17.0 ± 16.0) and minimum 02 %. However, none of these reached statistical significance.
  
  
  CONCLUSIONS
  In this study, Provent therapy had a high failure rate. Patients without nasal obstruction showed greater improvements using Provent than patients with obstruction. Correction of nasal obstruction may be a useful prerequisite for treatment with Provent.
authors.affiliation: Section of Sleep Surgery (m.f.), Rush University Medical Center, Chicago, Illinois, U.S.A.|Advanced Center for Specialty Care (m.f., m.s.h., s.y., t.p., m.s., n.j.j.), Advocate Illinois Masonic Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Michael
authors.initials: M
authors.lastname: Friedman
authors.affiliation: Advanced Center for Specialty Care (m.f., m.s.h., s.y., t.p., m.s., n.j.j.), Advocate Illinois Masonic Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Michelle S
authors.initials: MS
authors.lastname: Hwang
authors.affiliation: Advanced Center for Specialty Care (m.f., m.s.h., s.y., t.p., m.s., n.j.j.), Advocate Illinois Masonic Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Sreeya
authors.initials: S
authors.lastname: Yalamanchali
authors.affiliation: Advanced Center for Specialty Care (m.f., m.s.h., s.y., t.p., m.s., n.j.j.), Advocate Illinois Masonic Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Thomas
authors.initials: T
authors.lastname: Pott
authors.affiliation: Advanced Center for Specialty Care (m.f., m.s.h., s.y., t.p., m.s., n.j.j.), Advocate Illinois Masonic Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Mandeep
authors.initials: M
authors.lastname: Sidhu
authors.affiliation: Advanced Center for Specialty Care (m.f., m.s.h., s.y., t.p., m.s., n.j.j.), Advocate Illinois Masonic Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Ninos J
authors.initials: NJ
authors.lastname: Joseph
mesh_terms: D045422:Continuous Positive Airway Pressure / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000150:complications*; D010865:Pilot Projects; D017286:Polysomnography; D011446:Prospective Studies; D019736:Prostheses and Implants; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D016896:Treatment Outcome
keywords: Obstructive sleep apnea; Provent sleep apnea therapy