title: Systematic review: the influence of nasal obstruction on sleep apnea.
abstract: BACKGROUND
  Obstructive sleep apnea syndrome (OSAS) is a common disorder that can lead to cardiovascular morbidity and mortality, as well as to metabolic, neurological, and behavioral consequences. It is currently believed that nasal obstruction compromises the quality of sleep when it results in breathing disorders and fragmentation of sleep. However, recent studies have failed to objectively associate sleep quality and nasal obstruction.
  
  
  OBJECTIVE
  The aim of this systematic review is to evaluate the influence of nasal obstruction on OSAS and polysomnographic indices associated with respiratory events.
  
  
  METHODS
  Eleven original articles published from 2003 to 2013 were selected, which addressed surgical and non-surgical treatment for nasal obstruction, performing polysomnography type 1 before and after the intervention.
  
  
  CONCLUSIONS
  In most trials, nasal obstruction was not related to the apnea-hypopnea index (AHI), indicating no improvement in OSAS with reduction in nasal resistance. However, few researchers evaluated other polysomnography indices, such as the arousal index and rapid eye movement (REM) sleep percentage. These could change with nasal obstruction, since it is possible that the nasal obstruction does not completely block the upper airways, but can increase negative intrathoracic pressure, leading to sleep fragmentation.
authors.affiliation: Postgraduate Program in Neurology, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, RJ, Brazil.
authors.forename: Debora Petrungaro
authors.initials: DP
authors.lastname: Migueis
authors.affiliation: Postgraduate Program in Neurology, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, RJ, Brazil; Clinical Investigation Division, Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, Brazil.
authors.forename: Luiz Claudio Santos
authors.initials: LC
authors.lastname: Thuler
authors.affiliation: Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil.
authors.forename: Lucas Neves de Andrade
authors.initials: LN
authors.lastname: Lemes
authors.affiliation: Postgraduate Program in Neurology, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, RJ, Brazil.
authors.forename: Chirlene Santos Souza
authors.initials: CS
authors.lastname: Moreira
authors.affiliation: Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, RJ, Brazil.
authors.forename: Lucia
authors.initials: L
authors.lastname: Joffily
authors.affiliation: Postgraduate Program in Neurology, Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, RJ, Brazil; Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, RJ, Brazil. Electronic address: mestneuro@gmail.com.
authors.forename: Maria Helena de
authors.initials: MH
authors.lastname: Araujo-Melo
mesh_terms: D006801:Humans; D015508:Nasal Obstruction / Q000150:complications* / Q000503:physiopathology*; D017286:Polysomnography; D012890:Sleep / Q000502:physiology*; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000503:physiopathology
keywords: Apneia obstrutiva do sono; Fragmentação do sono; Nasal obstruction; Obstructive sleep apnea; Obstrução nasal; Polissonografia; Polysomnography; Resultado do tratamento; Sleep fragmentation; Treatment outcome
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