Impact of Isolated Nasal Surgery on Sleep Quality, Architecture, and Disordered Breathing in Obstructive Sleep Apnea with Nasal Obstruction
Year: 2024
Type: article
Abstract: Background:Obstructive sleep apnea syndrome (OSAS) is frequently associated with nasal obstruction, which contributes to impaired sleep quality and poor tolerance to continuous positive airway pressure therapy. The role of isolated nasal surgery in modifying sleep parameters and sleep-disordered breathing remains debated. Objective: To evaluate the effect of nasal surgery on sleep quality, architecture, position, and sleep-disordered breathing (SDB) (including obstructive apnea and snoring) in adult patients with obstructive sleep apnea syndrome (OSAS) and nasal obstruction. Methodology:This was a prospective observational study with 55 adults who were diagnosed with obstructive sleep apnea and nasal obstruction under 55 years of age that had isolated nasal surgery (septo-surgery, turbinate reduction, or functional endoscopic sinus surgery). Evaluation of sleep, sleep-disordered breathing, and architecture with respect to positional distribution was done using polysomnography, preoperative and then at three months postoperatively. Subjective daytime sleepiness was assessed using the Epworth Sleepiness Scale (ESS). Results:After surgery on the nose, there was a significant increase in total sleep time (396.8 ± 42.7 to 432.5 ± 36.2 min, p < 0.001), sleep efficiency (86.2 ± 6.7% to 89.9 ± 6.9%, p = 0.022), as well as in ESS scores (9.2 ± 3.5 to 6.1 ± 2.9, p < 0.001). The increase in REM sleep was also marked (15.1 ± 5.2% to 18.8 ± 5.7%, p = 0.013). The snoring index fell (31.6 ± 15.8% to 25.4 ± 17.1%, p = 0.038). However, no significant changes were identified in the apnea-hypopnea index, apnea index, minimum SaO₂, and positional sleep distribution. Conclusion:Isolated nasal surgery improves sleep quality, architecture, and snoring but does not significantly affect AHI or positional breathing patterns. It should be considered a valuable adjunct rather than a curative treatment for OSAS.
Institution: Nishtar Medical College and Hospital
Language: English
Subfield: Physiology (medical)
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7221210112