PAP treatment in patients with OSA does not induce long‐term nasal obstruction

• Published in: Journal of Sleep Research
• Main Authors: Värendh, Maria, Andersson, Morgan, Björnsdóttir, Erla, Arnardottir, Erna Sif, Gislason, Thorarinn, Pack, Allan, Hrubos-Strøm, Harald, Johannisson, Arne, Júlíusson, Sigurður
• Other Authors: Læknadeild (HÍ), Faculty of Medicine (UI), Heilbrigðisvísindasvið (HÍ), School of Health Sciences (UI), Háskóli Íslands, University of Iceland
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wiley 2018
• Subjects: Acoustic measurements; Adherence; Apnea; Breathing; Nasal anatomy; Nose; Survey; Kæfisvefn; Öndun; öNDUNARV; Reykjavík; Iceland
• Online Access: https://hdl.handle.net/20.500.11815/2126; https://doi.org/10.1111/jsr.12768

Publisher's version (útgefin grein) We hypothesized that positive airway pressure treatment would induce nasal obstruction and decrease nasal cavity due to mucosal swelling. We further hypothesized that subjective and objective nasal obstruction at baseline would negatively affect positive airway pressure adherence. A total of 728 patients with sleep apnea were investigated in the Icelandic Sleep Apnea Cohort at baseline and 2 years after starting positive airway pressure. Patients underwent home sleep apnea testing at baseline. Questionnaires were answered and acoustic rhinometry was completed at baseline and follow-up. The proportion of patients reporting subjective nocturnal nasal obstruction was reduced (baseline: 35% versus follow-up: 24%; p < 0.001). Small interior nasal dimensions increased (p < 0.001) independent of adherence to treatment. Small nasal volume at baseline was a determinant for becoming a non-user of positive airway pressure treatment (odds ratio 2.22, confidence interval 95% 1.35–3.67, p = 0.002). Subjective nasal obstruction decreased 2 years after initiating positive airway treatment in sleep apnea, and objectively small nasal dimensions increased. Small nasal volume at baseline was a negative predictor for positive airway pressure treatment adherence. Maybe most importantly, positive airway pressure treatment did not cause long-term objective or subjective nasal obstruction. The authors are thankful to Sigrun Gudmundsdottir and Lovisa Gudmundsdottir, Sleep Department, Landspitali, Reykjavík, Iceland, for all their work with data collection; and Heidar Bergsson and Eyjolfur Sigurdsson for statistical preparation of the data. The authors would also like to show their gratitude to Greg Maislin, Bethany Staley, Brendan Keenan and the other staff at the Centre for Sleep and Circadian Neurobiology at the University of Pennsylvania, who helped analyse the sleep studies and other data of the cohort. Finally, the authors are thankful to Professor Robin L. Anderson, La Trobe University, ...