Beyond the airway: the impact of septoplasty and turbinate reduction on somnolence and sleep disordered breathing risk-a prospective study.

INTRODUCTION

Chronic nasal obstruction is a well-recognized driver of daytime somnolence and obstructive sleep-disordered breathing (OSDB). While septoplasty and inferior turbinate reduction (S + ITR) are standard treatments to restore nasal airflow, the relationship between objective gains in Peak Nasal Inspiratory Flow (PNIF) and the resolution of sleepiness remains poorly understood.

OBJECTIVE

To investigate the impact of S + ITR on daytime somnolence and to determine if these improvements correlate with nasal airflow (PNIF) or anthropometric changes.

METHODS

In this prospective study (N = 32), patients underwent S + ITR for symptomatic nasal obstruction. Outcomes included the Epworth Sleepiness Scale (ESS), the Berlin Questionnaire (as a screening tool for OSDB risk), airflow (PNIF), and Body composition at baseline and 3 months after surgery.

RESULTS

S + ITR resulted in a significant reduction in daytime somnolence, with ESS scores improving by a mean of 2.7 ± 4.4, p = 0.002. Berlin Questionnaire revealed significant improvements in Category 1 (Snoring/Apnea: p = 0.024), Category 2 (Somnolence/Fatigue: p < 0.001), whereas Category 3 (Systemic/BMI) remained stable (p = 0.422). ESS improvement did not correlate with PNIF airflow gains (p = 0.516). An inverse correlation was noted between ESS gains and BMI variation (r = - 0.381 for ΔESS vs. ΔBMI, p = 0.035).

CONCLUSION

Nasal surgery is associated with a reduction in daytime sleepiness and the screened risk for OSDB. The lack of correlation with PNIF suggests that the surgical benefit for sleepiness may be modulated by other factors beyond nasal airflow improvement. Further research is needed as the exact mechanisms remain to be elucidated.