The role of nasal obstruction in obstructive sleep apnea syndrome.

In summary, there is much evidence in the literature that nasal obstruction causes obstructive sleep apnea, usually of mild to moderate degree, in many individuals. In addition, it is a contributory factor in individuals with severe obstructive sleep apnea. This appears to occur because of its contribution to upper airway resistance which directly or indirectly results in a reduction in intraluminal pressure during inspiration and collapse. Nasal obstruction via its influence on the so-called nasal-pulmonary reflex, may also result in alveolar hypoventilation. In patients who have symptoms consistent with obstructive sleep apnea syndrome and/or other disorders of excessive somnolence, a careful history eliciting findings of possible nasal obstruction as well as a thorough nasal examination is appropriate. If nasal obstruction is present, intervention should be considered as part of the routine therapy for obstructive sleep apnea syndrome.