Snoring exclusively during nasal breathing: a newly described respiratory pattern during sleep
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The aim of this study is to describe a distinctive respiratory pattern seen in subjects with inferior turbinate hypertrophy, nasal obstruction, and a polysomnogram-proven diagnosis of primary snoring or mild obstructive sleep apnea. These subjects demonstrated increased snoring with purely nasal breathing and alleviation of snoring with oral breathing. The study design is case series with chart review. The setting was a university-based tertiary care hospital.
A retrospective chart review was performed for patients with complaints of nasal obstruction with associated inferior turbinate hypertrophy and a polysomnogram-proven diagnosis of mild obstructive sleep apnea or primary snoring. Demographic and polysomnography information were collected and analyzed. Snoring and airflow patterns were reviewed.
Twenty-five subjects were identified as having met the inclusion and exclusion criteria on polysomnography for either primary snoring or mild obstructive sleep apnea with inferior turbinate hypertrophy and no other significant nasal deformity or abnormality. Seventeen (68 %) of these patients had polysomnograms which demonstrated snoring during nasal breathing and alleviation of snoring with oral breathing. Of the 17 who snored during nasal breathing, ten of the subjects were female and seven of the subjects were male. The mean age was 27 years (range 18 to 68 years). The mean apnea–hypopnea index was 2.3 events/h (range 0 to 9.7 events/h). The mean body mass index was 25 kg/m2 (range 20 to 43 kg/m2).
Our study describes a newly recognized pattern of snoring in patients with a polysomnogram-proven diagnosis of either primary snoring or mild obstructive sleep apnea. This pattern of breathing demonstrates patients who snore during nasal breathing even with known nasal obstruction present and subsequently have resolution or improvement of the snoring with oral breathing.
KeywordsSnoring Nasal obstruction Polysomnogram Obstructive sleep apnea Turbinate hypertrophy Upper airway resistance syndrome
Conflict of interest
None of the authors has any conflict of interest.
- 7.Smith PL, Wise RA, Gold AR, Schwartz AR, Permutt S (1988) Upper airway pressure–flow relationships in obstructive sleep apnea. J Appl Physiol (Bethesda, MD) 64(2):789–795Google Scholar
- 11.Hedner JA, Wilcox I, Sullivan C (1994) Speculations on the interaction between vascular disease and obstructive sleep apnoea. In: Saunders N, Sullivan C (eds) Sleep and breathing, 2nd edn. Marcel Dekker, New York, pp 823–846Google Scholar
- 12.Tsuda H, Lowe AA, Chen H, Fleetham JA, Ayas NT, Almeida FR (2011) The relationship between mouth opening and sleep stage-related sleep disordered breathing. J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med 7(2):181–186Google Scholar
- 17.Kohler M, Bloch KE, Stradling JR (2007) The role of the nose in the pathogenesis of obstructive sleep apnoea and snoring. Eur Respir J Off J Eur Soc Clin Respir Physiol 30(6):1208–1215Google Scholar