Abstract
Sleep-disordered breathing (SDB) is a clinical entity that consists of a wide spectrum of sleep-related breathing abnormalities. Those related to upper airway obstruction include snoring, upper airway resistance syndrome (UARS) and obstructive sleep apnoea–hypopnoea syndrome (OSAHS). The latter is a leading cause of neuropsychological, cerebro- and cardiovascular diseases, metabolic disorders, loss in work productivity and increased risk of motor vehicle accidents.
As the nose plays an important role in the physiology of the respiratory tract, the authors remind the anatomy and physiology of the nose and the role of the nasal disorders in the pathogenesis of SDB. They also review the different methods to treat nasal obstruction, medically or surgically.
To summarise, the authors point out that reducing nasal obstruction and resistance improves subjectively the snoring, the daytime sleepiness and the quality of life, but fails to improve significantly objective polysomnography data, such as the apnoea–hypopnoea index (AHI) or nocturnal oxygen desaturation. When some positive effects have been reported, improvement of sleep apnoea occurred only in approximately 15–20% of the patients.
Results of nasal surgery in patients with sleep apnoea/hypopnoea are therefore barely predictable. Nevertheless, nasal procedures improve CPAP compliance in individuals with OSA and nasal obstruction requiring high CPAP settings.
A global management of the patient with a multilevel airway approach is therefore recommended to treat in an optimal way sleep-disordered breathing.
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References
Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230–5.
Phillipson EA. Sleep apnea–a major public health problem. N Engl J Med. 1993;328:1271–3.
Pirsig W. The nose and sleep-disordered breathing. Sleep Breath. 2003;7:51–2.
Primhak R, Kingshott R. Sleep physiology and sleep-disordered breathing: the essentials. Arch Dis Child. 2012;97:54–8.
Ferris BG Jr, Mead J, Opie LH. Partitioning of respiratory flow resistance in man. J Appl Physiol. 1964;19:653–8.
Rhee JS, Weaver EM, Park SS, et al. Clinical consensus statement: diagnosis and management of nasal valve compromise. Otolaryngol Head Neck Surg. 2010;143:48–59.
Spielmann PM, White PS, Hussain SS. Surgical techniques for the treatment of nasal valve collapse: a systematic review. Laryngoscope. 2009;119:1281–90.
Courtiss EH, Goldwyn RM. The effects of nasal surgery on airflow. Plast Reconstr Surg. 1983;72:9–21.
Kennedy DW, Zinreich SJ, Kumar AJ, Rosenbaum AE, Johns ME. Physiologic mucosal changes within the nose and ethmoid sinus: imaging of the nasal cycle by MRI. Laryngoscope. 1988;98:928–33.
Rappai M, Collop N, Kemp S, de Shazo R. The nose and sleep-disordered breathing: what we know and what we do not know. Chest. 2003;124:2309–23.
Mladina R, Cujic E, Subaric M, Vukovic K. Nasal septal deformities in ear, nose, and throat patients: an international study. Am J Otolaryngol. 2008;29:75–82.
Grymer LF, Hilberg O, Pedersen OF. Prediction of nasal obstruction based on clinical examination and acoustic rhinometry. Rhinology. 1997;35:53–7.
Bauchau V, Durham SR. Prevalence and rate of diagnosis of allergic rhinitis in Europe. Eur Respir J. 2004;24:758–64.
Brozek JL, Bousquet J, Baena-Cagnani CE, et al. Allergic rhinitis and its impact on asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol. 2010;126:466–76.
Fokkens WJ, Lund VJ, Mullol J, et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology. 2012;50:1–12.
Georgalas C. The role of the nose in snoring and obstructive sleep apnoea: an update. Eur Arch Otorhinolaryngol. 2011;268(9):1365–73.
McNicholas WT. The nose and OSA: variable nasal obstruction may be more important in pathophysiology than fixed obstruction. Eur Respir J. 2008;32:3–8.
Farre R, Montserrat JM, Navajas D. Assessment of upper airway mechanics during sleep. Respir Physiol Neurobiol. 2008;163:74–81.
Horner RL. Neural control of the upper airway: integrative physiological mechanisms and relevance for sleep disordered breathing. Compr Physiol. 2012;2:479–535.
Gold AR, Schwartz AR. The pharyngeal critical pressure. Chest. 1996;110:1077–88.
Fitzpatrick MF, Driver HS, Chatha N, Voduc N, Girard AM. Partitioning of inhaled ventilation between the nasal and oral routes during sleep in normal subjects. J Appl Physiol. 2003a;94:883–90.
Fitzpatrick MF, McLean H, Urton AM, Tan A, O’Donnell D, Driver HS. Effect of nasal or oral breathing route on upper airway resistance during sleep. Eur Respir J. 2003b;22:827–32.
McNicholas WT, Coffey M, Boyle T. Effects of nasal airflow on breathing during sleep in normal humans. Am Rev Respir Dis. 1993;147:620–3.
White DP, Cadieux RJ, Lombard RM, Bixler EO, Kales A, Zwillich CW. The effects of nasal anesthesia on breathing during sleep. Am Rev Respir Dis. 1985;132:972–5.
Berry RB, Kouchi KG, Bower JL, Light RW. Effect of upper airway anesthesia on obstructive sleep apnea. Am J Respir Crit Care Med. 1995;151:1857–61.
Ko JH, Kuo TB, Lee GS. Effect of postural change on nasal airway and autonomic nervous system established by rhinomanometry and heart rate variability analysis. Am J Rhinol. 2008;22:159–65.
Lundberg JO. Nitric oxide and the paranasal sinuses. Anat Rec (Hoboken). 2008;291:1479–84.
Lundberg JO, Weitzberg E. Nasal nitric oxide in man. Thorax. 1999;54:947–52.
Blitzer ML, Loh E, Roddy MA, Stamler JS, Creager MA. Endothelium-derived nitric oxide regulates systemic and pulmonary vascular resistance during acute hypoxia in humans. J Am Coll Cardiol. 1996;28:591–6.
Lundberg JO. Airborne nitric oxide: inflammatory marker and aerocrine messenger in man. Acta Physiol Scand Suppl. 1996;633:1–27.
Haight JS, Djupesland PG. Nitric oxide (NO) and obstructive sleep apnea (OSA). Sleep Breath. 2003;7:53–62.
Atkeson A, Jelic S. Mechanisms of endothelial dysfunction in obstructive sleep apnea. Vasc Health Risk Manag. 2008;4:1327–35.
Paludetti G, Almadori G, Scarano E, Deli R, Laneri de Bernart A, Maurizi M. Nasal obstruction and skull base development: experimental study in the rat. Rhinology. 1995;33:171–3.
Scarano E, Ottaviani F, Di Girolamo S, Galli A, Deli R, Paludetti G. Relationship between chronic nasal obstruction and craniofacial growth: an experimental model. Int J Pediatr Otorhinolaryngol. 1998;45:125–31.
Yamada T, Tanne K, Miyamoto K, Yamauchi K. Influences of nasal respiratory obstruction on craniofacial growth in young Macaca fuscata monkeys. Am J Orthod Dentofac Orthop. 1997;111:38–43.
Peltomaki T. The effect of mode of breathing on craniofacial growth–revisited. Eur J Orthod. 2007;29:426–9.
Principato JJ. Upper airway obstruction and craniofacial morphology. Otolaryngol Head Neck Surg. 1991;104:881–90.
Harari D, Redlich M, Miri S, Hamud T, Gross M. The effect of mouth breathing versus nasal breathing on dentofacial and craniofacial development in orthodontic patients. Laryngoscope. 2010;120:2089–93.
Juliano ML, Machado MA, Carvalho LB, Prado LB, Do Prado GF. Mouth breathing children have cephalometric patterns similar to those of adult patients with obstructive sleep apnea syndrome. Arq Neuropsiquiatr. 2009;67:860–5.
Erler T, Paditz E. Obstructive sleep apnea syndrome in children: a state-of-the-art review. Treat Respir Med. 2004;3:107–22.
Poirrier AL, Pire S, Raskin S, Limme M, Poirrier R. Contribution of postero-anterior cephalometry in obstructive sleep apnea. Laryngoscope. 2012;122(10):2350–4.
Cakirer B, Hans MG, Graham G, Aylor J, Tishler PV, Redline S. The relationship between craniofacial morphology and obstructive sleep apnea in whites and in African-Americans. Am J Respir Crit Care Med. 2001;163:947–50.
Ip MS, Lam B, Lauder IJ, et al. A community study of sleep-disordered breathing in middle-aged Chinese men in Hong Kong. Chest. 2001;119:62–9.
Stupak HD. The human external nose and its evolutionary role in the prevention of obstructive sleep apnea. Otolaryngol Head Neck Surg. 2010;142:779–82.
Davidson TM. The great leap forward: the anatomic basis for the acquisition of speech and obstructive sleep apnea. Sleep Med. 2003;4:185–94.
Davidson TM, Sedgh J, Tran D, Stepnowsky CJ Jr. The anatomic basis for the acquisition of speech and obstructive sleep apnea: evidence from cephalometric analysis supports the great leap forward hypothesis. Sleep Med. 2005;6:497–505.
Shprintzen RJ. The origin of speech ease: evolution of the human upper airway and its functional implications for obstructive sleep apnea. Editorial commentary: the great leap forward: the anatomic basis for the acquisition of speech and obstructive sleep apnea by Terence M. Davidson. Sleep Med. 2003;4:171–3.
Mladina R. The role of maxillar morphology in the development of pathological septal deformities. Rhinology. 1987;25:199–205.
Cole P. Acoustic rhinometry and rhinomanometry. Rhinol Suppl. 2000;16:29–34.
Virkkula P, Maasilta P, Hytonen M, Salmi T, Malmberg H. Nasal obstruction and sleep-disordered breathing: the effect of supine body position on nasal measurements in snorers. Acta Otolaryngol. 2003b;123:648–54.
Virkkula P, Hurmerinta K, Loytonen M, Salmi T, Malmberg H, Maasilta P. Postural cephalometric analysis and nasal resistance in sleep-disordered breathing. Laryngoscope. 2003a;113:1166–74.
Yahyavi S, Parsa FM, Fereshtehnejad SM, Najimi N. Objective measurement of nasal airway dimensions and resistance using acoustic rhinometry and rhinomanometry in habitual snorers compared with non-snorers. Eur Arch Otorhinolaryngol. 2008;265:1483–7.
Liistro G, Rombaux P, Belge C, Dury M, Aubert G, Rodenstein DO. High Mallampati score and nasal obstruction are associated risk factors for obstructive sleep apnoea. Eur Respir J. 2003;21:248–52.
Cakmak O, Coskun M, Celik H, Buyuklu F, Ozluoglu LN. Value of acoustic rhinometry for measuring nasal valve area. Laryngoscope. 2003;113:295–302.
Wilson AM, Sims EJ, Robb F, Cockburn W, Lipworth BJ. Peak inspiratory flow rate is more sensitive than acoustic rhinometry or rhinomanometry in detecting corticosteroid response with nasal histamine challenge. Rhinology. 2003;41:16–20.
Nathan RA, Eccles R, Howarth PH, Steinsvag SK, Togias A. Objective monitoring of nasal patency and nasal physiology in rhinitis. J Allergy Clin Immunol. 2005;115:S442–59.
Hopkins C, Gillett S, Slack R, Lund VJ, Browne JP. Psychometric validity of the 22-item Sinonasal outcome test. Clin Otolaryngol. 2009;34:447–54.
Lindsay RW. Disease-specific quality of life outcomes in functional rhinoplasty. Laryngoscope. 2012;122(7):1480–8.
Piccirillo JF, Merritt MG Jr, Richards ML. Psychometric and clinimetric validity of the 20-item Sino-nasal outcome test (SNOT-20). Otolaryngol Head Neck Surg. 2002;126:41–7.
Poirrier AL, Ahluwalia S, Goodson A, Ellis M, Bentley M, Andrews P. Is the Sino-nasal outcome Test-22 a suitable evaluation for septorhinoplasty? Laryngoscope. 2013;123(1):76–81.
Grover SS, Pittman SD. Automated detection of sleep disordered breathing using a nasal pressure monitoring device. Sleep Breath. 2008;12:339–45.
Maury G, Cambron L, Jamart J, Marchand E, Senny F, Poirrier R. Added value of a mandible movement automated analysis in the screening of obstructive sleep apnea. J Sleep Res. 2013;22(1):96–103.
Senny F, Maury G, Cambron L, Leroux A, Destine J, Poirrier R. The sleep/wake state scoring from mandible movement signal. Sleep Breath. 2012;16:535–42.
Storms W. Allergic rhinitis-induced nasal congestion: its impact on sleep quality. Prim Care Respir J. 2008;17:7–18.
Kessler RC, Almeida DM, Berglund P, Stang P. Pollen and mold exposure impairs the work performance of employees with allergic rhinitis. Ann Allergy Asthma Immunol. 2001;87:289–95.
Marshall PS, O’Hara C, Steinberg P. Effects of seasonal allergic rhinitis on selected cognitive abilities. Ann Allergy Asthma Immunol. 2000;84:403–10.
Wilken JA, Berkowitz R, Kane R. Decrements in vigilance and cognitive functioning associated with ragweed-induced allergic rhinitis. Ann Allergy Asthma Immunol. 2002;89:372–80.
Bousquet J, Schunemann HJ, Zuberbier T, et al. Development and implementation of guidelines in allergic rhinitis - an ARIA-GA2LEN paper. Allergy. 2010;65:1212–21.
Church MK, Maurer M, Simons FE, et al. Risk of first-generation H(1)-antihistamines: a GA(2)LEN position paper. Allergy. 2010;65:459–66.
Ferguson BJ. Influences of allergic rhinitis on sleep. Otolaryngol Head Neck Surg. 2004;130:617–29.
Golden S, Teets SJ, Lehman EB, et al. Effect of topical nasal azelastine on the symptoms of rhinitis, sleep, and daytime somnolence in perennial allergic rhinitis. Ann Allergy. 2000;85:53–7.
Weiner JM, Abramson MJ, Puy RM. Intranasal corticosteroids versus oral H1 receptor antagonists in allergic rhinitis: systematic review of randomised controlled trials. BMJ. 1998;317:1624–9.
Passalacqua G, Albano M, Canonica GW, et al. Inhaled and nasal corticosteroids: safety aspects. Allergy. 2000;55:16–33.
Kedem E, Shahar E, Hassoun G, Pollack S. Iatrogenic Cushing’s syndrome due to coadministration of ritonavir and inhaled budesonide in an asthmatic human immunodeficiency virus infected patient. J Asthma. 2010;47:830–1.
Mahlab-Guri K, Asher I, Gradstein S, et al. Inhaled fluticasone causes iatrogenic cushing’s syndrome in patients treated with ritonavir. J Asthma. 2011;48:860–3.
Samaras K, Pett S, Gowers A, McMurchie M, Cooper DA. Iatrogenic Cushing’s syndrome with osteoporosis and secondary adrenal failure in human immunodeficiency virus-infected patients receiving inhaled corticosteroids and ritonavir-boosted protease inhibitors: six cases. J Clin Endocrinol Metab. 2005;90:4394–8.
Valin N, De Castro N, Garrait V, Bergeron A, Bouche C, Molina JM. Iatrogenic Cushing’s syndrome in HIV-infected patients receiving ritonavir and inhaled fluticasone: description of 4 new cases and review of the literature. J Int Assoc Physicians AIDS Care (Chic). 2009;8:113–21.
Foisy MM, Yakiwchuk EM, Chiu I, Singh AE. Adrenal suppression and Cushing’s syndrome secondary to an interaction between ritonavir and fluticasone: a review of the literature. HIV Med. 2008;9:389–96.
Kerr P, Millar T, Buckle P, Kryger M. The importance of nasal resistance in obstructive sleep apnea syndrome. J Otolaryngol. 1992;21:189–95.
Craig TJ, Teets S, Lehman EB, Chinchilli VM, Zwillich C. Nasal congestion secondary to allergic rhinitis as a cause of sleep disturbance and daytime fatigue and the response to topical nasal corticosteroids. J Allergy Clin Immunol. 1998;101:633–7.
Hughes K, Glass C, Ripchinski M, et al. Efficacy of the topical nasal steroid budesonide on improving sleep and daytime somnolence in patients with perennial allergic rhinitis. Allergy. 2003;58:380–5.
Ratner PH, Howland WC 3rd, Arastu R, et al. Fluticasone propionate aqueous nasal spray provided significantly greater improvement in daytime and nighttime nasal symptoms of seasonal allergic rhinitis compared with montelukast. Ann Allergy Asthma Immunol. 2003;90:536–42.
Craig TJ, Mende C, Hughes K, Kakumanu S, Lehman EB, Chinchilli V. The effect of topical nasal fluticasone on objective sleep testing and the symptoms of rhinitis, sleep, and daytime somnolence in perennial allergic rhinitis. Allergy Asthma Proc. 2003;24:53–8.
Kiely JL, Nolan P, McNicholas WT. Intranasal corticosteroid therapy for obstructive sleep apnoea in patients with co-existing rhinitis. Thorax. 2004;59:50–5.
Craig TJ, Hanks CD, Fisher LH. How do topical nasal corticosteroids improve sleep and daytime somnolence in allergic rhinitis? J Allergy Clin Immunol. 2005;116:1264–6.
McLean HA, Urton AM, Driver HS, et al. Effect of treating severe nasal obstruction on the severity of obstructive sleep apnoea. Eur Respir J. 2005;25:521–7.
Gurevich F, Glass C, Davies M, et al. The effect of intranasal steroid budesonide on the congestion-related sleep disturbance and daytime somnolence in patients with perennial allergic rhinitis. Allergy Asthma Proc. 2005;26:268–74.
Rabasseda X. A report from the American Academy of Allergy, Asthma and Immunology 2012 annual meeting (March 2–6, 2012 - Orlando, Florida, U.S.A.). Drugs Today (Barc). 2012;48:303–10.
Kakumanu S, Glass C, Craig T. Poor sleep and daytime somnolence in allergic rhinitis: significance of nasal congestion. Am J Respir Med. 2002;1:195–200.
Rombaux P, Liistro G, Hamoir M, et al. Nasal obstruction and its impact on sleep-related breathing disorders. Rhinology. 2005;43:242–50.
Stuck BA, Czajkowski J, Hagner AE, et al. Changes in daytime sleepiness, quality of life, and objective sleep patterns in seasonal allergic rhinitis: a controlled clinical trial. J Allergy Clin Immunol. 2004;113:663–8.
Petruson B. Snoring can be reduced when the nasal airflow is increased by the nasal dilator Nozovent. Arch Otolaryngol Head Neck Surg. 1990;116:462–4.
Petruson B. Increased nasal breathing decreases snoring and improves oxygen saturation during sleep apnoea. Rhinology. 1994;32:87–9.
Ellegard E. Mechanical nasal alar dilators. Rhinology. 2006;44:239–48.
Riechelmann H, Karow E, DiDio D, Kral F. External nasal valve collapse - a case–control and interventional study employing a novel internal nasal dilator (Nasanita). Rhinology. 2010;48:183–8.
Cheng D, Iriarte GC. The paper clip nasal dilator. Laryngoscope. 1998;108:1247–8.
Hoijer U, Ejnell H, Hedner J, Petruson B, Eng LB. The effects of nasal dilation on snoring and obstructive sleep apnea. Arch Otolaryngol Head Neck Surg. 1992;118:281–4.
Hoffstein V, Mateika S, Metes A. Effect of nasal dilation on snoring and apneas during different stages of sleep. Sleep. 1993;16:360–5.
Liistro G, Rombaux P, Dury M, Pieters T, Aubert G, Rodenstein DO. Effects of breathe right on snoring: a polysomnographic study. Respir Med. 1998;92:1076–8.
Todorova A, Schellenberg R, Hofmann HC, Dimpfel W. Effect of the external nasal dilator breathe right on snoring. Eur J Med Res. 1998;3:367–79.
Gosepath J, Amedee RG, Romantschuck S, Mann WJ. Breathe right nasal strips and the respiratory disturbance index in sleep related breathing disorders. Am J Rhinol. 1999;13:385–9.
Bahammam AS, Tate R, Manfreda J, Kryger MH. Upper airway resistance syndrome: effect of nasal dilation, sleep stage, and sleep position. Sleep. 1999;22:592–8.
Schonhofer B, Franklin KA, Brunig H, Wehde H, Kohler D. Effect of nasal-valve dilation on obstructive sleep apnea. Chest. 2000;118:587–90.
Pevernagie D, Hamans E, Van Cauwenberge P, Pauwels R. External nasal dilation reduces snoring in chronic rhinitis patients: a randomized controlled trial. Eur Respir J. 2000;15:996–1000.
Djupesland PG, Skatvedt O, Borgersen AK. Dichotomous physiological effects of nocturnal external nasal dilation in heavy snorers: the answer to a rhinologic controversy? Am J Rhinol. 2001;15:95–103.
Schonhofer B, Kerl J, Suchi S, Kohler D, Franklin KA. Effect of nasal valve dilation on effective CPAP level in obstructive sleep apnea. Respir Med. 2003;97:1001–5.
Devars du Mayne M, Pruliere-Escabasse V, Zerah-Lancner F, Coste A, Papon JF. Polypectomy compared with ethmoidectomy in the treatment of nasal polyposis. Arch Otolaryngol Head Neck Surg. 2011;137:111–7.
Jankowski R, Pigret D, Decroocq F, Blum A, Gillet P. Comparison of radical (nasalisation) and functional ethmoidectomy in patients with severe sinonasal polyposis. A retrospective study. Rev Laryngol Otol Rhinol (Bord). 2006;127:131–40.
Verse T, Maurer JT, Pirsig W. Effect of nasal surgery on sleep-related breathing disorders. Laryngoscope. 2002;112:64–8.
Kim ST, Choi JH, Jeon HG, Cha HE, Kim DY, Chung YS. Polysomnographic effects of nasal surgery for snoring and obstructive sleep apnea. Acta Otolaryngol. 2004;124:297–300.
Virkkula P, Bachour A, Hytonen M, et al. Snoring is not relieved by nasal surgery despite improvement in nasal resistance. Chest. 2006;129:81–7.
Koutsourelakis I, Georgoulopoulos G, Perraki E, Vagiakis E, Roussos C, Zakynthinos SG. Randomised trial of nasal surgery for fixed nasal obstruction in obstructive sleep apnoea. Eur Respir J. 2008;31:110–7.
Li HY, Lin Y, Chen NH, Lee LA, Fang TJ, Wang PC. Improvement in quality of life after nasal surgery alone for patients with obstructive sleep apnea and nasal obstruction. Arch Otolaryngol Head Neck Surg. 2008b;134:429–33.
Li HY, Lee LA, Wang PC, Chen NH, Lin Y, Fang TJ. Nasal surgery for snoring in patients with obstructive sleep apnea. Laryngoscope. 2008a;118:354–9.
Morinaga M, Nakata S, Yasuma F, et al. Pharyngeal morphology: a determinant of successful nasal surgery for sleep apnea. Laryngoscope. 2009;119:1011–6.
Tosun F, Kemikli K, Yetkin S, Ozgen F, Durmaz A, Gerek M. Impact of endoscopic sinus surgery on sleep quality in patients with chronic nasal obstruction due to nasal polyposis. J Craniofac Surg. 2009;20:446–9.
Li HY, Lee LA, Wang PC, Fang TJ, Chen NH. Can nasal surgery improve obstructive sleep apnea: subjective or objective? Am J Rhinol Allergy. 2009;23:e51–5.
Choi JH, Kim EJ, Kim YS, et al. Effectiveness of nasal surgery alone on sleep quality, architecture, position, and sleep-disordered breathing in obstructive sleep apnea syndrome with nasal obstruction. Am J Rhinol Allergy. 2011;25:338–41.
Sufioglu M, Ozmen OA, Kasapoglu F, et al. The efficacy of nasal surgery in obstructive sleep apnea syndrome: a prospective clinical study. Eur Arch Otorhinolaryngol. 2012;269:487–94.
Li HY, Wang PC, Chen YP, Lee LA, Fang TJ, Lin HC. Critical appraisal and meta-analysis of nasal surgery for obstructive sleep apnea. Am J Rhinol Allergy. 2011;25:45–9.
Nakata S, Noda A, Yagi H, et al. Nasal resistance for determinant factor of nasal surgery in CPAP failure patients with obstructive sleep apnea syndrome. Rhinology. 2005;43:296–9.
Li HY, Wang PC, Hsu CY, Lee SW, Chen NH, Liu SA. Combined nasal-palatopharyngeal surgery for obstructive sleep apnea: simultaneous or staged? Acta Otolaryngol. 2005;125:298–303.
Stow NW, Sale PJ, Lee D, Joffe D, Gallagher RM. Simultaneous tonsillectomy and nasal surgery in adult obstructive sleep apnea: a pilot study. Otolaryngol Head Neck Surg. 2012;147(2):387–91.
Carroll W, Wilhoit CS, Intaphan J, Nguyen SA, Gillespie MB. Snoring management with nasal surgery and upper airway radiofrequency ablation. Otolaryngol Head Neck Surg. 2012;146:1023–7.
Friedman M, Tanyeri H, Lim JW, Landsberg R, Vaidyanathan K, Caldarelli D. Effect of improved nasal breathing on obstructive sleep apnea. Otolaryngol Head Neck Surg. 2000;122:71–4.
Kotecha B. The nose, snoring and obstructive sleep apnoea. Rhinology. 2011;49:259–63.
Mohsenin V. Gender differences in the expression of sleep-disordered breathing : role of upper airway dimensions. Chest. 2001;120:1442–7.
Pepin JL, Leger P, Veale D, Langevin B, Robert D, Levy P. Side effects of nasal continuous positive airway pressure in sleep apnea syndrome. Study of 193 patients in two French sleep centers. Chest. 1995;107:375–81.
Sugiura T, Noda A, Nakata S, et al. Influence of nasal resistance on initial acceptance of continuous positive airway pressure in treatment for obstructive sleep apnea syndrome. Respiration. 2007;74:56–60.
Powell NB, Zonato AI, Weaver EM, et al. Radiofrequency treatment of turbinate hypertrophy in subjects using continuous positive airway pressure: a randomized, double-blind, placebo-controlled clinical pilot trial. Laryngoscope. 2001;111:1783–90.
Friedman M, Wilson M. Re-redefining success in airway surgery for obstructive sleep apnea. Sleep. 2009;32:17.
Weaver TE, Grunstein RR. Adherence to continuous positive airway pressure therapy: the challenge to effective treatment. Proc Am Thorac Soc. 2008;5:173–8.
Zonato AI, Bittencourt LR, Martinho FL, Gregorio LC, Tufik S. Upper airway surgery: the effect on nasal continuous positive airway pressure titration on obstructive sleep apnea patients. Eur Arch Otorhinolaryngol. 2006;263:481–6.
Kohler M, Bloch KE, Stradling JR. The role of the nose in the pathogenesis of obstructive sleep apnoea and snoring. Eur Respir J. 2007;30:1208–15.
Kohler M, Bloch KE, Stradling JR. The role of the nose in the pathogenesis of obstructive sleep apnea. Curr Opin Otolaryngol Head Neck Surg. 2009;17:33–7.
Chen W, Kushida CA. Nasal obstruction in sleep-disordered breathing. Otolaryngol Clin N Am. 2003;36:437–60.
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Poirrier, AL., Eloy, P., Rombaux, P. (2023). Nose and Sleep Breathing Disorders. In: Celebi, Ö.Ö., Önerci, T.M. (eds) Nasal Physiology and Pathophysiology of Nasal Disorders. Springer, Cham. https://doi.org/10.1007/978-3-031-12386-3_23
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