Impact of Isolated Nasal Surgery on Sleep Quality, Architecture, and Disordered Breathing in Obstructive Sleep Apnea with Nasal Obstruction

Authors

  • Salman Ali Department of Ear Nose and Throat (ENT). Nishtar Medical University and Hospital, Multan - Pakistan
  • Intasar Ashraf Department of Ear Nose Throat (ENT), Ibn E Siena Hospital & Research Institute, Multan – Pakistan
  • Muhammad Zahid Ishaq Department of Ear Nose Throat (ENT). Nishtar Medical University and Hospital, Multan - Pakistan
  • Sanaullah Bhatti Department of Ear Nose and Throat (ENT), Bakhtawar Amin Trust and Teaching Hospital, Multan - Pakistan
  • Shahlla Majeed Department of Ear Nose and Throat (ENT). Nishtar Medical University and Hospital, Multan - Pakistan

Keywords:

Obstructive sleep apnea, nasal obstruction, nasal surgery, polysomnography, snoring

Abstract

Background:Obstructive sleep apnea syndrome (OSAS) is frequently associated with nasal obstruction, which contributes to impaired sleep quality and poor tolerance to continuous positive airway pressure therapy. The role of isolated nasal surgery in modifying sleep parameters and sleep-disordered breathing remains debated. Objective: To evaluate the effect of nasal surgery on sleep quality, architecture, position, and sleep-disordered breathing (SDB) (including obstructive apnea and snoring) in adult patients with obstructive sleep apnea syndrome (OSAS) and nasal obstruction. Methodology:This was a prospective observational study with 55 adults who were diagnosed with obstructive sleep apnea and nasal obstruction under 55 years of age that had isolated nasal surgery (septo-surgery, turbinate reduction, or functional endoscopic sinus surgery). Evaluation of sleep, sleep-disordered breathing, and architecture with respect to positional distribution was done using polysomnography, preoperative and then at three months postoperatively. Subjective daytime sleepiness was assessed using the Epworth Sleepiness Scale (ESS). Results:After surgery on the nose, there was a significant increase in total sleep time (396.8 ± 42.7 to 432.5 ± 36.2 min, p < 0.001), sleep efficiency (86.2 ± 6.7% to 89.9 ± 6.9%, p = 0.022), as well as in ESS scores (9.2 ± 3.5 to 6.1 ± 2.9, p < 0.001). The increase in REM sleep was also marked (15.1 ± 5.2% to 18.8 ± 5.7%, p = 0.013). The snoring index fell (31.6 ± 15.8% to 25.4 ± 17.1%, p = 0.038). However, no significant changes were identified in the apnea-hypopnea index, apnea index, minimum SaO₂, and positional sleep distribution. Conclusion:Isolated nasal surgery improves sleep quality, architecture, and snoring but does not significantly affect AHI or positional breathing patterns. It should be considered a valuable adjunct rather than a curative treatment for OSAS.

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Published

2024-06-02

How to Cite

Ali, S., Ashraf, I., Ishaq, M. Z. ., Bhatti, S., & Majeed, S. (2024). Impact of Isolated Nasal Surgery on Sleep Quality, Architecture, and Disordered Breathing in Obstructive Sleep Apnea with Nasal Obstruction. Pakistan Journal of Chest Medicine, 30(2), 238–245. Retrieved from https://www.pjcm.net/index.php/pjcm/article/view/965

Issue

Vol. 30 No. 2 (2024)

Section

Original Article

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