Table of Contents Author Guidelines Submit a Manuscript
International Journal of Otolaryngology
Volume 2014, Article ID 717419, 8 pages
http://dx.doi.org/10.1155/2014/717419
Review Article

Nasal Involvement in Obstructive Sleep Apnea Syndrome

1Department of Otorhinolaryngology and Head and Neck Surgery, Brasília University Hospital, HUB, SGAN 605, Avenida L2 Norte, 70830-200 Brasília, DF, Brazil
2Universidade de Brasília (UnB), Campus Universitário Darcy Ribeiro, 70910-900 Brasília, DF, Brazil

Received 27 August 2014; Accepted 9 November 2014; Published 20 November 2014

Academic Editor: David W. Eisele

Copyright © 2014 Daniel de Sousa Michels et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Numerous studies have reported an association between nasal obstruction and obstructive sleep apnea syndrome (OSAS), but the precise nature of this relationship remains to be clarified. This paper aimed to summarize data and theories on the role of the nose in the pathophysiology of sleep apnea as well as to discuss the benefits of surgical and medical nasal treatments. A number of pathophysiological mechanisms can potentially explain the role of nasal pathology in OSAS. These include the Starling resistor model, the unstable oral airway, the nasal ventilatory reflex, and the role of nitric oxide (NO). Pharmacological treatment presents some beneficial effects on the frequency of respiratory events and sleep architecture. Nonetheless, objective data assessing snoring and daytime sleepiness are still necessary. Nasal surgery can improve the quality of life and snoring in a select group of patients with mild OSAS and septal deviation but is not an effective treatment for OSA as such. Despite the conflicting results in the literature, it is important that patients who are not perfectly adapted to CPAP are evaluated in detail, in order to identify whether there are obstructive factors that could be surgically corrected.