Effects of nasal surgery on sleep quality in obstructive sleep apnea syndrome with nasal obstruction

Background: The purpose of this study was to evaluate the effects of nasal surgery on nasal resistance, sleep apnea, and sleep quality in adult male patients with obstructive sleep apnea syndrome (OSAS). A prospective study was performed in OSAS patients who underwent isolated nasal surgery in a tertiary referral center. Methods: During the 3-year study period, 49 OSAS patients suffering from symptomatic nasal obstruction/impaired nasal breathing underwent the standard polysomnography before and after surgery. Polysomnography along with measures of nasal resistance and daytime sleepiness (the Epworth sleepiness scale [ESS] scores) were reviewed also. Results: Surgery decreased the nasal resistance (0.55 +/- 0.37 Pa/cm(3) per second versus 0.17 +/- 0.19 Pa/cm(3) per second; p < 0.001) and ESS scores (11.7 +/- 4.1 versus 3.3 +/- 1.3; p < 0.001), without changes in the apnea-hypopnea index (AHI, 44.6 +/- 22.5 versus 42.5 +/- 22.0). Surgery increased nadir oxygen saturation (76.2 +/- 10.9% versus 78.8 +/- 8.1%; p < 0.01), shortened apnea-hypopnea duration (averaged/maximum; 33.5 +/- 7.3/61.1 +/- 46.0 versus 28.8 +/- 7.4/47.3 +/- 36.1 second; p < 0.05/p < 0.01), and improved sleep quality. Conclusion: The results suggest that nasal surgery is useful for lowering nasal resistance, ameliorating sleep-disordered breathing, and improving sleep quality and daytime sleepiness in OSAS.