PAP treatment in patients with OSA does not induce long-term nasal obstruction

Maria Värendh, Morgan Andersson, Erla Björnsdóttir, Erna S. Arnardóttir, Thorarinn Gislason, Allan I. Pack, Harald Hrubos-Strøm, Arne Johannisson, Sigurdur Juliusson

Research output: Contribution to journalArticlepeer-review


We hypothesized that positive airway pressure treatment would induce nasal obstruction and decrease nasal cavity due to mucosal swelling. We further hypothesized that subjective and objective nasal obstruction at baseline would negatively affect positive airway pressure adherence. A total of 728 patients with sleep apnea were investigated in the Icelandic Sleep Apnea Cohort at baseline and 2 years after starting positive airway pressure. Patients underwent home sleep apnea testing at baseline. Questionnaires were answered and acoustic rhinometry was completed at baseline and follow-up. The proportion of patients reporting subjective nocturnal nasal obstruction was reduced (baseline: 35% versus follow-up: 24%; p < 0.001). Small interior nasal dimensions increased (p < 0.001) independent of adherence to treatment. Small nasal volume at baseline was a determinant for becoming a non-user of positive airway pressure treatment (odds ratio 2.22, confidence interval 95% 1.35–3.67, p = 0.002). Subjective nasal obstruction decreased 2 years after initiating positive airway treatment in sleep apnea, and objectively small nasal dimensions increased. Small nasal volume at baseline was a negative predictor for positive airway pressure treatment adherence. Maybe most importantly, positive airway pressure treatment did not cause long-term objective or subjective nasal obstruction.

Original languageEnglish
Article numbere12768
JournalJournal of Sleep Research
Issue number5
Early online date2018 Sept 28
Publication statusPublished - 2019 Oct

Subject classification (UKÄ)

  • Otorhinolaryngology

Free keywords

  • acoustic measurements
  • adherence
  • apnea
  • breathing
  • nasal anatomy
  • nose
  • survey


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