Screening for Nasal Patency-Article: Influence of Nasal Resistance on Oral Appliance Treatment Outcome in Obstructive Sleep Apnea

Article: Influence of Nasal Resistance on Oral Appliance Treatment Outcome in Obstructive Sleep Apnea

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Obstructive sleep apnea (OSA) is a sleep disorder characterized by the narrowing and occlusion of the upper airway during sleep, resulting in sleep fragmentation and intermittent hypoxemia. It is estimated that approximately 17% of adults have mild or worse OSA, and 5.7% have moderate or worse OSA. OSA is associated with increased morbidity and mortality from cardiovascular complications. The pathophysiology of OSA is not fully understood, but it is believed that anatomical changes of the upper airway and functional abnormalities of upper airway dilating muscles play a role. Nasal obstruction has been shown to be positively associated with OSA. High nasal resistance is known to induce or exacerbate OSA, and it is plausible that high nasal resistance could negatively affect the outcome of oral appliance treatment for OSA. This study aimed to compare nasal resistance in responders and non-responders to oral appliance treatment and to assess the effect of mandibular advancement on nasal resistance. It was found that responders to oral appliance treatment had lower nasal resistance in the sitting position compared to non-responders. However, there was no significant change in nasal resistance with oral appliance treatment in either response group. Logistic regression analysis revealed that nasal resistance and body mass index were the most important predictive factors for oral appliance treatment outcome. These findings suggest that higher levels of nasal resistance may negatively impact treatment outcome with oral appliance therapy for OSA. Further research is needed to investigate the relationship between nasal function and treatment outcome and to explore methods for lowering nasal resistance to improve treatment outcome.

Keywords

Obstructive sleep apnea

OSA

sleep disorder

upper airway

sleep fragmentation

intermittent hypoxemia

cardiovascular complications

nasal obstruction

nasal resistance

oral appliance treatment