臨床
閉塞性睡眠時無呼吸の鼻閉と重症度と呼吸経路
2023 年 116 巻 4 号 p. 313-322
詳細
2023 年 116 巻 4 号 p. 313-322
Objectives: The purposes of this study were to determine what each of the nasal resistance values means and which nasal resistance values reflect the degree of nasal congestion, and to examine which factors are correlated with the severity of obstructive sleep apnea (OSA), and how oral breathing affects OSA.
Methods: The correlations among the nasal resistance values obtained by anterior rhinomanometry (inspiration, expiration, bilateral, ipsilateral, laterality) were examined in 613 cases diagnosed as having OSA. Correlations of the nasal resistance values with the oxygen desaturation index (ODI)3% and anthropometric measurements, the morbidity period of snoring, and the period of apnea obtained from a questionnaire were investigated. The patients were then classified into three groups according to the degree of nasal congestion (often, sometimes, never), and the breathing route (oral, oronasal, nasal) obtained from the questionnaire and each of the factors were compared among the groups.
Results: Higher values and lower values of nasal resistance were positively correlated with the laterality and bilateral values, respectively (p < 0.001). The ODI3% was positively correlated with the BMI, cervical circumference, and morbidity period of snoring and period of apnea (p < 0.001), but not with any of the nasal resistance values. Laterality of nasal resistance during inspiration and the proportion of oral-breathing patients were higher in the often-nasal congestion group (p < 0.001). The onset of snoring was significantly earlier in the oral-breathing group than in the other groups (p < 0.001).
Conclusion: The laterality of nasal resistance during inspiration reliably indicated the severity of nasal congestion. The morbidity period of snoring and that of apnea were both correlated with the ODI3%, which suggests that repetitive snoring and apnea over the long term might contribute to the severity of OSA. There was no correlation between any of the nasal resistance values and the ODI3%. The onset of snoring at a young age was related with oral breathing, which might cause OSA.
