[Obstructive sleep apnea and obstructing nasal polyps].

BACKGROUND

Nasal obstruction may be a causative factor in the etiology of obstructive sleep apnea. No studies were found that dealt with the role of nasal polyps in sleep apnea.

METHODS

Two male patients, 69 and 44 years old, were examined in our clinic because of nasal polyps occluding the nasal cavity. Their main complaint was nasal breathing obstruction with hyposmia. The clinical history revealed snoring but neither apnea nor daytime sleepiness was reported. Both patients underwent full nocturnal 12-channel polysomnography (PSG) prior to endonasal sinus surgery. PSG and nasal endoscopy were performed 3 months postoperatively.

RESULTS

The patients showed an increased apnea hypopnea index (AHI) from 21.1 to 76.6 and 7 to 38.8 respectively. Excessive daytime sleepiness (EDS) appeared and relative duration of REM sleep decreased. Nasal CPAP therapy was recommended.

CONCLUSIONS

Although patients felt relieved after surgery since their nasal breathing problem was solved, the results with respect to AHI, EDS, and sleep pattern were unexpected. Perhaps these findings can be explained by surgical alteration of nasal receptors or by a postoperative switch from oral to nasal nocturnal breathing.