The relationship between sleep-disordered breathing (SDB) and nasal obstruction is unclear. In order to better understand, we performed an extensive computer-assisted review and analysis of the medical literature on this topic. Data were grouped into reports of normal control subjects, patients with isolated nasal obstruction, and those with SDB. We conclude that SDB can both result from and be worsened by nasal obstruction. Nasal breathing Buy Viagra pills increases ventilatory drive and nasal occlusion decreases pharyngeal patency in normal subjects. Nasal congestion from any cause predisposes to SDB. Although increased nasal resistance does not always correlate with symptoms of congestion, nasal congestion typically results in a switch to oronasal breathing that compromises the airway. Moreover, oral breathing in children may lead to the development of facial structural abnormalities associated with SDB. We postulate that the switch to oronasal breathing that occurs with chronic nasal conditions is a final common pathway for SDB.

Abbreviations: AHI = apnea-hypopnea index; CPAP = continuous positive airway pressure; EDS = excessive daytime sleepiness; EMG = electromyography; NARES = nonallergic rhinitis with nasal eosinophilia syndrome; NR = nasal resistance; OSAS = obstructive sleep apnea syndrome; Pes = esophageal pressure; SDB = sleep-disordered breathing; UARS = upper airway resistance syndrome.

Sleep-disordered breathing (SDB) is common, afflicting as much as 2 to 4% of the population. The most studied form, obstructive sleep apnea syndrome (OSAS), occurs most often in middle-aged men and obese individuals. Thus, risk factors for OSAS were originally thought to be morbid obesity and male gender. As our understanding of OSAS and other forms of SDB improved, other risk factors surfaced. These include central obesity, family history, smoking, alcohol consumption, menopause, ethnicity, and craniofacial abnormalities. We have observed a number of patients in our pulmonary, allergy, and sleep medicine practices who have nasal disorders, including allergic rhinitis, in association with SDB.