Abstract
Although there is a strong correlation between oral/oro-nasal breathing and apnoea-hypopnoea index (AHI) in patients with obstructive sleep apnoea (OSA) and normal nasal resistance at wakefulness, it remains unknown whether the pharmacological prevention of potential nasal obstruction during sleep could decrease oral/oro-nasal breathing and increase nasal breathing and subsequently decrease AHI. This study evaluated the effect of a combination of a nasal decongestant with corticosteroid on breathing route pattern and AHI.
Twenty-one patients with OSA (mean AHI 31.1 events/hour) and normal nasal resistance at wakefulness were enrolled in a randomized crossover trial of one-week treatment with nasal tramazoline and dexamethazone compared with one-week treatment with nasal placebo. At the start and end of each treatment period, patients underwent nasal resistance measurement and overnight polysomnography with attendant measurement of breathing route pattern.
Nasal tramazoline with dexamethazone was associated with decrease in oral/oro-nasal breathing epochs and concomitant increase in nasal breathing epochs, and mean decrease of AHI by 21%
. The change in nasal breathing epochs was inversely related to the change in AHI (Rs=0.78; p<0.001).
In conclusion, nasal tramazoline with dexamethazone in OSA patients with normal nasal resistance at wakefulness can restore the preponderance of nasal breathing epochs and modestly improve AHI.
- © 2014 ERS