Author(s)
Judd Fastenberg, MD
Howard Stupak, MD
Affiliation(s)
Jacobi Medical Center, Albert Einstein College of Medicine
Abstract:
"Objective: The contribution of the oropharyngeal airway to obstructive sleep apnea (OSA) has garnered far more attention that that of the nasal airway throughout the otolaryngology literature. Recent studies suggest that the nasal airway may play a more significant role in OSA than previously thought. The introduction of handheld spirometers now allows otolaryngologists an easy, objective tool for measurement of nasal airflow. While most studies have focused on peak nasal inspiratory flow, there is evidence to suggest that expiratory nasal flow may correlate more closely to nasal patency. We describe the correlation between results of office-based nasal spirometry with polysomnograms in 35 patients to illustrate the potential for this tool to help identify those patients with a nasal contribution to OSA.
Methods: 35 patients who presented to the otolaryngology clinic and who had undergone a polysomnogram in the previous 6 months underwent nasal spirometry in the office with a hand-held FDA-approved spirometry device. All polysomnograms were performed at the same sleep center. Patients also completed NOSE and SNOT questionnaires. Polysomnogram, spirometry, and questionnaire results were then statistically analyzed and compared.
Results: There was a strong correlation between reduced nasal expiratory flow and AHI on polysomnogram. Nasal inspiratory flow did not correlate as well. Reduced expiratory flow also correlated well with subjective complaints of OSA as demonstrated by validated questionnaire.
Conclusion: Handheld spirometry may offer otolaryngologists a relatively easy way to identify patients with nasal contribution to OSA, with reduced nasal expiratory flow closely correlated to elevated AHI on polysomnogram."