Objective

Increased nasal resistance (NR) can augment upper airway collapse in patients with obstructive sleep apnea (OSA). Posture change can lead to altered nasal resistance. Our study aimed to investigate the influence of posture changes on NR in patients with OSA.

Methods

Healthy controls without subjective nasal obstruction (apnea–hypopnea index (AHI) < 5 events/h), patients with OSA and subjective nasal obstruction, and patients with OSA and no subjective nasal obstruction were recruited. NR was measured by active anterior rhinomanometry in sitting, supine, left-lateral, and right-lateral postural positions. Total NR and postural change-related NR increments were calculated and compared among groups.

Results

In total, 26 healthy controls and 72 patients with OSA (mean AHI 39.7 ± 24.8 events/h) were recruited. Of patients with OSA, 38/72 (53%) had subjective nasal obstruction. Compared with controls, patients with OSA and no subjective nasal obstruction had lower total NR (inspiration, p = 0.037; expiration, p = 0.020) in the supine postural position. There was no difference in sitting, left-lateral, and right-lateral total NR among groups. Total NR was higher in lateral compared to sitting posture in both patients with OSA and in controls. The NR increment for sitting to supine postural change was significantly lower in patients with OSA (inspiration, p = 0.003; expiration, p = 0.005) compared with controls. The change in NR showed no statistically significant difference among groups in supine-left or supine-right postural change.

Conclusion

Patients with OSA had lower supine total NR and lower total NR increment in the sitting to supine postural change, which may be related to a different posture-related NR regulatory mechanism. This study provides a new exploratory direction for the compensatory mechanism of the upper airway to collapse during sleep.

中文翻译：

---

姿势改变对阻塞性睡眠呼吸暂停患者鼻阻力的影响

客观的

鼻阻力 (NR) 增加会加剧阻塞性睡眠呼吸暂停 (OSA) 患者的上气道塌陷。姿势改变会导致鼻阻力改变。我们的研究旨在调查姿势改变对 OSA 患者 NR 的影响。

方法

招募了无主观鼻塞（呼吸暂停低通气指数 (AHI) < 5 次/小时）的健康对照、患有 OSA 和主观鼻塞的患者以及患有 OSA 但没有主观鼻塞的患者。NR 是通过主动前鼻测压法在坐姿、仰卧、左侧和右侧姿势位置测量的。计算总 NR 和与姿势变化相关的 NR 增量，并在各组之间进行比较。

结果

总共招募了 26 名健康对照者和 72 名 OSA 患者（平均 AHI 39.7 ± 24.8 次事件/小时）。在 OSA 患者中，38/72 (53%) 有主观性鼻塞。与对照组相比，患有 OSA 且无主观鼻塞的患者 在仰卧位时的总 NR（吸气， p  = 0.037；呼气，p = 0.020）较低。各组之间的坐姿、左侧和右侧总 NR 没有差异。在 OSA 患者和对照组中，与坐姿相比，侧卧姿势的总 NR 更高。OSA 患者坐姿到仰卧姿势变化的 NR 增量显着较低（吸气，p  = 0.003；呼气，p = 0.005) 与对照组相比。NR 的变化在左仰卧位或右仰卧位姿势变化的组间没有统计学显着差异。

结论

OSA 患者的仰卧位总 NR 较低，坐位到仰卧位姿势变化时的总 NR 增量也较低，这可能与不同的姿势相关 NR 调节机制有关。该研究为睡眠时上气道塌陷的代偿机制提供了新的探索方向。