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High nasal resistance is stable over time but poorly perceived in people with tetraplegia and obstructive sleep apnoea

Authors	Wijesuriya, NS. Lewis, C. Butler, JE. Lee, BB. Jordan, AS. Berlowitz, DJ. Eckert, DJ.
Type	Journal Article (Original Research)
Journal	Respiratory Physiology & Neurobiology
Year of Publication	2016
URL	http://www.sciencedirect.com/science/article/pii/S1569904816302129
DOI	http://dx.doi.org/10.1016/j.resp.2016.09.014
Abstract	Obstructive sleep apnoea (OSA) is highly prevalent in people with tetraplegia. Nasal congestion, a risk factor for OSA, is common in people with tetraplegia. The purpose of this study was to quantify objective and perceived nasal resistance and its stability over four separate days in people with tetraplegia and OSA (n = 8) compared to able-bodied controls (n = 6). Awake nasal resistance was quantified using gold standard choanal pressure recordings (days 1 and 4) and anterior rhinomanometry (all visits). Nasal resistance (choanal pressure) was higher in people with tetraplegia versus controls (5.3[6.5] vs. 2.1[2.4] cmH2O/L/s, p = 0.02) yet perceived nasal congestion (modified Borg score) was similar (0.5[1.8] vs. 0.5[2.0], p = 0.8). Nasal resistance was stable over time in both groups (CV = 0.23 ± 0.09 vs. 0.16 ± 0.08, p = 0.2). These findings are consistent with autonomic dysfunction in tetraplegia and adaptation of perception to high nasal resistance. Nasal resistance may be an important therapeutic target for OSA in this population but self-assessment cannot reliably identify those most at risk.

Authors

Wijesuriya, NS.
Lewis, C.
Butler, JE.
Lee, BB.
Jordan, AS.
Berlowitz, DJ.
Eckert, DJ.

Type

Journal Article (Original Research)

Journal

Respiratory Physiology & Neurobiology

Year of Publication

2016

URL

http://www.sciencedirect.com/science/article/pii/S1569904816302129

DOI

http://dx.doi.org/10.1016/j.resp.2016.09.014

Abstract

Obstructive sleep apnoea (OSA) is highly prevalent in people with tetraplegia. Nasal congestion, a risk factor for OSA, is common in people with tetraplegia. The purpose of this study was to quantify objective and perceived nasal resistance and its stability over four separate days in people with tetraplegia and OSA (n = 8) compared to able-bodied controls (n = 6). Awake nasal resistance was quantified using gold standard choanal pressure recordings (days 1 and 4) and anterior rhinomanometry (all visits). Nasal resistance (choanal pressure) was higher in people with tetraplegia versus controls (5.3[6.5] vs. 2.1[2.4] cmH2O/L/s, p = 0.02) yet perceived nasal congestion (modified Borg score) was similar (0.5[1.8] vs. 0.5[2.0], p = 0.8). Nasal resistance was stable over time in both groups (CV = 0.23 ± 0.09 vs. 0.16 ± 0.08, p = 0.2). These findings are consistent with autonomic dysfunction in tetraplegia and adaptation of perception to high nasal resistance. Nasal resistance may be an important therapeutic target for OSA in this population but self-assessment cannot reliably identify those most at risk.

http://www.ibas.org.au/what-we-do/publications/3872871

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High nasal resistance is stable over time but poorly perceived in people with tetraplegia and obstructive sleep apnoea