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Original Research: SLEEP MEDICINE |

Snoring Is Not Relieved by Nasal Surgery Despite Improvement in Nasal Resistance*

Paula Virkkula, MD, PhD; Adel Bachour, MD, PhD; Maija Hytönen, MD, PhD; Tapani Salmi, MD, PhD; Henrik Malmberg, MD, PhD; Kirsti Hurmerinta, DDS, PhD; Paula Maasilta, MD, PhD, FCCP
Author and Funding Information

*From the ENT Hospital (Drs. Virkkula, Hytönen, and Malmberg), the Departments of Clinical Neurophysiology (Dr. Salmi) and Pulmonary Medicine (Drs. Bachour and Maasilta), and the Cleft Palate Center (Dr. Hurmerinta), Department of Plastic Surgery, Helsinki University Central Hospital, Helsinki, Finland.

Correspondence to: Paula Virkkula, MD, PhD, ENT Hospital, Helsinki University Central Hospital, Haartmaninkatu 4.E., PO Box 220, FIN-00029 HUS, Helsinki, Finland; e-mail: paula.virkkula@hus.fi



Chest. 2006;129(1):81-87. doi:10.1378/chest.129.1.81
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Objectives: In the present study, we evaluated the effect of nasal surgery on snoring time, snoring intensity, and sleep-disordered breathing. The role of abnormal cephalometry in treatment outcome was assessed.

Design: A cross-sectional prospective study.

Setting: University teaching hospital.

Patients: Forty consecutive snoring men who were referred to ENT Hospital because of a snoring problem or suspicion of sleep apnea.

Interventions: The patients underwent anterior rhinomanometry and polysomnography (PSG) with recording of snoring before and after operative treatment of nasal obstruction. Cephalometric radiographs were obtained before surgery.

Results: Nasal resistance decreased significantly in the overall patient group. Snoring time, snoring intensity, nocturnal breathing, and sleep architecture did not change after nasal surgery. Cephalometry did not predict operative outcome in these patients. Snoring intensity was found to be significantly higher during non-rapid eye movement (NREM) sleep than during rapid eye movement sleep.

Conclusions: Operative treatment of mainly structural nasal obstruction did not seem to decrease snoring intensity, snoring time, or sleep-disordered breathing in an objective assessment by PSG performed after surgery. The effect of treating inflammatory nasal changes during nocturnal breathing, as well as the role of cephalometry in the prediction of treatment outcome will need further evaluation. Higher snoring intensity related to NREM sleep may add to the sleep disturbance of a bed partner in the evening.

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