Nasal symptoms are a common side effect of CPAP therapy. Although most patients experience self-limiting nasal congestion, at least 10% complain of persistent nasal problems to some degree after 6 months of therapy. Nasal symptoms can be treated in a variety of ways (inhaled nasal steroids, antihistamines, topical saline sprays and heated humidification); there is limited trial data of their effectiveness. The ideal and best treatment is heated humidification. Unfortunately heated humidification is expensive and many patients cannot afford this treatment. Nasal sesame oil (“Nozoil™”) has been shown to be superior to Normal Saline when used in patients with nasal symptoms associated with dry winter months in the northern hemisphere. The aim of the study was to assess the effect of “Nozoil™” on nasal symptoms and objective compliance.
Randomised, single-blinded, cross-over trial of subjects with obstructive sleep apnoea on CPAP with nasal symptoms, recruited from a tertiary referral Sleep Disorders Centre. Subjects were assessed with visual analogue scales of nasal symptoms, anterior rhinomanometry, and objective compliance at enrolment and at the end of each 2 week intervention period. Patients were randomised to normal saline (NS) or “Nozoil™” for 2 weeks then crossed over for a further 2 weeks.
17 subjects have completed the protocol. Compliance significantly improved on “Nozoil™” from baseline (5.50±2.05 hours/day improving to 6.50±1.35, p=0.007) and also when compared to NS (6.50±1.35 vs. 5.97±1.55, p=0.002). There was no statistically significant difference with nasal resistance between the baseline and intervention measurements. Significant subjective improvements in nasal crustiness (p<0.05), nasal and sinus discomfort on CPAP (p<0.001) and CPAP tolerance (p<0.001) were seen with the use of “Nozoil™”. Subjects also reported “Nozoil™” was superior to NS in making it easier to breathe through the nose (p<0.001).
The use of “Nozoil™” in subjects with nasal side effects with CPAP results in improvements in objective compliance with CPAP and subjective improvement in nasal symptoms.
“Nozoil™” is a potential alternative treatment for patients with nasal symptoms on CPAP.
John Feenstra, None.