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Do Nasal Polyps Cause Sleep Apnea

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Clinical And Experimental Evidence

NASAL POLYPS, Causes, SIgns and Symptoms, Diagnosis and Treatment.

Evidence suggests that experimental reduction of nasal patency and flow has a significant effect on breathing during sleep.

Suratt et al. induced obstructive apneas in healthy subjects through nasal occlusion with gauze. Lavie et al. investigated the influence of partial and complete obstruction of the nose in healthy subjects and observed a significant increase in the number of apneas during sleep.

Evidence from several observational and cross-sectional studies demonstrates that the objective increase in measures of nasal resistance and the presence of allergic rhinitis are associated with OSAS. Lofaso et al. performed posterior rhinomanometry in 528 patients and observed an increased nasal resistance in OSAS patients compared to the control group. In a large population study, Young et al. identified chronic nasal congestion as a risk factor for OSAS.

Data from an electromyographic study in healthy men performed by Basner et al. demonstrated that the upper airway tone is lower during oral breathing than during nasal breathing, suggesting that the activity of the dilator muscles of the upper airway can be modulated by receptors in the nasal mucosa, sensitive to airflow or pressure. However, two other studies demonstrated that the airway did not affect the electromyographic activity of the genioglossus muscle in normal individuals, but other pharyngeal dilator muscles have not been studied .

Nasal Involvement In The Pathophysiology Of Obstructive Sleep Apnea Syndrome

The nose accounts for over 50% of the total upper airway resistance and plays an important role in the establishment of physiological functions such as humidification, heating, and air filtration .

Among the places of greatest resistance to nasal airflow are the vestibule and nasal valve area, determined by the alar cartilages, septum, and inferior turbinates .

The nasal mucosa is a dynamic organ controlled by the autonomic nervous system. Periodic nasal congestion and decongestion have been termed the nasal cycle by Heetderks . This cycle occurs in approximately 80% of the adult population. In patients with permanent unilateral nasal obstruction, the nasal cycle may contribute to a significant increase in total airway resistance .

In healthy individuals, the lateral decubitus increases congestion in the ipsilateral nasal cavity and reduces airflow resistance in the contralateral nasal cavity. This does not occur due to a hydrostatic effect, but rather as a reflex response caused by asymmetric pressure on the body . This reflex interrupts the nasal cycle . However, in the assessment of both nasal cavities, no significant changes were observed in the cross-sectional area when comparing supine and lateral decubitus .

To fully explain the relationship between airflow, nasal obstruction, and sleep apnea, it is necessary to understand some dynamic theories of physics.

Starling resistor model.

Can Fixing A Deviated Septum Cure Sleep Apnea

The only way to fix deviated septum is through surgery. The most common surgical procedure is called septoplasty, which physically repositions the septum. In some cases, balloon sinuplasty is a more appropriate option. It is minimally invasive, and uses an inflatable device to realign the septum.

Fixing deviated septum wont cure OSA, but may significantly reduce the severity of it by freeing blockages and calming inflamed tissues. While treating the side effects of or correcting deviated septum sounds fairly straightforward, it’s important to also treat OSA, if present, to protect your health.

If you and your doctor discover that OSA is the prime culprit of your breathing issues and not deviated septum, nasal surgery may still prove a helpful option. However, CPAP is by far the most common sleep apnea treatment. It is also the most effective and non-invasive treatment available.

If you come to this turning point in your medical journey, we hope youll turn to us. CPAPsupplies.com is here to help you treat OSA affordably and as comfortably as possible!

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Ready To Live Your Life Free Of Nasal Polyps

If you are suffering from chronic sinusitis, its time to talk to Dr. Pasha about your options. After all, chronic sinus and allergy symptoms will only get worse. Furthermore, they can result in permanent damage to your nasal passage and sinus cavities.

Hence, the sooner you speak with Dr. Pasha, the better chance you have for a simple, in-office procedure to get the relief you need. Confirm your appointment today!

Tonsillitis Snoring And Sleep Apnea

Nasal Polyps and Treatment

Sanja Jelic, MD, is board-certified in sleep medicine, critical care medicine, pulmonary disease, and internal medicine.

Enlarged tonsils caused by tonsillitis can cause snoring and sleep apnea or worsen current sleep disorders worse. Tonsillitis is especially common in children who suffer from sleep apnea and is a common reason that tonsillectomies are performed in the United States. While more rare, enlarged tonsils may also cause sleep apnea or snoring in adults as well. It should be noted that while snoring can be associated with sleep apnea, not all people who snore have sleep apnea. Snoring occurs due to vibration of the soft tissues in the upper airway, enlarged tonsillar tissue can contribute to these noises.

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Interpretation Of Findings And Comparison With Other Studies

Recently, these biomechanical differences were experimentally demonstrated in the sinonasal mucosa of patients with NP.11 Pezato R, Voegels RL, Pinto Bezerra TF, Perez-Novo C, Stamm AC, Gregorio LC.Mechanical disfunction in themucosal oedema formation of patients with nasal polyps. Rhinology 2014 52:162-16622 Pezato R, Voegels RL, Stamm AC, Gregório LC. Why we should avoid using inferior turbinate tissue as control to Nasal Polyposis studies. Acta Otolaryngol 2016 136:973-97533 Pezato R, Voegels RL. Why do we not find polyps in the lungs? Bronchial mucosa as a model in the treatment of polyposis. Med Hypotheses 2012 78:468-470 The biomechanical dysfunction found in NP is characterized by a deficiency in the ability to properly raise interstitial hydrostatic pressure in response to fluid extravasation during the inflammatory process, a mechanism that is crucial to limit the development of edema, and is closely related to the extracellular matrix composition.11 Pezato R, Voegels RL, Pinto Bezerra TF, Perez-Novo C, Stamm AC, Gregorio LC.Mechanical disfunction in themucosal oedema formation of patients with nasal polyps. Rhinology 2014 52:162-16622 Pezato R, Voegels RL, Stamm AC, Gregório LC. Why we should avoid using inferior turbinate tissue as control to Nasal Polyposis studies. Acta Otolaryngol 2016 136:973-97533 Pezato R, Voegels RL. Why do we not find polyps in the lungs? Bronchial mucosa as a model in the treatment of polyposis. Med Hypotheses 2012 78:468-470

Clinical And Experimental Evidence Of Correlation Between Nasal Pathology And Sdb

Several lines of evidence suggest that experimental reduction of nasal patency and flow has a significant effect on breathing during sleep. In one study, intranasal application of petroleum jelly gauzes in healthy volunteers-induced obstructive apnoeic episodes and resulted in significant increases in AHI, producing frank OSA in one subject . In another study, artificially induced complete or partial nasal obstruction resulted in significant alteration of sleep pattern, with increased micro arousals and total number of apnoeas . In a clinical setting, a number of studies have shown that the application of nasal packs during the management of epistaxis results in significantly worse quality of sleep with multiple apnoeas and desaturation episodes . Hence, it is probably safe to conclude that artificially induced partial or complete nasal obstruction results in increased sleep apnoeas.

In a recent overview McNicholas tried to synthesise these apparently conflicting results, pointing out that reversible nasal obstruction maybe more closely associated with SRDB than permanent nasal obstruction, noting that studies assessing patients with temporal obstruction tended to show a more consistent association with SDB than studies assessing patients with structural abnormalities such as deviated nasal septum.

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What Questions Should I Ask My Healthcare Provider About Nasal Polyps

Consider asking your healthcare provider:

  • How can I lessen the symptoms?
  • Do I need medications or surgery or both?
  • Should I restrict my activities?
  • Do I need to see a specialist?
  • Should I go to the emergency room for any symptoms?

A note from Cleveland Clinic

When nasal polyps grow in the nose or sinuses, they can cause bothersome symptoms and lead to infections. Talk to your healthcare provider about medications and short surgeries. These treatments can shrink nasal polyps and relieve symptoms.

Navigating A Nasal Nexus: Sleep Apnea And The Deviated Septum

Nasal Polyposis (Nasal Polyps)

Being deviant isnt always as much fun as it sounds, especially if a deviated septum is causing the chaos. If you are experiencing interrupted sleep, it would be natural to wonder if sleep apnea and nasal septum issues are related, or even causal. Most importantly, how might you get a good nights sleep again? Were here to help you navigate your nasal passageways – but not in a gross way!

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When Surgery May Be Necessary

We usually suggest the surgical removal of nasal polyps only if non-surgical treatments do not improve symptoms or if growths are so large that they are causing severe disruption to quality of life. Nasal polyps that cause obstructive sleep apnea also present a risk for numerous secondary health concerns related to the lack of oxygenation and quality sleep.

The idea of removing nasal polyps may create unnecessary stress due to the perception created by older surgical techniques. Many people believe that a nasal surgery will end in having their nasal passages packed with gauze for several weeks. This is no longer the norm. Newer methods of treating nasal conditions have improved efficiency, safety, and post-surgical comfort. If your nasal polyps need to be surgically removed, Dr. Gould will explain all of the details of the procedure as well as what to expect concerning post-surgical sinus treatment.

How Your Sinuses Affect Your Sleep

Your sinuses are a series of eight air-filled chambers that run in four right-left pairs from your forehead to your cheeks. While nobody is sure why we have developed sinuses, we do know they make our skulls lighter and affect the sound of our voices.

Sinuses are lined with tissues that can become infected, inflamed, and swollen, causing a condition called sinusitis. Women, men, and children with sinusitis often develop sleep apnea, too. When your sinuses are congested and infected, its hard to breathe freely, especially when youre lying down at night.

You can also develop nasal polyps in your sinuses. Polyps are benign tumors, but they block the flow of mucus and air, leading to congestion and, possibly, apneas.

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Visual Analog Scale And Nasal Obstruction Symptom Evaluation Scale

For the evaluation of nasal obstruction symptoms, all participants were asked to score their nasal obstruction severity in a 10-cm VAS, ranging from 0 to 10, with 0 meaning complete absence of nasal obstruction, and 10 meaning complete nasal obstruction.

The NOSE scale, previously adapted to Brazilian Portuguese,77 Bezerra TFP, Padua FGM, Pilan RRM, Stewart MG, Voegels RL. Cross-cultural adaptation and validation of a quality of life questionnaire: the Nasal Obstruction Symptom Evaluation questionnaire. Rhinology 2011 49:227-231 was also administered and calculated for all participants, with scores ranging from 0 to 12. Because of the characteristics of this study, the assessment of nasal obstruction during sleep and exercise was not considered.

Do I Qualify For A Presumptive Claim For These Chronic Respiratory Conditions

Surgery for Obstructive Sleep Apnea

In order to establish presumptive service connection for asthma, rhinitis, and/or sinusitis under 38 CFR 3.320, your evidence must show qualifying service at one of the specified duty locations, and manifestation of the qualifying diagnosed chronic disability within the presumptive period .

With those conditions met, the nexus between the condition and your exposure to particulate matter in the duty location is presumed, and you will be service-connected for that condition.

EXCEPTIONS: Presumptive service connection for these conditions cannot be established if there is affirmative evidence the conditions were caused by another condition or event that occurred between your qualifying service and the onset of the disability. Another exception would be if there is evidence that the condition was caused by the veterans own willful misconduct or the abuse of alcohol or drugs.

IMPORTANT: There is no minimum time requirement for the service in the qualifying duty location. As long as your service took place in the Southwest Asia theater of operations from Aug. 2, 1990 to nowor in Afghanistan, Uzbekistan, Syria or Djibouti from Sept. 19, 2001 to nowit doesnt matter if your service was two weeks, two months or two years.

What does matter is that your condition manifested within 10 years of discharge from active duty service. The limitation of 10 years past your date of active duty discharge means you must have developed the condition during that period.

EXAMPLES:

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Home Remedies For Chronic Sinusitis And Sleep Apnea

If you regularly deal with chronic sinusitis and sleep apnea, we highly recommend seeing your doctor. However, there are steps you can take on your own to find some relief. These steps include:

  • Quit smoking to decrease additional tissue inflammation in your airways.
  • Take a break from alcohol . Sedatives may have the same effect.
  • Weight loss and regular exercise may help alleviate sleep apnea symptoms.
  • Get tested for food and airborne allergies to see if your sinus passageways are becoming inflamed by allergens, as well as chronic sinusitis.
  • Maintain healthy sleeping habits, which include going to bed and waking up at consistent times, avoiding caffeine after midday, and eating your last meal no less than two hours before bedtime.
  • Do Nasal Polyps Cause Sleep Apnea

    If the thought of having growths in your nose makes you a little uncomfortable, youre not alone. Though generally considered non-cancerous, nasal polyps are common because they can block airways.

    If youve been told you breathe through your mouth at night or make loud, gasping noises when you sleep, you could be battling obstructive sleep apnea . Its a common but serious health condition that can lead to other life-threatening events, including stroke or heart attack, if not treated properly.

    Curious if nasal polyps are causing you sleep apnea? Heres how you can tell and what you can do.

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    Why Should I Seek An Evaluation For My Sinusitis And Sleep Apnea

    When the sinus cavities have difficulty draining, it can lead to sinusitis thats chronic or recurrent . This could be an indication of an underlying anatomical issue. This same issue could be whats causing your airway to become partially or completely blocked during sleep, leading to sleep apnea.

    In cases where sinusitis is caused by allergies or a common cold, medication and nasal sprays can often effectively treat the problem.

    However, if an anatomical problem is the cause of your symptoms, conservative treatments such as medication will rarely provide much relief. Some of the most common anatomical issues include nasal polyps, blocked or narrow sinus openings, or a deviated septum.

    If an anatomical issue is at the root of your symptoms, a minimally invasive procedure can often correct the underlying issue and thus resolve your symptoms. This can provide substantial relief and reduce your chances of developing long-term chronic health issues that have been associated with sleep apnea, such as heart disease and high blood pressure.

    Three Pathways Have Been Identified As Causing The Changes In The Pulmonary Arteries That Lead To Pah

    Snoring and Obstructive Sleep Apnea 4: Nasal Region Surgery

    Treatment for PAH targets the three key pathways. The three major therapeutic classes of PAH treatment are prostacyclins, endothelin receptor antagonists, and phosphodiesterase type five inhibitors. Additional treatment includes diuretics, oxygen when needed, anticoagulants, and the use of calcium channel blockers. In rare cases for select patient with the most severe cases of PAH, lung or heart and lung transplantation is considered.

    For PAH patients controlling your intake of salt and foods high in sodium is extremely important. Fluid retention is a common problem for people with PAH. Reducing the amount of salt and foods high in sodium is one way to decrease water build up. Monitoring fluid intake is another way to avoid swelling and fluid retention. Restricting your fluid intake to 2 L per day is recommended.

    Regarding exercise for PAH patients, light resistance training and light to moderate aerobic activities such as walking or swimming may be recommended. People with PAH should not exercise upper and lower limb at the same time. Patient with severe limitation of activity and history of dizziness or fainting during exercise should not participate in any regular exercise program.

    If you think you may have pulmonary arterial hypertension or have been diagnosed with pulmonary arterial hypertension, then referral to a pulmonary arterial hypertension specialist is recommended.

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    What Is The Connection Between Sinusitis And Sleep Apnea

      Sleep apnea and sinusitis are both health conditions that reduce your quality of sleep by disrupting your breathing. While Obstructive Sleep Apnea blocks the throat, a sinus inflammation blocks the nasal passages. The result of either condition is an inability to get a good nights sleep because you were unable to breathe. When you are experiencing those disruptions, your brain is telling your body to go to sleep. When this happens on a regular basis, it leads to chronic sleep loss and fatigue.

      Chronic sleep loss also leads to a whole host of other health problems from high blood pressure to diabetes. If you think you are suffering from sleep apnea, sinusitis, or both, the best way to combat this and regain your ability to sleep well is by learning more about the two, how they are related, how they are not related, and finding a doctor to help you sleep better.

      Make Sure Youre Getting Enough Sleep

      Sleep deprivation can actually cause snoring because it can lead to increased relaxation of the throat muscles as your body tries to catch up on some much-needed zzzs. Adults should be getting around seven hours of sleep a night. If you are getting less than that, look at ways you can prioritize better sleep hygiene.

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