Snoring Is Not Relieved by Nasal Surgery Despite Improvement in Nasal Resistance: Results
Differences between the subgroups were evaluated using the Mann-Whitney U test. Comparisons of snoring intensity between REM sleep and NREM sleep, between supine and nonsupine sleep position, and between preoperative and postoperative measurements were analyzed using the Wilcoxon matched-pair test. A Pearson correlation analysis was used to evaluate the relationship between the change in REM sleep time and the change in snoring time.
The computations were performed using a commercial statistical package (Statistica, version 5.1; Statsoft Inc; Tulsa, OK). A p value of < 0.05 was considered to indicate statistical significance.
After nasal surgery, the TNR decreased significantly in the overall patient group. A decrease in nasal resistance was found both in the baseline measurement without nasal decongestion and after decongestion of the nasal mucosa (p < 0.05 for both). After nasal surgery, both baseline and decongested nasal measurements showed improvement in nasal patency in the subgroup of surgically improved patients (p < 0.05 for both), but not in the subgroup with no improvement in nasal resistance (Table 1). canadian neighbor pharmacy viagra
Snoring time did not decrease after nasal surgery in the overall patient group or in the subgroups (Fig 2). The preoperative snoring intensity index was 68.8 (SD, 10.0) during NREM sleep and 65.6 (SD, 7.4) during REM sleep. The postoperative snoring intensity index was 70.7 (SD, 7.3) during NREM sleep and 66.5 (SD, 8.7) during REM sleep. Preoperative and postoperative snoring intensity indexes did not change significantly in the overall patient sample or in the subgroups. The snoring intensity index was found to be significantly higher during NREM sleep than during REM sleep in both sleep studies (p < 0.05 for both). No significant changes in the snoring intensity index were noticed between patients in the supine and nonsupine position during REM or NREM sleep.
Table 1—Patient Characteristics and Preoperative Data on Rhinomanometry in Patients With > 20% of Operative Improvement in the TNR of Decongested Nasal Mucosa and in Patients With No Improvement of Mean TNR
|Variables||Surgical Improvement (n = 25)||No Improvement (n = 15)|
|Age, yr||41.0 (9.5)||47.7 (8.1)|
|BMI, kg/m2||29.0 (3.6)||26.3 (2.5)|
|ESS score||7.2 (4.0)||4.7 (2.6)|
|Baseline, supine||0.693 (0.643)||0.395 (0.490)|
|Decongested||0.436 (0.357)||0.226 (0.272)|
Figure 2. Individual snoring times (as the percentage of total sleeping time) in 40 consecutive snoring men prior to nasal surgery (PRE) and following nasal surgery (POST). The following subgroups were determined according to nasal improvement: patients in whom nasal resistance did not improve significantly after surgery; and patients in whom nasal resistance improved > 20% after surgery.
Category: Pulmonary Function | Tags: nasal obstruction, polysomnography, rhinomanometry, sleep apnea, snoring, surgery, treatment outcome