Snoring Is Not Relieved by Nasal Surgery Despite Improvement in Nasal Resistance: Treatment

Snoring Is Not Relieved by Nasal Surgery Despite Improvement in Nasal Resistance: TreatmentObjective snoring measurement has been performed earlier in one surgical study and in some studies using nasal dilators, nasal decongestants or topical corticosteroids.’’ Some studies have reported the degree of nasal obstruction before and after treatment by objective nasal measurement. Patient samples in nonsurgical studies have varied from subjects without nasal symptoms or signs of nasal pathology to unselected snorers and those with abnormal rhinoscopy findings.

Despite mainly good treatment outcomes in subjective markers of snoring, objective snoring recordings in patients with nasal pathology who were treated surgically or with dilators have given controversial results. A randomized placebo-controlled study in patients with nasal pathology investigated 12 nonobese patients with chronic rhinitis and without other ENT abnormalities. In these patients with an AHI of < 20, snoring frequency (ie, the number of snores per hour of sleep) decreased when using the nasal dilator compared with use of the placebo. Snoring loudness did not decrease. Our patients were consecutive snoring men who primarily had a structural nasal obstruction. Other ear, nose, and throat pathologies were not excluded, but nasal surgery had been chosen as a first-line treatment. It is possible that the differing results are due to the selected sample in the former study, the differences in the measurement of snoring, or study design. In the present study, better sleep in the second sleep study due to the so-called first night effect might have decreased the possible beneficial effect of treatment on snoring to some degree. We could not find a significant relationship between the change in REM sleep time and the change in snoring time in a correlation analysis. Moreover, other stud-ies on applying nasal strips, topical corticosteroids, and nasal surgery seemed to support our findings.

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