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Introduction Adults with chronic rhinosinusitis with nasal polyps (CRSwNP) often suffer from sleep disruption and sleep apnea. As the apneic profile of CRSwNP may differ from obstructive sleep apnea (OSA) classic patients without nasal polyps (NP), it may prove useful to define a new profile for OSA screening in these patients. The aim of the current study was to compare baseline characteristics and apneic profile of OSA patients with CRSwNP to OSA patients without NP. Materials and methods Thirty-one apneic patients with CRSwNP and 62 apneic cases without NP were included in our study. Both groups underwent nasal endoscopy, Epworth Sleepiness Scale (ESS) evaluation, and overnight polysomnography (PSG). We additionally accessed anthropometric characteristics such as snoring, tiredness, observed apnea, high blood pressure, body mass index (BMI), age, neck circumference, male gender, and OSA risk via the STOP-Bang questionnaire. Results Although the patients were matched according to age and gender, the median BMI and STOP-Bang score were significantly higher in patients with OSA than in those with OSA and CRSwNP. Notably, the median ESS showed low somnolence and a low median apnea-hypopnea index in patients with CRSwNP, despite the fact that the lowest median oxygen saturation was not significantly different between groups. Conclusions Anthropometric characteristics in individuals with apnea caused by CRSwNP were significantly different from those in individuals with typical. This finding will improve screening and treatment of apneic patients CRSwNP.

INTRODUCTION: Obstructive sleep apnea syndrome (OSAS) is a common disorder that can lead to cardiovascular morbidity and mortality, as well as to metabolic, neurological, and behavioral consequences. It is currently believed that nasal obstruction compromises the quality of sleep when it results in breathing disorders and fragmentation of sleep. However, recent studies have failed to objectively associate sleep quality and nasal obstruction. OBJECTIVE: The aim of this systematic review is to evaluate the influence of nasal obstruction on OSAS and polysomnographic indices associated with respiratory events. METHODS: Eleven original articles published from 2003 to 2013 were selected, which addressed surgical and non-surgical treatment for nasal obstruction, performing polysomnography type 1 before and after the intervention. RESULTS/CONCLUSIONS: In most trials, nasal obstruction was not related to the apnea-hypopnea index (AHI), indicating no improvement in OSAS with reduction in nasal resistance. However, few researchers evaluated other polysomnography indices, such as the arousal index and rapid eye movement (REM) sleep percentage. These could change with nasal obstruction, since it is possible that the nasal obstruction does not completely block the upper airways, but can increase negative intrathoracic pressure, leading to sleep fragmentation. RESUMO INTRODUÇÃO: A síndrome da apneia obstrutiva do sono (SAOS) é um distúrbio muito prevalente que pode ocasionar morbi-mortalidade cardiovascular, além de consequências metabólicas, neurológicas e comportamentais. Atualmente, acredita-se que a obstrução nasal comprometa a qualidade do sono, devido a distúrbios respiratórios e fragmentação do sono. Entretanto, até o momento estudos recentes não conseguem relacionar objetivamente qualidade do sono e obstrução nasal. OBJETIVO: O objetivo principal desta revisão sistemática é avaliar a influência da obstrução nasal na SAOS e em índices polissonográficos associados a eventos respiratórios. MÉTODO: Foram selecionados um total de 11 artigos originais de 2003 a 2013 com tratamentos cirúrgicos e não cirúrgicos da obstrução nasal, realizando a polissonografia do tipo 1 antes e após a intervenção. RESULTADOS/CONCLUSÕES: Na maioria dos ensaios, a obstrução nasal não se relacionou ao índice de apneia-hipopneia, indicando ausência de melhora da SAOS com a redução da resistência nasal. Entretanto, poucos pesquisadores avaliaram índices polissonográficos como o índice de despertares e o percentual do sono REM (movimento rápido dos olhos) que poderiam vir alterados, uma vez que a obstrução nasal possivelmente não obstrui completamente a via aérea superior, mas aumenta a pressão negativa intratorácica, levando à fragmentação do sono.