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Effects of CPAP in patients with obstructive apnoea: is the presence of allergic rhinitis relevant?

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Purpose

The aim of the study is to compare the effects of continuous positive airway pressure (CPAP) on the nasal cavities of patients with obstructive sleep apnoea (OSA) and with or without allergic rhinitis (AR/nonAR).

Methods

This paper is a prospective, longitudinal study. Thirty-four consecutive CPAP treatment-adherent patients with OSA (17 AR and 17 nonAR) were evaluated before and 2 months after treatment, by means of clinical (otorhinolaryngological symptoms, daytime sleepiness, overall and rhinoconjunctivitis-specific quality of life), anatomical (otorhinolaryngological examination), functional (auditory function, tubal function, nasal airflow, and mucociliary clearance), and biological variables (nasal cytology). No humidifier or anti-allergy medicines were used during treatment.

Results

Before treatment, patients with AR presented a higher score, compared to nonAR in rhinitis symptoms (4.82 ± 2.53 vs. 0.93 ± 1.02, p = 0.000), otologic symptoms (2.06 ± 1.95 vs. 0.44 ± 0.72, p = 0.004), cutaneous/ocular symptoms (2.12 ± 2.17 vs. 0.65 ± 1.17, p = 0.052), immunoglobulin E (181.82 ± 126.09 vs. 66.13 ± 97.97, p = 0.004), and nasal neutrophils (14.42 ± 31.94 vs. 0.16 ± 0.39, p = 0.031). After treatment, nonAR and AR groups improved in daytime sleepiness (11.53 ± 4.60 vs. 7.53 ± 2.87, p = 0.000 and 13.76 ± 4.93 vs. 7.53 ± 4.41, p = 0.001) respectively and increased nasal neutrophil (0.16 ± 0.39 vs. 5.78 ± 9.43, p = 0.001 and 14.42 ± 31.94 vs. 79.47 ± 202.08, p = 0.035). The symptoms and quality of life improved in patients with AR. NonAR patients, significantly increase nasal dryness (1.65 ± 1.27 vs. 0.00, p = 0.002) and mucociliary clearance times (38.59 ± 24.90 vs. 26.82 ± 23.18, p = 0.016).

Conclusions

CPAP produces inflammation with increased nasal neutrophil levels in AR and nonAR patients. Nevertheless, patients with AR observed an improvement in nasal symptoms and quality of life, whereas in patients without AR, a relevant worsening of nasal dryness and mucociliary transport was observed.

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Acknowledgements

The authors would like to thank Maite Carrión, Ainhoa Asensio, and Carmen León for their help carrying out this project.

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Author notes

  1. A. Cisternas and F. Aguilar featured above contributed equally to the development of this work.

Authors and Affiliations

  1. Unidad de Medicina del Sueño, Instituto Nacional del Tórax, Santiago de Chile, Chile

    A. Cisternas

  2. Servicio de Otorrinolaringología, Hospital General de Granollers, Av/ Francesc Ribas s/n, 08402, Granollers, Spain

    F. Aguilar

  3. Unidad Multidisciplinar de Trastornos del Sueño, Hospital Clínic, Barcelona, Spain

    J. M. Montserrat, M. Torres, A. Iranzo & I. Vilaseca

  4. Ciber Enfermedades Respiratorias (CIBERES), Bunyola, Spain

    J. M. Montserrat & I. Vilaseca

  5. Facultad de Medicina, Universitat de Barcelona, Barcelona, Spain

    J. M. Montserrat, A. Iranzo & I. Vilaseca

  6. Institut d’Investigació Biomédica August Pi i Sunyer (IDIBAPS), Barcelona, Spain

    J. M. Montserrat & A. Iranzo

  7. Servicio de Radiodiagnóstico, Hospital Universitari Germans Trias i Pujol, Badalona, Spain

    M. Àvila

  8. Servicio de Radiodiagnóstico, Hospital Clínic, Barcelona, Spain

    J. Berenguer

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  1. A. Cisternas
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  2. F. Aguilar
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  3. J. M. Montserrat
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  4. M. Àvila
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  5. M. Torres
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  6. A. Iranzo
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  7. J. Berenguer
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  8. I. Vilaseca
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Corresponding author

Correspondence to F. Aguilar.

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Funding

This study was funded under Grant FISS PI07/0318. The sponsor had no role in the design or conduct of this research.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Cisternas, A., Aguilar, F., Montserrat, J.M. et al. Effects of CPAP in patients with obstructive apnoea: is the presence of allergic rhinitis relevant?. Sleep Breath 21, 893–900 (2017). https://doi.org/10.1007/s11325-017-1510-9

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  • DOI: https://doi.org/10.1007/s11325-017-1510-9

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