Nasal obstruction in sleep-disordered breathing

Despite the recognition that nasal obstruction can interfere with the titration and subsequent tolerance of nasal positive airway pressure therapy in patients diagnosed with sleep-related breathing disorders, the importance of nasal airflow limitation in the development of such sleep disorders remains largely underappreciated. While its exact role remains presumptive, nasal obstruction early in life clearly affects ventilation and may influence craniofacial development such that future risk of sleep-disordered breathing is increased. Clinical studies to date suggest that patients who may benefit most from correction of nasal obstruction as a sole intervention may be those with the mildest forms of sleep-disordered breathing without other significant predisposing anatomic abnormalities.