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1 From the Sleep Disorders Center, Rhode Island Hospital/Brown University, Providence
2 From the Sleep Research Laboratory, Department of Psychiatry and Human Behavior, E.P. Bradley Hospital/Brown University, East Providence, RI
3 From the Department of Plastic Surgery, Rhode Island Hospital/Brown University, Providence
Study objectives: We postulated that nasal occlusion would provide a challange enabling us to assess factors predisposing development of sleep apnea in older children/adolescents and young adults. Factors of interest included sex, age, body mass index (BMI), tonsillar hypertrophy, and cephalometric measurements.
Design: Sleep and breathing variables were examined and compared for four groups of subjects between one baseline night and one night of nasal occlusion in a sleep research laboratory.
Subjects: Healthy, normal boys (n=23, mean age=13.3±2.1 years), girls (n=22, mean age=13.8±1.8 years), men (n=23, mean age=22.2±1.5 years), and women (n=24, mean age=22.4±1.8 years) were studied.
Measurements and results: The following sleep and sleep-related breathing measures showed significant increases in all four groups from baseline to occlusion: percentage of stage 1, number of transient arousals, transient arousal index, apnea index, respiratory disturbance index (RDI), and mean apnea length. No significant relationships were found between occlusion-night RDI and tonsillar size, cephalometric variables, or BMI, either singly or in combination.
Conclusions: Subjects' responses to nasal occlusion varied: most demonstrated a minimal and clinically insignificant increase in RDI; few showed a marked increase in RDI. Significant increases of sleep fragmentation—even even in the absence of frankly disturbed breathing—indicate that nasal occlusion may secondarily affect waking function if prolonged over a series of nights.
Key Words: adolescent • apnea • body mass index • cephalometrics • nasal obstruction • sleep • young adult
Submitted on April 7, 1995
Accepted on September 25, 2007
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