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Rhinitis and the severity of OSA
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  1. P Michael
  1. Research Fellow, Department of Otolaryngology, St Bartholomew’s Hospital, London, UK; philip.michaelvirgin.net

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There is controversy regarding whether nasal congestion is a risk factor for the obstructive sleep apnoea syndrome (OSAS). NARES (non-allergic rhinitis with eosinophilia) is a rare form of rhinitis, presenting with typical symptoms of perennial disease in the presence of eosinophilic nasal inflammation but negative tests of atopy. This paper aimed to assess whether OSAS was more severe in patients with NARES (n = 10) than controls without nasal inflammation, matched for age and BMI (n = 16). The diagnosis of NARES was confirmed by testing nasal wash for eosinophilic cationic protein and analysing serum samples for total and specific IgE. OSAS was confirmed by polysomnography.

The results suggest that the polysomnographic indices of hypopnoea index, apnoea-hypopnoea index, and minimal oxygen saturation were significantly worse (all p<0.01) in the patients with NARES. This paper reinforces previous research that suggests nasal inflammation may aggravate OSAS, and reminds chest physicians to be aware of treatable causes of rhinitis which may contribute to the severity of disease.