报告的鼻塞与多种睡眠相关症状相关，但与呼吸暂停低通气指数仅呈适度关联。
Reported nasal obstruction is associated with multiple sleep-related symptoms but shows only a modest association with the apnea-hypopnea index.
文献信息
| PMID | 42868773 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Kai-Ping Wang |
| 作者单位 | Univ. Grenoble Alpes, HP2 Laboratory, Inserm U1300, CHU Grenoble Alpes , Grenoble, France. |
| 期刊 | Sleep medicine |
| SCI 分区 | Q1 |
| IF | 4.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 在接受阻塞性睡眠呼吸暂停（OSA）评估的患者中，鼻塞常被报告，但其对疾病严重程度和患者报告症状的贡献仍不完全清楚。
目的： 探讨使用鼻塞症状评估（NOSE）评分评估的报告鼻塞类别与呼吸暂停低通气指数（AHI）、睡眠参数及患者报告症状之间的关联。
方法： 在这项前瞻性队列的回顾性观察分析中，纳入了4369名转诊进行睡眠评估且具有基线AHI数据的成人。根据初始筛查问题，若为阳性则随后进行鼻塞症状评估（NOSE）问卷，将鼻塞分为无报告鼻塞、轻度、中度或重度/极重度。使用多变量回归模型评估鼻塞类别与AHI、客观睡眠参数及患者报告症状之间的关联。
结果： 基线时，3602名患者（82.4%）无报告鼻塞，而767名患者（17.6%）报告鼻塞。在鼻塞患者中，210名（27.4%）为轻度阻塞，345名（45.0%）为中度阻塞，212名（27.6%）为重度阻塞。与无报告鼻塞相比，中度和重度鼻塞类别与更高的调整后AHI估计值相关，尽管这些关联较为适度。相比之下，鼻塞类别与患者报告症状的关联更为一致。中度和重度阻塞与更高的嗜睡、失眠严重程度、乏力、抑郁症状、晨起头痛、呼吸困难及记忆抱怨相关。
结论： 报告的鼻塞与多种患者报告症状相关，并在较小程度上与中度和重度鼻塞患者更高的调整后AHI估计值相关。这些发现表明，鼻塞不应仅被视为客观OSA严重程度的标志，而应被视为一个补充性临床维度，捕捉AHI未完全反映的患者感知的睡眠相关损害。
英文摘要
BACKGROUND: Nasal obstruction is frequently reported in patients evaluated for obstructive sleep apnea (OSA), but its contribution to disease severity and patient-reported symptoms remains incompletely understood.
OBJECTIVES: To examine the associations between reported nasal obstruction categories, assessed using the Nasal Obstruction Symptom Evaluation (NOSE) score, apnea-hypopnea index (AHI), sleep parameters and patient-reported symptoms.
METHODS: In this retrospective observational analysis of a prospective cohort, 4369 adults referred for sleep assessment with available baseline AHI data were included. Nasal obstruction was categorized as no reported obstruction, mild, moderate, or severe/extreme based on an initial screening question followed, when positive, by the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire. Associations between nasal obstruction categories, AHI, objective sleep parameters and patient-reported symptoms were assessed using multivariable regression models.
RESULTS: At baseline, 3602 patients (82.4%) had no reported nasal obstruction, whereas 767 patients (17.6%) reported nasal obstruction. Among patients with nasal obstruction, 210 (27.4%) had mild obstruction, 345 (45.0%) had moderate obstruction, and 212 (27.6%) had severe obstruction. Moderate and severe nasal obstruction categories were associated with higher adjusted AHI estimates compared with no reported nasal obstruction, although these associations were modest. In contrast, nasal obstruction categories were more consistently associated with patient-reported symptoms. Moderate and severe obstruction were associated with higher sleepiness, insomnia severity, asthenia, depressive symptoms, morning headaches, dyspnea, and memory complaints.
CONCLUSION: Reported nasal obstruction was associated with multiple patient-reported symptoms and, to a lesser extent, with higher adjusted AHI estimates among patients with moderate and severe nasal obstruction. These findings suggest that nasal obstruction should not be considered solely as a marker of objective OSA severity, but rather as a complementary clinical dimension capturing patient-perceived sleep-related impairment that is not fully reflected by AHI.