Nasal continuous positive airway pressure (CPAP) can cause undesirable
nasal symptoms, such as congestion to obstructive sleep apnoea (OSA)
patients, whose symptoms can be attenuated by the addition of heated
humidification. However, neither the nature of nasal symptoms nor the
effect of heated humidification on nasal pathophysiology and pathology
are convincingly known.
20 patients with OSA on nasal CPAP who exhibited symptomatic nasal
obstruction were randomised to receive either 3 weeks of CPAP treatment
with heated humidification or 3 weeks of CPAP treatment with sham-heated
humidification, followed by 3 weeks of the opposite treatment,
respectively. Nasal symptom score, nasal resistance, nasal lavage
interleukin-6, interleukin-12 and tumour necrosis factor-alpha and nasal
mucosa histopathology were assessed at baseline and after each treatment
arm.
Heated humidification in comparison with sham-heated humidification was
associated with decrease in nasal symptomatology, resistance and lavage
cytokines, and attenuation of inflammatory cell infiltration and
fibrosis of the nasal mucosa.
In conclusion, nasal obstruction of OSA patients on CPAP treatment is
inflammatory in origin and the addition of heated humidification
decreases nasal resistance and mucosal inflammation
