The influence of nasal abnormalities in adherence to continuous positive airway pressure device therapy in obstructive sleep apnea patients. What role does the nose play?

Haddad et al. analyzed the effect of nasal abnormalities in adherence to continuous positive airway pressure (CPAP) therapy [1]. The findings of that study underline the fact that nasal parameters such as the degree of septal deviation, the hypertrophy of the inferior turbinate, and nasal peak inspiratory flow do not predict CPAP adherence in subjects with moderate or severe obstructive sleep apnea (OSA). However, there are some aspects that may be of interest in performing an analysis as several papers documenting the role of the nose on OSA syndrome have been published in the literature. Combining the fact that the ideal method or test for the correct evaluation of nasal functions in OSA does not exist yet and that adherence to CPAP is the consequence of many factors, we suggest an explanation why it is so hard to demonstrate the role of the nose in CPAP adherence.