Phase of nasal cycle during sleep tends to be associated with sleep stage

Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo.
The Laryngoscope (Impact Factor: 2.14). 08/2013; 123(8). DOI: 10.1002/lary.23986
Source: PubMed


Background and objectives:
The phenomena of periodic cycles of vascular engorgement on the nasal cavity mucosa that alternate between right and left sides are termed the "nasal cycle." The physiologic mechanisms underlying this cycle have not been entirely clarified, even more so during sleep. In this study, we measured the periodic patterns of the normal nasal cycle, not only during wakefulness but also during sleep.

Study design case series methods:
Our team utilized a method for functional rhinologic assessment, the portable rhinoflowmeter (Rhinocycle, Rhinometrics, Lynge, Denmark), measuring airflow independently through each nostril during 24 hours on 20 healthy subjects aged 20 to 56 years, and without any nasal pathology or diagnosed medical, psychiatric, or sleep disorders. In addition, a nocturnal polysomnogram was simultaneously performed during sleep.

Nineteen of 20 subjects showed a detectable nasal cycle, and 16 of 19 subjects presented a change of the cyclic phase during sleep. The mean nasal cycle duration was 234.2 ± 282.4 minutes (median, 164.1 minutes), although variation was considerable. The mean cycle duration time during sleep was significantly longer than that in wakefulness (P <0.005). The reversal of cyclic phase during sleep tended to be associated with REM sleep (68.8%) and postural changes (18.8%). It never occurred in slow-wave sleep.

Nasal cycle duration during sleep is longer than in wakefulness. Changes in laterality of nasal cycle frequently coincide with switches in posture, tend to occur in REM sleep, never occur in slow-wave sleep, and may be absent in subjects with severe nasal septal deviations.

Download full-text


Available from: Robson Capasso, Mar 12, 2014
1 Follower
42 Reads
  • Source
    • "REM sleep stage is characterized by marked nasal congestion.12,13 Accordingly, we next addressed the hypothesis that children with rhinitis have more REM-related OSA. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Rhinitis and obstructive sleep apnea (OSA) often coexist during childhood. To delineate this clinical association, we examined OSA severity and polysomnogram (PSG) features in children with rhinitis and OSA. Given that rapid-eye-movement (REM) sleep is characterized by nasal congestion, we hypothesized that children with rhinitis have more REM-related breathing abnormalities. We conducted a retrospective cross-sectional analysis of 145 children with PSG-diagnosed OSA. Outcomes included PSG parameters and obstructive apnea-hypopnea index (OAHI) during REM and non-REM. Linear multivariable models examined the joint effect of rhinitis and OSA parameters with control for potential confounders. Rhinitis was present in 43% of children with OSA (n = 63) but overall OAHI severity was unaffected by the presence of rhinitis. In contrast, OAHI during REM sleep in children with moderate-severe OSA was significantly increased in subjects with rhinitis and OSA (44.1/hr; SE = 6.4) compared with those with OSA alone (28.2/hr; SE = 3.8). Rhinitis is highly prevalent in children with OSA. Although OSA is not more severe in children with rhinitis, they do have a distinct OSA phenotype characterized by more REM-related OSA. Further research is needed to delineate the link between REM-sleep and the physiology of the nose during health and disease.
    American Journal of Rhinology and Allergy 03/2014; 28(1):56-61. DOI:10.2500/ajra.2014.28.3994 · 1.81 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To compare the occurrence, duration and relative amplitudes of the nasal cycle (NC) during wakefulness and sleep, and to investigate the relationship of the NC to body position. Study Design / Methods: In 20 healthy subjects the NC was measured by long-term rhinoflowmetry for an average 23.1 hours during wakefulness and sleep. Head and body position were also recorded during the night. Results: A classic NC was displayed by 50% of subjects during wakefulness, and by 75% of subjects during sleep. Cycle duration during wakefulness was 91.1 minutes (±65.2; 20-337), increasing significantly during sleep to 178 minutes (±92.8; 21-498) (p<0.01). The relative mean flow of the working phase during wakefulness was 67.6% (±8.0; 58-90), and was significantly higher during sleep at 82.0% (±6.8; 63-93) (p<0.01). On recumbency there was a significant correlation between body position and resting phase side (r=0.67; p=0.024). To a significant extent positional shifts led to subsequent NC laterality changes (22%; p<0.01). Conversely, positional shifts preceded NC laterality changes to a significant extent (57.6%; p<0.01). Body position changed in a non-significant number of cases (30.3%; p=0.16) due to reversal of the congestion side of the inferior turbinates. Conclusion: The results of our study show that the NC during sleep is characterized by longer cycle durations and greater amplitudes than during wakefulness on normal physical activity. Shifts in body position during sleep alter the NC in a specific direction to a significant extent, but the opposite is not the case.
    The Laryngoscope 06/2014; 124(6). DOI:10.1002/lary.24546 · 2.14 Impact Factor