Content uploaded by Bengt-Ake Bengtsson
Author content
All content in this area was uploaded by Bengt-Ake Bengtsson on Aug 02, 2015
Content may be subject to copyright.
Improved nasal breathing in snorers increases nocturnal growth hormone secretion and serum concentrations of insulin-like growth factor 1 subsequently
Abstract
In snoring men improved nasal breathing during sleep has been shown to decrease snoring and morning tiredness. The aim was to evaluate whether improved nasal breathing had any effect on growth hormone (GH) secretion, the nocturnal secretion of GH being associated with deep sleep. Forty-two snoring men, mean age 45 years and mean body mass index 26 kg.m-2, slept every night during one month with the Nozovent nostril dilator. Before and at the end of the test period, we analysed serum insulin-like growth factor 1 (IGF-1), thyrotropin (TSH), free thyroxine (free T4), free 3,5,3'-triiodothyronine (free T3), cortisol and testosterone in blood sampled at 08:00 h. Fifteen of the 37 snoring men who completed the study experienced a reduction in snoring and were less tired in the morning during the test period. In this group, the mean IGF-1 concentration was significantly increased (p < 0.05) after one month. There was no significant difference in mean IGF-1 level between the snorers and a population sample. Likewise, TSH, free T4, free T3, cortisol and testosterone concentrations were within normal limits. Snorers with reduced snoring and morning tiredness due to improved nasal breathing showed an increase in morning IGF-1 concentration which can probably be explained by higher nocturnal GH secretion induced by more deep sleep.
... The role of deep breathing in reducing stress and lowering the level of cortisol has also been reported in clinical studies (67). In some cases, improved breathing also increases the secretion of growth hormones, including IGF-1, without cortisol surge (68). Reduction of cortisol could prevent the inhibitory effect of stress hormone in decreasing sclera tension during myopia deterioration. ...
Pediatric myopia is increasing globally and has become a major public health issue. However, the mechanism of pediatric myopia is still poorly understood, and there is no effective treatment to prevent its progression. Based on results from animal and clinical studies, certain neuronal–humoral factors (NHFs), such as IGF-1, dopamine, and cortisol may be involved in the progression of pediatric myopia. Digital therapeutics uses evidence-based software as therapeutic interventions and it has the potential to offer innovative treatment strategies for pediatric myopia beyond conventional treatment methods. In this perspective article, we introduce digital therapeutics SAT-001, a software algorithm that modulates the level of NHFs to reduce the progression of pediatric myopia. The proposed mechanism is based on a theoretical hypothesis derived from scientific research and clinical studies and will be further confirmed by evidence generated from clinical studies involving pediatric myopia.
... Its ability to increase airflow and decrease nasal resistance has been demonstrated in multiple studies 16 and was observed with different end points, such as mouth dryness, 17 blood pressure during exercise, 18 and levels of growth hormone secretion. 19 Nasal airflow was characterized in a study by the use of nasal and oral flow volume loops with and without the NoZovent nasal clip. 20 The study found that without any devices, healthy individuals displayed either a variable extrathoracic obstruction or a fixed one and that the use of Nozovent improved nasal flow in the prior but made no difference in the latter. ...
Importance:
The internal nasal valve is the narrowest part of the nasal airway and a common site of inspiratory collapse and obstruction of nasal airflow. Over-the-counter mechanical nasal dilators are an alternative to surgical intervention that attempts to improve airflow through the internal nasal valve.
Objective:
To determine the efficacy of over-the-counter mechanical nasal dilators and classify these products by mechanism.
Evidence review:
A database of 33 available over-the-counter mechanical nasal dilators was generated via a PubMed search as well as an internet search via Amazon.com and Google, conducted from April 1, 2013, through December 31, 2015. Products determined to be unavailable or discontinued were excluded from the database. Of the devices examined in published literature, efficacy was based on objective measures, such as measured airflow, the cross-sectional area of the nasal valve, and changes in resistance. Measures of reported sleep quality or patient perception were excluded.
Findings:
An analysis of each product's mechanism revealed 4 broad classes: external nasal dilator strips, nasal stents, nasal clips, and septal stimulators. A review demonstrated 5 studies supporting the use of external nasal dilator strips, 4 studies supporting the use of nasal clips, 1 study supporting the use of nasal stents, and no studies supporting the use of septal stimulators.
Conclusions and relevance:
Our findings suggest that external nasal dilator strips and nasal clips effectively relieve obstruction of the internal nasal valve and may be an alternative to surgical intervention in some patients.
... At 1 month, there was also an increase in serum levels of insulin-like growth factor 1 (=IGF-1) in the group of men who "snored less and experienced less tiredness in the morning". Increased levels of IGF-1 have also been found in continuous positive airway pressure (=CPAP) treatments of sleep apnea, and after adenotonsillectomy, and are probably caused by the increased secretion of growth hormone induced by more deep sleep (75) . ...
Most studies on nasal dilators have used Breathe Right or Nozovent. Both devices dilate the nasal valves, reduce nasal resistance, and improve nasal airflow. The use of dilators improves airflow most on inspiration, as the valve is stabilised and prevented from collapse. The response varies greatly between individuals, and can be impressive. The effect of nasal dilators may be lower in non-Caucasians. During exercise, nasal dilators delay the onset of oronasal breathing, and can have only small effects on performance thereafter. Nozovent and Breathe Right can reduce snoring, and improve otherwise obstructed breathing during sleep in selected patients. It is a challenge to find those patients, and one way could be to perform polysomnography with and without nasal dilator.
The purpose of this article was to study the impact of external dilation on nasal airway dimensions, sleep architecture, and snoring. Eighteen heavy snorers without severe obstructive sleep apnea syndrome (mean apnea-hypopnea index (AHI) 9.3) reporting nocturnal nasal obstruction were enrolled in a randomized (controlled) cross-over study, evaluating subjective and objective effects of external nasal dilation (Breathe Right, 3M). The active dilator was also worn during a one-week pretrial run-in period. Polysomnography, recording of snoring sounds, and repeated acoustic rhinometry were performed on two consecutive nights, one with the active dilator and one with a placebo strip. The significant subjective improvement reported during the run-in period compared to the preceding period without dilator (p 2) external dilation significantly improved the mean sleep PaSO2 (92.4 → 96.7) and the percentage of sleep with a PaSO2
A number of hormones, including hypothalamic neuropeptides acting as neurotransmitters and neuromodulators in the CNS, are involved in the physiologic regulation of breathing and participate in adjustment of breathing in disease. In addition to central effects, some hormones also control breathing at peripheral chemoreceptors or have local effects on the lungs and airways. Estrogen and progesterone seem to protect from sleep-disordered breathing, whereas testosterone may predispose to it. Progesterone and thyroxine have long been known to stimulate respiration. More recently, several hormones such as corticotropin-releasing hormone and leptin have been suggested to act as respiratory stimulants. Somatostatin, dopamine, and neuropeptide Y have a depressing effect on breathing. Animal models and experimental human studies suggest that also many other hormones may be involved in respiratory control.
The Nozovent nostril dilator improves nasal breathing to the same degree as topical decongestants and reduces mouth dryness at night in 51% of nocturnal mouth breathers. It does not help every snorer but reduces the snoring heard by the sleeping partner in about 50%, improves the respiratory disturbance index significantly in 19% and gives less morning and daytime tiredness in 40% of snorers. The medium CPAP pressure can be significantly reduced with the dilator.
ResearchGate has not been able to resolve any references for this publication.