Nocturnal nasal congestion and nasal resistance

Objectives: To compare total nasal resistance (TNR) in upright and supine p ositions in patients who did and did not complain of nocturnal (supine) nas al congestion symptoms without daytime (upright) congestion, and to determi ne what other conditions were associated with nocturnal nasal congestion (N NC) symptoms Study Design: A prospective study comparing objectively measur ed nasal airflow in different positions (upright and reclining) with subjec tive patient symptoms. Methods: Subjects completed a questionnaire about na sal symptoms. Anterior rhinomanometry was performed with patients upright, reclined 45 degrees, and supine. TNR in subject subsets was compared using the Student t test. Results: TNR did not differ between upright patients wi th (n = 27) and without (n = 20) NNC. Supine TNR (P < .04) and increase in TNR (P < .02) between upright and supine was greater in patients with NNC, Smokers (n = 15, 10 with NNC, 5 without) had greater TNR increases when sup ine versus;nonsmokers (P < .02). Patients with rhinitis symptoms (n = 29, 1 8 with NNC, 11 without) had greater TNR increases when supine than patients without rhinitis (P < .01), Patients who both smoked and had rhinitis (n = 11, 7 with NNC, 4 without) had a greater supine TNR than patients who smok ed or had rhinitis alone (P < .02). Conclusions: Some patients without dayt ime nasal congestion experience NNC. They have a significantly greater TNR increase when supine versus patients without NNC, Smokers and patients with rhinitis, with or without NNC, have a significantly greater TNR increase w hen supine versus nonsmokers or patients without rhinitis, Smoking cessatio n and treatment of rhinitis may improve the patients' NNC.