Evaluation of the Efficacy of a Nasal Dilator in Habitual-Snorer Patients

I t has been suggested that conditions associated with nasal obstruction predispose to the development of snoring and OSA (1,2). Some authors indicated that the nose accounts for approximately half of the total airway resistance to airflow (3). Nasal obstruction may contribute to an increase in snoring and sleep apnea frequency and severity (4). For this reason, nasal dilators have been proposed as a cure for snoring. In 1905, Francis (5) proposed a nasal prosthesis to treat nasal obstruction. This appliance could be inserted into the nose dilating the region of the nasal valve. Many years later, some nasal dilators were tested and some authors reported subjective improvement in nocturnal breathing in some snorer patients or they demonstrated reduction in measured snoring frequency in slow-wave sleep (6). A type of nasal dilator that is currently used is a non-invasive external dilator ("Breathe Right", CNS, Inc., Minneapolis, MN) that is drug-free, elastic, has a small adhesive strip featuring a special backbone that mechanically improves nasal breathing by opening the nasal passages to reduce airflow resistance. Scharf et al (7) tested it in 20 light snorers using strictly subjective criteria to assess snoring. There was no statistically significant difference in snoring loudness between the baseline and the treatment nights, although the subjects reported significantly easier breathing and demonstrated reduction in sleepiness as assessed by the Stanford Sleepiness Scale. Another recent polysomnographic study showed that "Breathe Right" nasal strip reduces the sleep fragmentation in snorers without OSA (8). A portable multichannel monitoring device (MESAM 4) permits the objective evaluation of snoring and oxygen desaturations during the night (9,10). The snoring signal recorded by MESAM 4 has been validated using spectral analysis to identify snoring (11). Thus, MESAM 4 may be useful to establish if nasal dilators are successful in reducing snoring. Aim of this study was to evaluate a sample of selected habitual snorer subjects without OSA in order to objectively test the efficacy of Breathe Right nasal strip in reducing snoring.