Obstructive sleep apnea (OSA) patients who also have nasal polyposis are less likely to use continuous positive airway pressure (CPAP) treatment for the prescribed duration, according to the results of the DISCOVERY (Course of DISease in patients reported to the Swedish CPAP Oxygen and VEntilator RegistrY) study published in the Journal of Clinical Sleep Medicine.1 CPAP is the gold-standard treatment of OSA.

For this study, Swedish researchers selected 20,521 patients with OSA who were taking CPAP treatment between 2010 and 2018; of these nearly 30% were female. Data was obtained from the Swedish national quality registry for respiratory insufficiency and sleep apnoea (Swedevox). They sought to examine if the presence of nasal polyps contributed to nonadherence to CPAP. The baseline diagnosis of nasal polyposis was present in 331 (1.6%) patients with OSA. After one year of treatment, patients with nasal polyps were more likely to use CPAP for less than 4 hours every night with an adjusted odds ratio of 1.38. The unadjusted nocturnal duration of use of CPAP in these patients was 15.4 minutes less compared to patients who did not have nasal polyposis. The adjusted duration was shorter by 24.1 minutes.

Several factors account for failure of CPAP in patients with obstructive sleep apnea. Adding to the list, this study has identified nasal polyposis as a risk factor for CPAP failure. Hence, before initiating CPAP, these patients must be evaluated for nasal polyps and if present, their management may enhance compliance to treatment with better outcomes.

Reference

1. Bengtsson C, et al. Nasal polyposis is a risk factor for nonadherence to CPAP treatment in sleep apnea: the population-based DISCOVERY study. J Clin Sleep Med. 2023;19(3):573-579.